Renal Failure

Question 1

What is acute kidney injury?

Answer 1

This is damage to the renal system over a short time frame (hours-days).

Characterised by sudden and a significant drop in renal function.

Question 1

What are causes of AKI?

Answer 1

Hypotensive shock
Heart failure, MI
Organ failure
Overuse of NSAIDS (to reduce swelling)
Sever allergic reactions
Direct traumatic injury
Major surgery
Renal calculi

Question 2

What is acute renal failure?

Answer 2

If the environment of the kidney is disturbed enough it can precipitate acute renal failure.

The kidneys will stop blood filtering and toxins will begin to build up in the blood.

Question 2

What is one of the main causes of AKI?

Answer 2

Severe dehydration

Question 3

What are the 3 causes of acute renal failure?
(PIP)

Answer 3

Prerenal - sudden and severe drop in blood pressure or interruption of blood flow to the kidneys from severe injury/illness.

Intrarenal - Direct damage to the kidneys by inflammation, toxins, drugs, infection or reduced blood supply.

Postrenal - Sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumour, or injury.

Question 4

What is chronic kidney disease?

Answer 4

Slow and steady progression of disease.

Has many causes.

Results in slow progressive loss of function which usually cannot be regained.

Question 5

What happens in chronic renal failure?

Answer 5

As the number of functional nephrons
decrease the filtration load is taken up by
the remaining functional nephrons.

As function declines the remaining nephrons must work harder to maintain homeostasis.

This creates a snowball effect with an accelerating decline in renal function.

Question 6

What are the complications of renal failure?

Answer 6

HTN
Mineral bone disease
High phosphate
High creatinine
Anaemia
High potassium

Question 7

What is diabetic neuropathy?

Answer 7

Endothelial vascular molecules do not function properly in diabetic patients, this makes the blood vessels abnormally leaky.

Inflammatory mediators and phagocytes enter
the renal tissue causing damage and
inflammation.
Leaking in the glomerular vessels causes protein to enter the urine.
These obstruct the glomeruli and nephrons causing inflammation and damage.

Inflammation can lead to scarring and fibrosis with a corresponding loss in nephrons and renal
function.