Acute Renal Failure

Injury to the glomerulus and the tubules presents the onset of Intra-renal failure (Matzke, 2011). Some of the frequent causes for Intra-renal failure are glomerulonephritis; pyelonephritis; and tubular injury. Post-renal failure develops from things like ureteroliths, tumors, or anatomic impediments. Opposite of the acute form, the chronic form has a slow onset that has no early stage symptoms. It is important to know that following an acute episode a chronic renal episode often follows, and at this juncture the damage is irreversible. Glomerulonephritis and pyelonephritis combined, has been reported to be the forerunner in as much as half the cases from acute to chronic renal failure. Diabetes mellitus, renal vascular disease, such as atherosclerosis, hypertension, polycystic kidney disease, drug damage, and nephrolith are all examples of other causes of CKD (Pradeep, 2014). Biopsies of kidneys that suffered with CKD reveal smaller kidneys with scarring on the tubules.

All the symptoms that were described were based on the kidney functions, so more and further

Intrarenal acute renal failure- accounts for 30% to 40% of the cases of ARF- generally results from acute tubular necrosis due to disturbances within the glomerulus or renal tubules. ATN most often occurs after surgery but is also associated with sepsis, severe trauma, including severe burns,

Systemic and can quickly become life-threatening with organ failure, including reduced blood pressure and heart failure 1 2

Differentiate between the causes, signs and symptoms, and diagnostic findings in pre- renal, intra-renal, and post-renal failure.

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

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

• Higher risk of death, renal failure, and infarction in the elderly. Age is an independent predictor of increased complication, as are diabetes, cardiac failure, and chronic renal impairment.

obstruction to the kidneys, an imaging test which include CT scans or MRI to reveal a more

Acute renal failure is a sudden decrease of kidney function often characterized by the loss of homeostatic equilibrium of the internal medium causing waste accumulation in the blood. Aside from accumulation of waste products like nitrogen and urea, it is also characterized by a sudden decrease of glomerular filtration rate (GFR) which disables the kidney from filtering waste products that is harmful to the body. Evidently, acute renal failure disables the kidney from maintaining fluid and electrolyte balance. As stated by kidneyatlas.org, causes for acute renal failure are classified into three: prerenal, intrarenal, and postrenal.

Acute Kidney Injury (AKI) refers to the rapid decline of renal filtration and urine production. There are several causes for AKI but the damage is often due to an injury which causes functional and/or structural deviations in the kidney. This can lead to many different complications such an increased risk of chronic kidney disease, or it can effect other organ systems. Additionally, AKI can also potentially lead to death.

As for J.S. condition, he is developing acute kidney injury (AKI). The risk for having AKI is due to other preexisting issues such previous kidney impairment, cardiovascular and PVD, hypertension, DM, heart failure, malignancies, and BPH. This kind of renal failure is also common with individuals between the ages of 20 and 80 years old. It is characterized by a decreased of renal blood flow to 50% and GFR by 8ml/min/1.73 m2 every 10 years after the age of 30. Aging kidneys are unable in concentrating and diluting urine, conserving Na, producing prostaglandin, and maintaining levels of renin and aldosterone (Copstead & Banasik, 2013 p. 594).

Nephrotoxins, acute interstitial nephritis, glomerular damage, and vascular damage also correlate with intrarenal acute renal failure (Singh, Levy, & Pusey, 2013). Postrenal acute renal failure is usually a result of a urinary tract obstruction that affects the kidneys bilaterally, which causes the intraluminal pressure upstream from the site of the obstruction to increase with a progressive decrease in the glomerular filtration rate (McCance, Huether, Brashers, & Rote, 2014). A pattern consisting of several hours of anuria with flank pain followed by polyuria is typically found in individuals with postrenal acute renal failure (McCance, Huether, Brashers, & Rote, 2014).

High blood pressure which is called hypertension is another common disease which can cause chronic renal failure. This

common in patients who have had kidney transplantation.22 There are several causes that lead to