acute renal failure


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Related to acute renal failure: chronic renal failure

acute renal failure

An abrupt decline in renal function, marked by a rise in serum creatinine or azotemia, triggered by various processes—e.g., sepsis, shock, trauma, kidney stones, drug toxicity (aspirin, lithium, substances of abuse), toxins, iodinated radiocontrast.

Clinical findings
• Cardiovascular
Congestive heart failure, myocardial infarction, arrhythmias, cardiac arrest occur in up to 35% of patients with ARF. The elderly with low cardiac reserve are at risk of fluid overload secondary to oliguric ARF.

• Pulmonary
Lung disease occurs in over half of patients with ARF and may be linked to shared pulmonary and renal syndromes—e.g., Goodpasture syndrome, Wegener granulomatosis, polyarteritis nodosa, cryoglobulinemia, sarcoidosis. Hypoxia is common during hemodialysis and attributed to white cell sequestration by the lungs and alveolar hypoventilation.

• GI tract
Nausea, vomiting, anorexia; GI bleeding occurs in ± one third of patients with ARF and causes nearly 10% of deaths in patients with ARF. Other GI complaints include pancreatitis, jaundice linked to hepatic congestion, blood transfusions, and sepsis.

• Infections
Occur in up to 33% of patients with ARF; most occur in the lungs and urinary tract, and have mortality rates of up to 72%.
 
• Neurologic signs of uraemia occur in one-third of ARF patients, and have the expected findings of lethargy, somnolence, reversal of the sleep-wake cycle, and cognitive or memory deficits.

Types
• Prerenal—adaptive response to volume depletion and hypotension.
• Renal/intrinsic—response to cytotoxicity, ischaemia, or inflammation with structural and functional damage to the renal parenchyma.
• Postrenal—obstruction to the passage of urine.

Acute renal failure by type
Crescentic GN—renal vasculitis, anti-GBM disease, immune complex diseases.
Acute tubular injury—ischaemic, toxic, crystals, myoglobinuria
Acute tubulointerstitial nephritis.
Thrombotic microangiopathy—haemolytic-uraemic syndrome, accelerated hypertension, scleroderma.

acute renal failure

Acute kidney failure Nephrology An abrupt decline in renal function, triggered by various processes–eg, sepsis, shock, trauma, kidney stones, drug toxicity-aspirin, lithium, substances of abuse, toxins, iodinated radiocontrast. Cf Chronic kidney failure.

a·cute re·nal fail·ure

(ARF) (ă-kyūt' rē'năl fāl'yŭr)
A rapid decline of kidney function due to tubular injury. Signs are azotemia, fluid and electrolyte imbalance, and metabolic acidosis. Commonly caused by ischemia or nephrotoxins.
References in periodicals archive ?
A London study covering a similar period, 1998 through 2005, charted more than a 10-fold lower acute renal failure incidence among HIV-positive people in care for at least 3 months compared with those in the first 3 months of HIV care.
Ponikvar, "Low-flux versus high-flux synthetic dialysis membrane in acute renal failure: Prospective randomized study," Artificial Organs, vol.
Diagnostic evaluation of the patient with acute renal failure. Retrieved from www.kidneyatlas.org.
Extended daily veno-venous high-flux haemodialysis in patients with acute renal failure and multiple organ dysfunction syndrome using a single path batch dialysis system.
Rhabdomyolysis and acute renal failure associated with cocaine abuse.
Linas, 1998: The role of neutrophils in acute renal failure. Semin Nephrol., 18: 498-504.
I could barely move at that point and was admitted to the Royal Glamorgan Hospital, Llantrisant, where doctors told me I was suffering from acute renal failure and might not even see the day out.
suddenly experiences acute renal failure. She receives furosemide (Lasix[R]) 40 mg IV without response.
The essential difference between the two is that acute renal failure is a severe condition with a relatively sudden onset whose clinical signs become apparent over a period of a week or a month, while chronic renal failure is a disease that has been present for a long time.

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