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Acute vs Chronic renal failure

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by

Richard Dixon

on 11 February 2011

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Transcript of Acute vs Chronic renal failure

Acute vs Chronic renal failure Acute

DEfined as :
Rapid loss of glom fnx (hr/days)
Fall of Creatinine to less than 50 premobid fnx Problems
1. Uraemia
2. Fluid overload
3. hyperkalaemia
4. Met acidosis Causes

Pre-renal
hypoperfusion

Renal
GN
Interstitial nephritis
tubulopathy

Post-renal
Obstruction Ix

Cultures
urinalysis + culutre
Bloods
Arterial - Acidosis
Venous - K+, U+E, ANA, lipids, LFT
Biopsy
Renal biopsy
Functional
ECG (tented T-waves) Pre-renal Renal Post-renal Chronic

Def:
Persistant and Irreverible
reduction in renal fnx 5 stages (GFR)
1. > 90 ml/min
2. 60-90 ml/min
3. 30-60 ml/min
4. 15-30ml/min
5. < 15 min/min End-stage renal failure Causes of CRF

ANYthing Most commonly

DM
HTN
GN CNS
Peripheral neuropathy
Restless leg syndrome
tiredness and fatigue CVS
Fluid overload
Accelerated atherogenesis
Uraemic pericarditis GIT
Altered taste perception
Reduced absorption of ca2+ Electroltye/metabolic
Hyperkalaemia
Acidosis Blood
Anaemia of chronic disease
Impaired platelet fnx (uraemia) Bones
Hyperparathyroidism Management Acute - AKI

Treat complications

Treat underlying cause Indications for dialysis
1. complication of uraemia
2. refractory hyperkal
3. refractory fluid overload
4. anuria Chronic Conservative
Education
Planning for dialysis
Fluid restriction
Renal diet
Medical
rx cvs risk
Phosphate binders
Alfacalcidol
EPO
Quinine
Bicarb
Interventional
Renal-replacement therapy
Full transcript