Acute Kidney Failure

Acute Renal Failure: Test and Diagnosis

2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count [thrombocytopenia (deficiency of platelets/platelets): due tothrombotic microangiopathy] Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, … Acute Renal Failure: Test and Diagnosis

Acute Renal Failure: Drug Therapy

Therapeutic target Improvement of the symptomatology Therapy recommendations Loop diuretics (drugs for drainage) for overhydration and preserved diuresis (urinary excretion)Note: Therapeutic “flushing” of the kidney with large infusion volumes and administration of loop diuretics is now considered obsolete; it has no effect on acute renal failure. In acute renal failure (ANV), the following measures should … Acute Renal Failure: Drug Therapy

Acute Renal Failure: Diagnostic Tests

Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Renal ultrasonography (ultrasound examination of the kidneys) including the urinary tract. [postrenal renal failure: congested renal pelvis (e.g., due to prostate enlargement, retroperitoneal tumor). Measurement of renal size and parenchymal width allows … Acute Renal Failure: Diagnostic Tests

Acute Renal Failure: Prevention

Prevention of acute kidney failure (ANV) requires attention to reducing individual risk factors. The KDIGO guidelines provide recommendations for the prevention of acute kidney injury (“AKI”) in high-risk patients [see guidelines below]: Discontinuation of all nephrotoxic medications (see below for causes/medications). Maintenance of adequate perfusion pressure. Optimization of volume status (cave: fluid overload). Consideration of … Acute Renal Failure: Prevention

Acute Renal Failure: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate acute renal failure (ANV): In the initial phase, ANV usually progresses without specific symptoms. Three parameters provide initial clues to impending renal failure: Increased heart rate (if heart rate had increased by ten beats at a time; OR: 1.12). Cold extremities (arms and legs; OR: 1.52). Prolonged capillary … Acute Renal Failure: Symptoms, Complaints, Signs

Acute Renal Failure: Causes

Pathogenesis (development of disease) In acute renal failure (ANV), there is a sudden loss of excretory function of the kidneys, which is usually initially accompanied by oliguria (< 500 ml urine/day). Pathophysiologically, acute renal failure can be divided into three forms: Prerenal renal failure (70%): caused by a sudden or prolonged reduction in renal perfusion … Acute Renal Failure: Causes

Acute Renal Failure: Therapy

Therapy for acute renal failure (ANV) must include therapy for the underlying disease. General measures Drug withdrawal Nicotine restriction (refraining from tobacco use), as harmful to the kidneys! Avoid hyperglycemia (hyperglycemia). Review of permanent medication due topossible effect on the existing disease: discontinue all nephrotoxic drugs (if possible). Avoidance of environmental stress: Metals (cadmium, lead, … Acute Renal Failure: Therapy

Acute Renal Failure: Classification

Until 2004, more than 30 different definitions of acute renal failure existed. The RIFLE criteria standardized these and classified them into the stages shown in the table below. In 2007, the term “Acute Renal Failure” was replaced by the term “Acute Kidney Injury” to more accurately reflect the variation in the disease. In the course … Acute Renal Failure: Classification

Acute Renal Failure: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Auscultation (listening) of the heart[due todifferential diagnoses or possible causes of prerenal acute renal failure: Heart failure (cardiac insufficiency). … Acute Renal Failure: Examination

Acute Renal Failure: Medical History

Medical history (history of illness) represents an important component in the diagnosis of acute renal failure (ANV). Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). What complaints have you noticed? How long have these changes existed? Have you been injured? Do you have urinary urgency? How often do you need to urinate … Acute Renal Failure: Medical History

Acute Renal Failure: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Malformations of the genitourinary system Blood, blood-forming organs – immune system (D50-D90). Hemolysis – dissolution of erythrocytes (red blood cells). Hemolytic uremic syndrome (HUS) – triad of microangiopathic hemolytic anemia (MAHA; form of anemia in which erythrocytes (red blood cells) are destroyed), thrombocytopenia (abnormal reduction in platelets/platelets), and … Acute Renal Failure: Or something else? Differential Diagnosis

Acute Renal Failure: Complications

The following are the major diseases or complications that may be contributed to by acute renal failure (ANV): Respiratory system (J00-J99) Pulmonary edema – accumulation of water in lung tissue. Pneumonia (inflammation of the lungs) Shock lung Blood, blood-forming organs – immune system (D50-D90) Anemia (anemia) Bleeding tendency (uremic) – bleeding time prolonged by uremia, … Acute Renal Failure: Complications