Acute Renal Failure Flashcards
Def: Acute kidney injury
Encompasses mild damage that, does not cause azotemia, to severe damage associated with complete anuria
Infers reversibility
Def: Acute renal failure
Decreased GFR leading to the retention of nitrogenous wastes
RIFLE criteria - define AKI
R: risk I: injury F: failure L: loss E: end-stage kidney disease Based on proportion of serum creatinine increases and urine output decreases
Pre-renal etiologies for AKI
Insufficient blood flow to the kidneys
Characterized by reduced fractional excretion of sodium
Can be rapidly reversed if underlying cause is corrected
Renal etiologies for AKI
prolonged renal hypoperfusion prolonged obstruction excessive vasoconstriction thrombosis DIC transfusions rxns infectious causes immune-mediated causes neoplasia secondary to systemic disease
Post-renal etiologies AKI
urine leakage or obstruction
pressure on the collecting tubules
urine leakage
Four phases of acute renal failure
initial –> extension –> maintenance –> recovery
initial phase
decrease in urine output or increase in creatinine
extension phase
- continued hypoxia and inflammation
- proximal tubule and loop of Henle susceptible to toxic and ischemic damage
- compromised Na:K pumps- leads to cell swelling and death
Maintenance phase
- 1-3 weeks duration
- urine output is increased or decreased
- urine= ultrafiltrate
Recovery phase
- heralded by polyuria
- extreme Na loss
Treatment of ARF
Fluids, fluids, fluids
shock dose
dog: 60-90 ml/kg
cat: 45 ml/kg
oliguria
insufficient urine production
< 0.5 ml/kg/hr
Mannitol
osmotic diuretic
increase circulatory volume - flushes through tubules
