Acute renal failure (ARF)

1.      Acute renal failure (ARF)

It is a clinical syndrome characterized by a rapid decline in renal function with progressive azotemia(nitrogenous waste) and increased serum creatinine level.

Aetiology

ARF c an be further divided into

·         Prerenal

It consists of outside the kidneys than reduce renal blood flow and lead to decreased glomerular perfusion and filtration

·         Intrarenal or Intrinsic

It is caused by damage to kidney tissues and structures

·         Postrenal  

It involves mechanical obstruction of urinary outflow between kidneys and urethral meatus

Clinical Manifestation

·         Hypotension, ischemia, hypovolaemia

·         Nausea, vomiting, drowsiness, confusion, coma , GI bleeding

·         Pulmonary oedema, kussmauls respiration

·         Anorexia, convulsion, asterixis, pericardial effusion

Diagnostic Tests

·         Urinalysis, CT, MRI, Ultrasound,  retrograde pyelogram, renal scan

Management

·         Maintaining fluid and electrolytic balance

·         Maintaining nutrition

·         Maintaining test/activity balance

·         Prevent injury and infection

·         Facilitate coping

·         Health education  to be given about the disease