Renal issues Flashcards
prerenal
acute renal failure
problem with blood getting into kidney
CAUSES OF PRE-RENAL FAILURE: • Hypovolaemia (-due to vomiting, diarrhea, dehydration, haemorrhage etc) • Triple whammy • Hypotention • Shock • Renal artery stenosis • Etc
renal
acute renal failure
any process that is damaging kidney eg toxin, inflammation, necrosis
• ATN!! Most common ccause of renal failure
ATN=death of tubular epithelial cells
• Interstitial: Acute interstitial nephritis.
• Glomerular: GN, diabetic nephropathy
• Vascular: hypertension, polyarteritis, Haemolytic uraemic syndrome, TTP, and vasculitis.
Postrenal
Acute renal failure
blocking outflow to kidney eg kidney stones, congenital PUJ obstruction
- A post-renal obstruction can occur anywhere from the renal pelvis to the urethra, and in order to cause an AKI, the obstruction must be bilateral, or occur in a patient with a solitary kidney).
- Intraluminal: Renal calculi. (kidney stone)
- Intramural: Retroperitoneal fibrosis, or strictures (narrowing of tube).
- Extramural: Benign prostatic hyperplasia, or malignancy.
Whats the best test for postrenal problem
imaging
Waths the best test for renal problem
urinalysis
Wats the best test for prerenal problem
pt assessment
Oliguria
lower than 400 mls of urine per day
the worse the kidney function,
the higher the serum creatinine level
kidney has a high reserve- u have to lose like 50% of kidney function before see
rise in serum creatinine
wen u only have 10% of renal function
= end stage renal failure
wen u have 15% renal function
get uraemia (urea in the blood)
These are the things that suggest CHRONIC RENAL FAILURE
anaemia
renal bone disease
small kidneys
peripheral neuropathy
Haemolysis
premature destruction of red cells
septicaemic shock
can get MICROANGIOPATHIC HAEMOLYSIS
2 feautres indicate MICROANGIOPATHIC HAEMOLYSIS
red cell fragmentation n
platelets decreasing
EFFECTIVE CIRCULATING VOLUME DEPLETION
this is where the volume state may be normal, high or low, but renal perfusion is reduced
circulation may be normal but u get all these problems like odema or low cardiac output
radiological hallmark of postrenal ARF
hydronephrosis
Diabetic nephropathy
its hallmark is albuminuria