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).
Specifically, J.S. condition falls under prerenal kidney injury and can be reversed before renal perfusion
Acute renal failure occurs quickly over a period of days or weeks with a reduction in GFR and elevation of BUN, plasma creatinine and crystatin C levels. Oliguria (urine output of < 30ml/hr or < 400 ml/day) is usually associated with ARF, although urine output may be normal or increased as well. Fluid is still filtered at the glomerulus but there is an alteration in tubular secretion or reabsorption. Most types of ARF are reversible if diagnosed and treated early (Perrin, 2009).
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
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
This change in RBF is most apparent in age 50 and will steadily decline by 10% per decade (Digiovanna, 2000). This decline is due to a multitude of dilation and constriction changes. Firstly, the renal arteries (e.g. accurate and interlobular) lose their shape and curve. Secondly, calcium builds up on the renal artery walls. Finally, the increased production of endothelin-1 and nitric oxide is responsible for the decline in renal blood flow (Čukuranović and Vlajković, 2005). The decline in RBF is the main cause for most the of the declines in renal physiological function: filtration, reabsorption, and hormone secretion (Digiovanna, 2000). The use of nonsteroidal anti-inflammatory drugs (NSAIDS) can also lead to arterial constriction and can further the aging affects on RBF (Digiovana,
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.
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
For the purpose of confidentiality, the patient will be identified by the initials A. S. A.S was a 52- year old African American woman who was admitted to the hospital when she started to experience severe urinary retention and shortness of breath. She has three adult children and eight grandchildren, but recently lost her husband of 25 years to diabetes. The patient appears to be very independent because she lives alone in her home and is aware of the disease process. She has a past medical history of acute renal
The primary function of the kidneys is to remove wastes from the blood, and seniors who fill their bodies with toxins increase the workload on their organs. Smoking and drinking alcohol both affect the blood vessels as well, which can lead to reduced blood flow in the kidneys. Although seniors tend to find ending these addictions challenging when they have indulged in them for years, stopping now greatly boosts kidney functioning and protects a senior from accumulating even more damage.
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,
Title: An exploration of the physiological changes during and after cardio-pulmonary bypass surgery that result in acute kidney injury
The diagnosis of AKI, at present, greatly be determined by changes in endogenous surrogate markers of kidney function, especially serum creatinine (S.Cr), serum urea and other urinary tests. Regrettably, these markers are not ideal, each has limitations and none reflects real kidney injury. The serum creatinine measures function, not injury. It may not change until nearly 50% of kidney function has been missing. In addition, S.Cr level is affected by multiple confounding factors such as gender, age, muscle mass, diet, race, and hydration
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
High blood pressure which is called hypertension is another common disease which can cause chronic renal failure. This