Frederick was given a preliminary diagnosis of a prerenal AKI. AKI is a complex condition with various different definitions available, most including a rapid decline in kidney function and the lack of ability of the kidneys to filter blood, subsequently leading to increased levels of serum creatinine and BUN levels in the blood (Cheung et al., 2008). AKI is the leading cause of nephrology consultation in the UK and carries with it high mortality rates (Basile, 2012). The primary causes of an AKI are hypoxia, ischemia and nephrotoxicity. The main underlying feature of an AKI is a rapid decrease in the glomerular filtration rate (GFR), which is strongly linked with a decrease in blood flow to the kidneys. The GFR depends on the interplay between …show more content…
It is secondary to under-perfusion of otherwise normally functioning kidneys and if detected early can be reversible. In Mr Jones’s case, his kidney’s experienced hypo-perfusion during surgery. Hypo-perfusion consequently causes azotemia due to the excess nitrogenous wastes in the blood. Medications, such as high doses of dopamine, can cause prerenal kidney injury due to the production of intrarenal vasoconstriction, which can lead to hypo perfusion of the glomeruli (Nissenson, 1998). The kidneys have an enormous blood supply and account for 20-25% of cardiac output. This blood supply is needed for the removal of waste products and the management of fluid and electrolyte balances. If the blood flow to the kidneys is reduced, this has a decreasing effect on the GFR leading to a decreased urine output, filtration and reabsorption of filtered material through the glomerulus. This can lead to further issues and effect other organs in the body. Fredrick experienced a decreased urine output as a symptom of his reduced GFR. Fredrick’s increased respiration rate noted during assessment was an indicator of his deterioration and alerted the medical team that there was an underlying issue. During the nurse’s assessment, they observed that Frederic had very poor urine output, which is also linked with the drop in the GFR in the kidneys. Thus, encouraging the nursing staff to take immediate action with thereputic
Prerenal acute renal failure- accounts for 60% of cases of ARF- is the most common cause of ARF and is caused by impaired renal blood flow. The GFR drops because of the decrease in filtration pressure. Poor perfusion can result from hypovolemia, hemorrhage, renal vasoconstricition, hypotension, or inadequate cardiac output. This type of renal failure may occur when chronic renal failure exists if a sudden stress is imposed on already marginally functioning kidneys. If blood volume or blood pressure and oxygen delivery is not restored, cell injury and acute tubular necrosis or acute interstitial necrosis may be caused (Perrin, 2009).
The C02 is low because of the low kidney function. This can also be caused by lung function as well.
This is an 82-year-old gentleman, who was referred from Dr. Gretchen Marsh’s office because the patient’s BUN and creatinine were high, as he has acute kidney injury. The patient went to Dr. Marsh’s office yesterday and was having generalized weakness. He does not have any vomiting. No diarrhea. No fever. No cough with expectoration. No sharpness. No wheezing. No headache. No dizziness. No passing out. No rectal bleeding. No hematemesis. No abdominal pain. No sore throat. No stuffy nose. No cough with expectoration. No burning, frequency, or
This is sudden injury to the kidneys which stops them working instantly or nearly instantly, AKI can range from the kidneys only to stop functioning slightly or to completely stop working. Due to the name of it some people think that it is physical injury or blow to the kidneys however it is a result in complications of other conditions. It is usually seen in older people who are very unwell and get admitted to hospital, it’s vital that AKI is detected quickly as if AKI
A low partial pressure of oxygen (PaO2) suggests that a person is not getting enough oxygen; Metabolic acidosis->Kidney failure, shock, diabetic ketoacidosis
However, acute kidney injury is complications are reversible. Patients with life threatening conditions are more susceptible to developing this disorder. Acute kidney injury is commonly developed after either chronic hypotension or hypovolemia or exposure to a nephrotoxic agent. With increased levels of blood urea nitrogen (BUN), creatinine, and potassium with or without a reduction in urine output develops acute kidney injury over hours or days (Lewis, 2014, p. 1101-1102). High incidents of hospitalized patients develop AKI, one out of five, and a high mortality rate. (Lewis, 2014, pp. 1101-1102)
Often times we may ignore the signs our body is trying to tell us. Mainly due to fear of the unknown. Our kidneys play an important role in our body. They are used to filter out waste through urination. There are many exams that physicians use to help diagnose renal failure and there are some less commonly used because they have no effect of diagnosis of renal failure. Ultra- sounds are the number one imaging modality to help in diagnosing renal failure and angiography of the kidney is the least used imaging modality. In order to prevent our body from shutting down it is imperative we pay attention to the signs of what our body is trying to tell us.
Chronic Kidney Disease (CKD) is a disease that is described as a loss of kidney function gradually over time. As kidney function decreases, the waste collection in the body’s blood becomes high and makes the individual feel sick. This disease can lead to other complications in the body such as anemia, poor nutritional health, high blood pressure, and nerve damage. These complications will begin to progress and show as CKD progresses to advanced stages. Early detection of this disease is essential when it comes to treatment. If CKD is diagnosed early enough the disease progression can be slowed down and managed. This disease will eventually lead to failure of the kidneys
The pathophysiology of acute renal failure is still uncertain though it is thought to be
Causes of kidney disease are wide-ranging in number; however diabetes, high blood pressure, inherited disease, and infection remain to be the contenders of cause (Davidson, 2011). Acute kidney disease can be identified by anuria and oedema. CKD is often called a “silent” killer, because instead of a sign, that would render immediate evidence, CKD only provides symptoms that many don’t know to correlate to renal issues. The symptoms may also increase at the latter stages of the
In patients with heart failure, hypovolemia, cirrhosis, nephrotic syndrome, or hypoalbuminemia, renal function may be further compromised. BUN, creatinine clearance, and urine output should be monitored closely (Lexi-Comp, 2016).
Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of
Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,
Mr. Armstrong has a history of renal insufficiency and uncontrolled hypertension, along with symptoms of fatigue, pedal edema, and occasional shortness of breath. He does not have a history of trauma or obstruction to his kidneys, but his creatinine and BUN levels are currently at 3.5 mg/dl and 40 mg/dl. Normal creatinine concentration values are 0.7 to 1.2 mg/dl and normal BUN values are 10 to 20 mg/dl; this reveals that Mr. Armstrong’s kidneys are not removing wastes properly (McCance, Huether, Brashers, & Rote, 2014). Mr. Armstrong’s history of renal insufficiency and uncontrolled hypertension is commonly found in patients diagnosed with intrarenal (intrinsic) acute renal failure. Intrarenal acute renal failure can be categorized as
stage is moderate, glomerular filtration rate (GFR) in the kidney has been reduced.7Yet, kidney still