Renal Failure is a common condition that could also be described as Acute renal failure (ARF) or Chronic renal failure(CRF), both conditions occur when there is a loss of kidney function. Kidney disease or renal failure is the ninth leading cause of death in the United States (Pradeep ,2014). Specifically, acute renal failure is characterized by the kidney’s sudden inability to filter blood, excrete wastes, concentrate urine, preserve electrolytes, and sustain fluid balance which leads to many problems in the human body. Acute renal failure alone is a frequent clinical problem, especially in the intensive care unit, where according to Clin (2004), “is associated with mortality of between 50% and 80%” (p5). As for the pathophysiology …show more content…
D, Jr.). Postrenal disorders are those that initiate in the urinary tract from the nephrons of the kidney. These types of kidney disorders can involve the renal pelvis, the ureters or the bladder and urethra.
If a patient’s signs and symptoms suggest that he or she has acute renal failure the primary caregiver might suggest tests and procedures verify the diagnosis. Some of those tests include urine output measurements which would help the physician determine the cause of the kidney failure. Another test that could be taken is a urinalysis which may show abnormalities that suggest kidney failure. Having a blood test that shows rising levels of urea and creatinine which are also measured to kidney function. Different imaging tests such as ultrasound or computerized tomography (CT) may be used to help get a clearer image of your kidneys and see any abnormalities. Lastly your physician might suggest a kidney biopsy to remove a small sample of kidney tissue for lab testing. In chronic kidney disease there are 5 different stages. Patients in stages 1 through 3 are primarily seen by their physician while patients with stage 4 CKD will be treated at the Nephrology clinic until the illness progresses to stage 5. At stage 5 of renal failure the patient starts to receive dialysis. Patients that are in Stages 1 and 2 have few symptoms. Often early stages of renal failure are identified by testing for abnormally high levels of creatinine or urea in the
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.
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).
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 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
Ms. S.M. was a patient admitted for the management of renal failure. During morning rounds, we noticed her potassium levels to be elevated. She was asymptomatic and her EKG did not show any abnormal changes. As a team, we coordinated with each other and successfully managed her potassium levels. The hours spent to manage this patient helped me to understand the importance of clear communication and the dynamics of team work in a hospital setting. Though we managed her hyperkalemia, the patient was still facing an uncertain prognosis with her kidney disease. Her family members were worried about providing financial support for her care, which is a major problem in India. It made me wonder if there was anything more we could do for her. However, along with providing clinical care, establishing a relationship with her and her son gave me a sense of satisfaction. It made me realize the potential of developing long term relations with my patients in this field.
Kidney failure is the result of kidney disease that has either not been treated, or failed to respond to treatment. Some kidney diseases are: Acute kidney failure (potentially reversible), Acute nephritic syndrome, Goodpasture syndrome, Atheroembolic renal disease, Glomerulonephritis, Polycystic kidney disease, and chronic kidney failure (end stage) (United States National Library, 2010). The usual treatment for kidney failure is medication and dialysis. Dialysis is used for end stage kidney failure, when the patient has lost
The pathophysiology of acute renal failure is still uncertain though it is thought to be
According to kidney.org, “Some urine tests require only a couple of tablespoonfuls of urine...other tests require collection of all urine produced for a full 24 hours. A 24-hour urine test shows how much urine your kidneys produce in one day. The test also can give an accurate measurement of how much protein leaks from the kidney into the urine in one day.” Urine tests can be extremely helpful in a diagnosis of renal failure. The other-blood tests, like GFR (Glomerular Filtration Rate), measure how well the kidneys are removing wastes and excess fluid from the blood. There are many other blood tests. Regardless, both blood and urine tests are a very good way to test to determine kidney failure (Coresh, 2014). Once a patient is identified with renal failure, the medical evaluation takes place. This includes, but is a surgery to place a healthy kidney from a different person’s body which will do enough of the work that the two failed kidneys used to do to keep the patient healthy and symptom free of renal failure (Smith, 2013). Peritoneal dialysis is a procedure that removes extra water, certain not limited to, the determination of the stage and the cause (Snyder,
Perform a urinalysis when possible to find levels of Specific Gravity (how concentrated the urine is), pH, Protein, Blood, Nitrites, Leukocytes, Ketones, Glucose and Bilirubin. The results of this test can help identify any possible impairment in renal function and identify the presence of an infection (Vera, 2011).
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,
Chronic Kidney Disease (CKD) is among the leading causes of mortality throughout the world, and its prevalence and the health care costs resulting from it are considerable and increasing. CKD commonly is silent and asymptomatic until its late stages. Accordingly, CKD is diagnosed prior to symptomatic stage of kidney failure, resulting in delays in proper interventions and the emergence of adverse consequences in the CKD patients
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
Hemodialysis (HD) is one of several renal replacement therapies used for the treatment of end stage kidney disease (ESKD) and kidney failure. Dialysis removes excess fluids and waste products and restores chemical and electrolyte balance. HD involves passing the patient’s blood through an artificial semipermeable membrane to perform the filtering and excretion functions of the kidney. One important step before starting regular hemodialysis sessions is preparing the vascular access; ideally, a vascular access should be placed weeks or months before you start dialysis. The
research paper, is to provide a general overview of the causes of kidney failure, shedding light on it