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note on congestive heart failure
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acute renal failure pathophysiology
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Explain the pathophysiology of acute renal failure. Include prerenal intrarenal and postrenal causes.
According to the Mayo Clinic Staff (2012), acute kidney renal failure occurs abruptly when your kidneys lose their filtering abilities and cannot filter waste products from your blood. This is also known as acute renal failure or acute kidney injury. When this happens, high levels of waste may become accumulated in your blood and will alter your bloods chemical make up causing them to get out of balance. This failure or injury could happen rapidly over a few hours or a few days and can become fatal. Mostly people who are hospitalized and who are critically ill will need intensive care. If you take care of your body, acute kidney may be reversible and you may recover normal kidney function.
Prerenal kidney failure causes could be any condition that reduces renal perfusion and causes a decreased glomerular filtration rate. If prerenal is identified and treated correctly, it may be reversible. Some conditions that may contribute to prerenal kidney failure are: fluid shifts related and secondary to burns, hypertension, and reduced cardiac output in patients with congestive heart failure. If the main cause continues to affect renal perfusion this may lead to ischemic damage to the nephrons (Ludwig, Mathews, Gregg 2012).
Intrarenal kidney failure causes are actual damage to the nephrons and the functions of the tissues in the kidneys. This damaged could be grouped together under kidney disease or acute tubular necrosis. ATN could be reversible but it may take weeks or months before adequate perfusion returns (Ludwig, Mathews, Gregg 2012).
Postrenal kidney failure is caused by obstruction to the urine flow or excretion. Common problems would tumors, benign prostatic hypertrophy (BPH), or kidney stones. Intrarenal failure, nephron damage could occur if this is left untreated (Ludwig, Mathews, Gregg 2012).
What diagnostic exams would be used to diagnose acute renal failure? How do these tests change as renal failure progresses through its 3 stages? Discuss, compare and contrast the 3 stages.
To have a better understanding of your patients particular case with acute kidney failure you would want to gather a patient history to see if they have used any nephrotoxic medications or have had systemic illnesses in the past that may have been related to poor perfusion in their body. The laboratory tests you would want to pay attention to would be a complete blood count, urinalysis, ultrasound, glomerular filtration rate and a measurement of serum creatinine and potassium level (Rahman, Shad, Smith 2012).
There are two types of glomerulonephritis—acute renal failure (ARF) and chronic kidney disease (CKD). The ACF form generally develops suddenly as a result of an infection or illness, such as, group A streptococci bacteria, hepatitis, or in diseases such as lupus or HIV (Mathias, 2013). This type may require dialysis to replace renal function while it lasts, however, kidney function usually returns after the primary illness is treated. Many acute patients will not have any other complications as no permanent damage is done. Whereas CKD is found in a person that has had glomerulonephritis for months to years in some cases and may be asymptomatic until the kidney has become irreversibly damaged. ARF can evolve to become chronic if the glomeruli do not respond to
The kidneys play a major role in the blood composition and volume , the excretion of metabolic wastes in the urine, the control the acid/base balance in the body and the hormone production for maintaining hemostasis. The damages to the GBM in the glomeruli alter filtration process that allows the protein and red blood cells to leak into the urine. Loss of protein like albumin in the urine results in a decrease of their level into the blood stream. Consequently, this patient’s blood reveals a decreased albumin (Alb) value of 2.9 g/dL, decreased serum total protein value of 5 .0 g/dL and in the urine presents of the protein and the RBCs. Impaired filtering capacity result in inability of kidneys to excrete excretory products like electrolytes and metabolic waste products that will then accumulate in the blood. Furthermore, inability of distal convoluted tubules to excrete sufficient quantities of potassium, sodium, magnesium (Mg), chloride (Cl), urea, creatinine (Cr), alkaline phosphatase (Alk Phos), and phosphate (PO4) results in their elevation in the blood. His laboratory values reveal an increased of sodium value of 149 meq/L, an increase of potassium value of 5.4meq/L, increased chloride value of 116 meq/L, increased blood urea nitrogen (BUN) serum of 143 mg/dL, and increased creatinine serum of 7.14 mg/dL. The other abnormal blood tests associated with a loss of kidneys’ filtration property identify in this patient are related to an increase of alkaline phosphatase value of 178 IU/L, increased magnesium value of 3.8mgdL, and increased phosphate (PO4) value of 5.9 mg/dL .
According to The National Kidney Foundation (2014) “Kidney Failure does not have symptoms that are found to be medical concerning which then once people find out they have Acute Renal Failure it is already in an advanced stage”. There are subjective and objective signs and symptoms for Acute Renal Failure. Subjective symptoms are Lethargy, Fatigue, restless leg syndrome, depression, shortness of breath, chest pain or pressure, confusion, intractable hiccups. Objective...
Nephrology consult called with M169 for Acute Kidney injury on Chronic Renal Failure. M169 consult impression Acute Kidney injury superimposed on Chronic Kidney Disease most likely 2nd to ATN caused by Hypoxia and Hypotension, severe metabolic acidosis 2nd to acute kidney injury.
...n ones are a kidney biopsy, imagine test, blood test and kidney ultrasound. After getting a positive test for Glomerulonephritis, the adequate treatment has to be implemented. The treatment needed varies from person to person depending on the level of damage, cause of the disease and symptoms. When the patient presents hypertension, the whole treatment is focused on lowering the high blood pressure. If other disease causes Glomerulonephritis, also known as secondary Glomerulonephritis, the doctor should provide medication to control either lupus or diabetes. In severe cases, it is recommended to go trough dialysis not only to drain the excess liquid but also to low blood pressure. In addition to any treatment implemented, the patients have to modify their diets in order to keep their kidneys healthy for longer time and prevent any complications (Mayo Clinic 2014).
There are several diagnostic test or evaluations done to prognosis acute renal failure. These are:
(3)Bellomo,R.,Cass,A.,Cole,L.,Finer,S.,Gallagher,M.,Lo,S.,McAthur,C.,McGuinness,S.,Myburgham J.,Norton,R.,Scheinkestel,C.,& Su,S. for renal study investigators(2009).Intensity of continuous renal-replacement therapy in critically ill patients. The New England Journal of Medicine, 361(17), 1627-1638.
According to the Mayo Clinic, Kidney Failure occurs when the kidneys are suddenly unable to filter waste products from the blood. This occurring, results in the body beginning to accumulate high levels of dangerous waste, which eventually leads to a chemical imbalance in the blood. Symptoms of the kidney’s inability to
Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.
Glomerulonephritis is a complex condition. The tiny filters within the kidneys (glomeruli) are damaged by inflammation. Damaged glomeruli can no longer filter wastes effectively from the blood. Complications of this disease include kidney failure, nephrotic syndrome (protein in the urine, high cholesterol, and low protein in the blood), and nephritic syndrome (body tissue swelling, protein and blood in the urine). Glomerulonephritis may occur alone, as a result of an immune system disorder, or due to an infection. The condition can be an acute type of illness or a chronic type of illness. The acute disease may be caused by infections, such as strep throat (streptococcal pharyngitis). It may also be caused by other diseases that affect the whole
If the patient has a urinary catheter, and most ICU patients do, he or she may not have any reportable symptoms. Therefore, good assessment of urinary elimination, done in relation to a patient’s signs, symptoms, urine amount, intake and output, and lab values, is important. The lab values are discussed in Chapter 5. Acute and chronic renal failure can cause numerous systemic symptoms and altered homeostasis ( Collins, 2011). See Table 3-10 for abnormal urinary elimination.
There are many tests that can confirm chronic renal disease. The first test is a blood test. The blood test just looks for the level of waste product in the blood. The second test is a urine test that reveals abnormalities and helps identify the cause of chronic kidney disease. The third option is imaging tests. Imaging tests include CT, MRI and ultrasound of the abdomen and a kidney scan and ultrasound. These tests help to assess the size and structure of the kidneys. The fourth test that can be ran is a biopsy. A biopsy is when a doctor goes in and takes a sample of the kidney issue and then sends it to the lab for further
If damage to the kidney continues, eventually the nephrons well die and total kidney failure will result. The acute form develops suddenly. The condition may develop after an infection in the throat or skin and symptoms commonly include facial puffiness, urine retention and bloody urine. Shortness of breath may also occur as a build up of fluid occurs around the lungs. Ordinarily acute glomerulonephritis will cease on its own, though dialysis is sometimes required for those afflicted who have a large amount of extra fluid within the body. Two further conditions are associated with this disease and those are nephritic syndrome and nephrotic syndrome. Nephrotic syndrome is characterised by the presence of proteinuria within the urine and this release of protein from the body can adversely affect osmotic processes in the body, leading towards irregular dehydration of the cells and pooling of fluids elsewhere in the body in the form of oedema, mainly noticeable within the face and
There are several factors that determine when it is appropriate to initiate dialysis in a patient, however, the primary factor for CKD patients is a Glomerular Filtration Rate (GFR) < 15ml/min/1.73m2. Other factors include uremia, hyperkalemia, inability
Many other diseases and conditions can damage the kidneys, for example, birth conditions like polycystic kidney disease; arteritis; injury or trauma; kidneys infections; stones; reflux; tobacco use. Not only that but, some medications for pain like non-steroidal medications, opiates; drugs like cocaine; toxics chemical. And also certain auto immune disorders like lupus or scleroderma. But, the most common causes of end stage renal disease in the United States are diabetes and high blood pressure. Diabetes is the biggest risk factors for developing the disease, one third of people that develop the disease have