renal failure


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Related to renal failure: acute renal failure, chronic renal failure

failure

 [fāl´yer]
inability to perform or to function properly.
adult failure to thrive a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a progressive functional deterioration of a physical and cognitive nature. The individual's ability to live with multisystem diseases, cope with ensuing problems, and manage his/her care are remarkably diminished.
bone marrow failure failure of the hematopoietic function of the bone marrow; see also bone marrow suppression.
congestive heart failure see congestive heart failure.
heart failure see heart failure.
kidney failure renal failure.
multiple organ failure failure of two or more organ systems in a critically ill patient; see also multiple organ failure.
renal failure see renal failure.
respiratory failure see respiratory failure.
failure to thrive (failure to thrive syndrome) physical and developmental retardation in infants and small children. The syndrome can be seen in children with a physical illness, but the term is most often taken to mean failure to thrive due to psychosocial effects such as maternal deprivation. The syndrome was first noticed when European psychiatrists studied the development of babies who had spent the first five years of their lives in institutions where they were deprived of the emotional warmth of a mother, father, or other primary caregiver.

Characteristics of the failure to thrive syndrome include lack of physical growth (for example, weight and height below the third percentile for age) and below normal achievement in fine and gross motor, social-adaptive, and language skills as assessed by psychometric testing using a tool such as the Denver Developmental Screening Test. Additionally, the child with this syndrome displays withdrawing behavior, avoidance of eye contact, and stiffness or flaccid posture when held. These children often have a history of irritability, feeding problems, and disturbed sleep patterns.

Parents of infants with failure to thrive syndrome typically display feelings of concern and inadequacy. The infant who is feeding poorly and is irritable may elicit a response in the caregiver that reflects tension and frustration. The need for comfort and nurturing by the infant may not be met, and this may lead to a cycle that exacerbates feeding problems.

Intervention encompasses identification of infants and mothers at risk for the syndrome and care of both mother or primary caregiver and infant. The major goals are to encourage the mother to express her feelings without fear of rejection, to model the role of mother and teach her nurturing behaviors, and to promote her self-esteem and confidence. Important nursing goals in the care of the infant include providing optimal nutrition, comfort, and rest; meeting the infant's psychosocial needs; and supplying emotional nurturance and sensory stimulation appropriate to the assessed developmental level.
ventilatory failure respiratory failure.

renal

 [re´nal]
pertaining to the kidney; called also nephric.
renal clearance tests laboratory tests that determine the ability of the kidney to remove certain substances from the blood. The most commonly used is the creatinine clearance test, which is a measure of the glomerular filtration rate.
renal failure inability of the kidney to maintain normal function, so that waste products and metabolites accumulate in the blood. This affects most of the body's systems because of its important role in maintaining fluid balance, regulating the electrochemical composition of body fluids, providing constant protection against acid-base imbalance, and controlling blood pressure. Called also kidney failure.
Acute renal failure occurs suddenly and may be caused by physical trauma, infection, inflammation, or exposure to nephrotoxic chemicals. Nephrotoxic agents include drugs such as penicillins, sulfonamides, aminoglycosides, and tetracyclines; radiographic iodine contrast materials; and heavy metals. These agents inflict damage on the renal tubules, causing tubular necrosis, and may also indirectly harm the tubules by producing severe vasoconstriction of renal blood vessels with ischemia of kidney tissue. Other causes of tubular ischemia include circulatory collapse, severe dehydration, and hypotension in certain compromised surgical patients.



Acute renal failure may be classified as: prerenal, associated with poor systemic perfusion and decreased renal blood flow; intrarenal, associated with renal ischemia or toxins; or postrenal, resulting from the obstruction of urine flow out of the kidneys.

oliguria is the hallmark of tubular necrosis, but it is not always present. Other symptoms besides a marked decrease in urinary output are related to fluid and electrolyte imbalances, anemia, hypertension, and uremia. In addition to supportive measures to restore and maintain a tolerable internal environment during acute renal failure, it may be necessary to remove toxic wastes by hemodialysis or peritoneal dialysis.
Chronic renal failure is a progressive loss of kidney function that may eventually progress to end-stage renal disease. The clinical course is described in four stages. First there is decreased renal reserve, with diminishing renal function but without accumulation of the end products of protein metabolism; the patient has no symptoms. In the second stage, renal insufficiency, the glomerular filtration rate (GFR) is depressed to about 30 ml per minute and plasma chemistry begins to show abnormalities as waste products accumulate. The third stage, frank renal failure, is characterized by steadily rising serum creatinine and blood urea nitrogen levels accompanying a drop in the GFR. The fourth and final stage is uremia; levels of protein end products continue to rise, residual urine function is less than 15 per cent, and all body systems are impaired.



Causes of renal failure are many and can be roughly divided into three groups: (1) those that directly affect the kidney by infection, inflammation, and upper urinary tract obstruction; (2) those in which there is an obstruction of the lower urinary tract; and (3) systemic diseases and toxicities, such as hypercalcemia, hypertension, disseminated lupus erythematosus, atheroma, and diabetes mellitus.
Treatment. The treatment of chronic renal failure is highly complex owing to its impact on systems throughout the body. It involves prevention of imbalances in water and electrolytes whenever possible and correction of these imbalances when they do occur. Therapy may include phosphate binders to prevent absorption of phosphorus from the intestinal tract, antihypertensive agents to control high blood pressure, diuretics to manage hypervolemia, erythropoietin to manage anemia, and cardiac drugs to manage heart failure. Fluids often are restricted to a given amount during each 24-hour period. Dietary restrictions are aimed at minimizing urea toxicity, controlling various metabolic upheavals and providing optimal nutrition. Protein intake is an especially critical factor because the end products of the metabolism of protein and amino acids are excreted for the most part by the kidney.



Symptomatic relief of the many manifestations of end-stage renal disease is a challenge to every member of the health care team. Virtually every system within the body is adversely affected in some way. Pathophysiologic changes involve the gastrointestinal tract, the skin, the cardiovascular system, the lungs, bone, and blood, and the metabolism of glucose and protein.

Hemodialysis or peritoneal dialysis may be employed to rid the body of wastes that the kidney can no longer handle. For some patients transplantation of a human kidney is a viable alternative to continuous dialysis. Others who cannot withstand surgery and long-term immunosuppression are not good candidates for a kidney transplant.

re·nal fail·ure

loss of renal function, either acute or chronic, that results in azotemia and syndrome of uremia.

renal failure

n.
Acute or chronic malfunction of the kidneys resulting from any of a number of causes, including infection, trauma, toxins, hemodynamic abnormalities, and autoimmune disease, and often resulting in systemic symptoms, especially edema, hypertension, metabolic acidosis, and uremia.

renal failure

Nephrology See Acute renal failure, Chronic renal failure, End-stage renal failure, Postpartum renal failure.

re·nal fail·ure

(rē'năl fāl'yŭr)
Impairment of renal function, either acute or chronic, with retention of urea, creatinine, and other waste products.
Synonym(s): kidney failure.

renal failure

See KIDNEY FAILURE.

Renal failure

Disorder characterized by the kidney's inability to filter wastes from the blood. It may be acute (occuring suddenly and usually reversable) or chronic (developing slowly over time as a result of permanent damage).
Mentioned in: Nephrotoxic Injury

re·nal fail·ure

(rē'năl fāl'yŭr)
Impairment of renal function, either acute or chronic, with retention of urea, creatinine, and other waste products.
Synonym(s): kidney failure.
References in periodicals archive ?
Acute Renal Failure Complicating Severe Acute Pancreatitis.
The objectives of this study were to determine mean cerebral blood flow in anemia secondary to chronic renal failure by doppler ultrasound and to compare the results with data gathered from healthy control subjects.
The overall prognosis of non-oliguric renal failure was far better than oliguric renal failure.
The combined results demonstrated that exercise is associated with improving the situation of VO2max in renal failure patients (MD = -1.36, 95% CI [-2.06,-0.65], P = 0.0002, P for heterogeneity=0.49, and [I.sup.2] = 0%) (Figure 3).
Anemia and thrombocytopenia in acute and chronic renal failure. Int J Hematol Oncol Stem Cell Res.
* The report reviews key players involved Acute Renal Failure (ARF) (Acute Kidney Injury) therapeutics and enlists all their major and minor projects
Naqvi R, Akhtar F, Ahmed E, Sheikh R, Ahmed Z, Naqvi A, Rizvi A; Acute Renal Failure of Obstetric Origin during 1994 at One Center.
Corticosteroid used in the study was to control concomitant immune mediated red blood cell destruction while aggressive fluid therapy and diuretics was to increase blood flow to kidney for correction of acute renal failure. Need of fluid threrapy and corticosteroid administration was explained by Schoeman (2009).
In this study, dental caries was observed in 8 (16%) patients with renal failure and in 22 (44%) patients of the control group.
At least 1,500 patients in Kyrgyzstan are in need of hemodialysis treatment, the Ministry of Health of Kyrgyzstan unveils data on hemodialysis treatment of patients with chronic renal failure.
They address fluid, electrolytes, acid-base disorders, and calcium-phosphorus metabolism; renal failure, including cystic diseases of the kidney, acute and chronic urinary tract obstruction, bleeding disorders in renal failure, leptospirosis, drug dosing, and the pathophysiology, prevention, and treatment of renal failure associated with severe congestive heart failure; hypertension, including pregnancy issues; glomerular disease; urinary stones; dialysis and transplantation; and pediatric issues.
Chronic renal failure is a progressive disease caused by the damage of the functional unit of the kidney the nephron.