Acute renal failure : Symptoms, Diagnosis, Management

Acute renal failure

Acute renal failure is a syndrome of varying causation that results in a sudden decline in renal function.

Etiology :

1.     Pre-renal causes: It results from the condition that decreases renal blood flow [eg. Hypovolemia, shock, hemorrage, burns, diuretic therapy]

2.     Post-renal causes : It comes from obstruction or distruption of urine flow anywhere along the urinary tract.

3.     Intra-renal causes : It results from injury in the renal tissue and is usually associated with Intra renal ischemia, toxins  immunologic  process,  systematic  and  vascular

disorders.

Signs and symptoms:

1.     Decreased tissue turger, dryness of mucous membrane, weight loss, hypotension, oliguria.

2.     Difficulty in voiding and changes in urine flow

3.     Fever and skin rashes odema

4.     Changes in urine volume, increases of blood urea, creatinine, uric acid, potassium etc.

Diagnosis :

1.     Urine analysis : Revels protenuria haematurea

2.     Raise of Serum creatinine in Blood

3.     Urine cultures

4.     Renal ultrasonography

Management :

1.     Correct any reversible cause of acute renal failure Eg: Improve renal perfusion maximize cardiac output, surgical release of obstruction

2.     Be alert for fluid excess or deficit.

3.     Monitor the signs of hypovolenia or hypervolemia.

4.     Monitor Intake and output chart,

5.     Weigh the patient daily

6.     Monitor vital signs.

7.     Correct and control biochemical imbalances

8.     Restore and maintain B/P

9.     Maintain nutrition

10.                        Initiate haemodialysis

11.                        Renal replacement theraphy

Complication:

1.     Infection

2.     Arrhythmias due to hyperkalemia

3.     Electrolyte abnormalities

4.     Gastrointestinal bleeding

5.     Multiple organ system failure