Acute Kidney Failure Flashcards
Two Types of Kidney Failure
- Acute
2. Chronic
Acute Kidney Failure
develops within hours or days, includes chance of function recovery
Possible causes:
- traumatic
- acute intoxications
- part of multiorgan failure
- various other diseases
Chronic Kidney Failure
develops over years, irreversible
Possible causes:
- secondary to high blood pressure and/or diabetes
- chronic bacterial inflammation of the kidneys
- cystic kidneys
- various autoimmune diseases
ESRD
End Stage Renal Disease
- diabetes
- obesity
Leading cause of kidney failure
diabetes
S/S of AKI
- primarily caused by the retention of nitrogenous wastes and fluids
- inability of the kidneys to regulate electrolytes
What is AKI?
- rapid loss of kidney function from renal cell damage
- occurs abruptly and can be reversed
- leads to cell hypoperfusion, cell death, decompensation of renal function
- prognosis depends on cause and condition of client
- near normal or normal kidney function may resume graduallly
Types of Acute Renal Failure
- Pre-renal
- Intrinsic (breaks down into Acute glmernulonephritis, Acute interstitial nephritis, and acute tubular necrosis)
- Post-renal
Pre-renal causes
- most common
- caused by transient renal hypoperfusion due to hypotension, decreased CO, decreased effective arterial blood volume
- intravascular fluid depletion
- dehydration
- decreased peripheral vascular resistance
- prerenal infection or obstruction
Intra-Renal (Intrinsic) causes
- tubular necrosis
- prolonged renal ischemia
- intrarenal infection or obstruction
- nephrotoxicity
- primary renal diseases
Primary renal disease
- Acute Glomerulonephritis
- System Lupus Erythematosis (SLE)
- Toxemia of Pregnancy
Post-Renal Causes
- mechanical obstruction of urinary outflow causing reflux and damage to renal tissue
causes: - bladder neck obstruction
- bladder cancer
- calculi
- post-renal infection
ATN
Acute Tubular Necrosis
Accounts for more than 50% of cases of acute renal failure
- destruction of tubular epithelial cells
- causes an abrupt and progressive decline in renal function
- prolonged ischemia is the primary cause
AKI Phases
- Initiation (hrs to days)
- maintenance (significant fall in GFR)
- Recovery (may take 1 yr to recover)
Rifle Criteria
Risk:
-Increased SCreat x1.5 or GFR decrease >25%.
-UO less than .5ml/kg/h for 6 hrs
Injury:
-Increased SCreat x2 or GFR decrease >50%.
-UO less than .5ml/kg/h for 12 hrs
Failure:
-Increased SCreat x3 or GFR decrease >75%. OR SCreat greater than or equal to 4mg/dL
-UO less than .3ml/kg/h for 24 hrs or Anuria for 12 hrs
Loss:
-Persistent ARF= complete loss of kidney function more than 4 weeks
ESKD:
more than 3 months
**RIF= High Sensitiity
**LE= High Specificity
