The document discusses acute renal failure (ARF), including its definition, epidemiology, etiology, diagnosis, and treatment. ARF can be pre-renal, renal, or post-renal in origin. The most common cause is acute tubular necrosis, often from hypotension, sepsis, or nephrotoxins. Diagnosis involves lab tests of kidney function and urinalysis. Treatment focuses on fluid management, avoiding nephrotoxins, and possibly dialysis.
20. Renal failure Differentiation between acute and chronic renal failure Acute Chronic History Short (days-week) Long (month-years) Haemoglobin concentration Normal Low Renal size Normal Reduced Renal osteodystrophy Absent Present Peripheral neuropathy Absent Present Serum Creatinine concentration Acute reversible increase Chronic irreversible
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23. Acute Renal failure Differentiation between Pre-renal, renal and post-renal causes Causes of acute renal failure Prerenal Renal postrenal Hypovolaemia Decreased active blood volume Decreased cardiac output Renovascular obstruction Acute tubular necrosis Interstinal nephritis Glomerular disease (acute glomerulonephritis) Small vessel diease Intrarenal vasoconstriction (in sepsis) Tubular obstruction Bilateral ureteric obstruction Unilateral ureteric obstruction Bladder outflow obstruction
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31. Acute Renal failure Changes during acute renal failure Hyperkalaemia ( ECG abnormalities) decreased bicarbonate elevated urea elevated creatinine elevated uric acid Hypocalcaemia Hyperphoshataemia Causes of acute renal failure In many chases kidney can recover from acute renal failure The function has to be temporarily replaced by dialysis disturbed fluid or electrolyte homeostasis must be balanced primary causes like necrosis, intoxication or obstruction must be treated
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36. Hilton, R. BMJ 2006;333:786-790 Differential diagnosis of acute renal failure