Acute Renal Failure: Diagnosis

1995 ◽  
Vol 16 (3) ◽  
pp. 101-106
Author(s):  
Azra Sehic ◽  
Russell W. Chesney
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Extracellular Volume ◽  
Electrolyte Imbalance ◽  
Waste Products ◽  
Postrenal Failure ◽  
Control Body ◽  
Stage Renal Disease ◽  
End Stage

Introduction Although acute renal failure (ARF) is relatively uncommon, its mortality rate is potentially so high that it is important to recognize this condition in children. Rapid deterioration of renal function is caused by numerous insults and results in typical findings, including extracellular volume expansion, hyperkalemia, hypertension, metabolic acidosis, and azotemia. It usually is reversible, with the majority of patients recovering completely. However, ARF can lead to residual impairment of renal function and progress to end-stage renal disease and death. Conservative medical treatment often is life-saving. Definition ARF represents the rapidly progressive (within several hours or days) cessation of renal function, which results in the inability of the kidney to control body homeostasis, manifesting in retention of nitrogenous waste products (azotemia) and fluid and electrolyte imbalance. On the basis of pathophysiologic process, ARF has been divided broadly into three diagnostic categories: prerenal, intrarenal (organic-intrinsic), and postrenal failure (Table 1). Prerenal and early postrenal failures are renal functional disorders and responses of a structurally intact kidney to extrarenal processes. These forms of renal dysfunction recover rapidly as soon as the cause is reversed. However, if these two disorders are not recognized in time, persist too long, or are treated inadequately, they can result in intrinsic renal failure.

scholarly journals HAEMODIALYSIS IN B. P. KOIRALA INSTITUTE OF HEALTH SCIENCES, DHARAN - AN INITIAL EXPERIENCE

2003 ◽  
Vol 40 (139) ◽  
pp. 134-138 ◽  
Author(s):  
Sanjib Kumar Sharma ◽  
P Kumar ◽  
A Chapagain ◽  
S Koirala
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Community Education ◽  
Health Sciences ◽  
Renal Diseases ◽  
Stage Renal Disease ◽  
End Stage

Dialysis supports life, in spite of complete cessation of renal functions. Haemodialysis(HD) service became available in B. P. Koirala Institute of Health Sciences, Dharansince September 1999. Six hundred and sixty one sessions of HD in 50 patients werecarried out in one year. End stage renal disease (ESRD), acute renal failure (ARF),acute on chronic renal failure constituted 54%, 26% and 20% of the patientsrespectively. Majority of the patients (72%) were between 15 to 50 years of age. Chronicglomerulonephritis, chronic interstitial nephritis, and diabetes nephropathy were themost common causes of ESRD. Recovery following HD was 70% in ARF,whileallpatients of acute on chronic renal failure improved following few sessions of HD.Drop out rate on maintained haemodialysis (MHD) was 52%. The increasing demandof dialysis service in this region is difficult to fulfill due to restricted facilities fordialysis, lack of renal transplantation in Nepal, and economic constraint in the part ofpatients. Primary and secondary prevention of renal diseases by community education,awareness and participation needs emphasis. Key Words: Haemodialysis, End stage renal disease, Acute renal failure,Acute on chronic renal failure.

scholarly journals Incidence of cutaneous manifestation in patients with end stage renal disease

2017 ◽  
Vol 4 (4) ◽  
pp. 989
Author(s):  
Khileshwar Singh ◽  
Amit Thakur ◽  
Kamlesh Dhruv
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cutaneous Manifestation ◽  
Renal Diseases ◽  
Cutaneous Manifestations ◽  
Stage Renal Disease ◽  
End Stage

Background: Kidney failure as well as renal diseases is the most important health problems affecting the middle and old age population all over the world. They were supposed to be fatal till recently. The objective of this study was to study incidence of cutaneous manifestation in patients with end stage renal disease.Methods: A hospital based cross sectional study was carried out from July 2012 to June 2013 in the Department of General Medicine, Late Baliram Kashyap Memorial Government Medical College, Jagdalpur, Chhattisgarh, India. It was possible to study a total of 50 cases of cutaneous manifestations that are already known cases of end stage renal disease. All patients with skin lesion were evaluated by history, clinical examination (systemic and dermatological), biopsy and other relevant investigations procedure for skin disease during the course of current renal disease and their stay in the hospital.Results: The incidence of cutaneous manifestations among patients with acute renal failure was zero. It was 86% among patients with chronic renal failure. The most common manifestation was pruritus in 14% of cases followed by oral candidiasis in 4% of cases. Next common was scabies in 6% of cases and this was followed by herpes zoster and Tinea cruris in 4% of cases each. Folliculitis was seen in only one case. It was seen that all types of cutaneous manifestations were present only in patients with chronic renal failure, whereas patients of acute renal failure did not show any sort of cutaneous manifestations.Conclusions: Chronic renal failure was observed as the important cause of cutaneous manifestations seen in patients with end stage renal disease. No cases were seen in patients with acute renal failure. Thus, it is important that patients with acute renal failure take proper precautions to avoid cutaneous manifestations up to the extent possible.

Evaluation of Induction Doses of Propofol: Comparison between Endstage Renal Disease and Normal Renal Function Patients

2002 ◽  
Vol 30 (5) ◽  
pp. 584-587 ◽  
Author(s):  
P. Goyal ◽  
G. D. Puri ◽  
C. K. Pandey ◽  
S. Srivastva
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Disease ◽  
Normal Renal Function ◽  
End Stage Renal Disease ◽  
Objective Assessment ◽  
Haemoglobin Concentration ◽  
End Point ◽  
Stage Renal Disease ◽  
End Stage

Anaemia, hypoproteinaemia and acidic pH in renal failure patients can alter the pharmacokinetics and pharmaco-dynamics of anaesthetic agents, resulting in altered dose requirements. We evaluated the induction dose of propofol in adult patients with end-stage renal disease by titrating the hypnotic effect by means of a clinical parameter as well as using a more objective assessment of hypnosis, the Bispectral Index (BIS) monitor. The dose was compared with that for patients with normal renal function. Propofol doses that provided the clinical end-point of hypnosis (syringe drop method), as well as the end-point of a mean (SD) BIS value of 50 (5), were evaluated in 27 end-stage renal disease and 27 normal renal function patients. Propofol was administered at 0.2mg/kg every 15 seconds until these end-points were achieved. End-stage renal disease patients required significantly higher propofol doses to achieve the clinical end-point of hypnosis (1.42 (0.24) mg/kg versus 0.89 (0.2) mg/kg in normal renal function patients, P<0.05 unpaired “t” test). Propofol dose required to achieve a BIS of 50 (5) was also higher in end-stage renal disease patients (2.03 (0.4) mg/kg versus 1.39 (0.43) mg/kg in normal renal function patients, P<0.05). There was a significant negative correlation of propofol dose with preoperative haemoglobin concentration. A hyperdynamic circulation in renal failure patients with anaemia may be responsible for the higher propofol dose requirement in this group.

Serious Renal Disease in Egypt

1995 ◽  
Vol 18 (5) ◽  
pp. 254-260 ◽  
Author(s):  
M.A. Essamie ◽  
A. Soliman ◽  
T.M.S. Fayad ◽  
S. Barsoum ◽  
C.M. Kjellstrand
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Disease ◽  
Diabetic Patients ◽  
Diabetes Mellitus Type Ii ◽  
End Stage Renal Failure ◽  
Common Diagnosis ◽  
Postrenal Failure ◽  
End Stage ◽  
The University

We studied serious renal disease in Egypt by registering all 155 patients coming to the nephrology service at the University of Cairo during a period of 62 days in 1993. The patients presented with severe uremic symptoms. Admission creatinine and urea levels were high, 804 μmol/l and 64 mmol/l. Fifteen percent of the patients died; 115 underwent dialysis. Sixty patients presented with chronic renal failure; 53 with acute renal failure, but 24 of these were later found to have end-stage renal failure. Of 29 patients with true acute renal failure, 11 (38%) had pre-renal failure and 7 (24%) postrenal failure. Twenty-one patients were followed up after transplantation and chronic dialysis, another 17 had nephrotic syndrome, 3 hypertension, and one had asymptomatic urinary abnormalities. The most common specific etiology for chronic end-stage renal failure was diabetes mellitus type II in the older patients; second most common was Schistosoma in the younger ones. Most diabetic patients came from the city. All but one Schistosoma patient came from rural Egypt. In the 22 patients who underwent renal biopsy the most common diagnosis was mesangio capillary glomerulonephritis. The prevalence of acute renal failure, particularly iatrogenic-toxic, is increasing

Acute Renal Failure: The Tip of the Iceberg?

1985 ◽  
Vol 30 (1) ◽  
pp. 19-22
Author(s):  
D. A. Power ◽  
J. Haughney ◽  
A. J. Nicholls ◽  
S. K. Asfar ◽  
J. Engeset ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Severe Disease ◽  
Survival Rates ◽  
Disease Process ◽  
Clinical Severity ◽  
Renal Unit ◽  
Severity Scores ◽  
Stage Renal Disease ◽  
End Stage

This study reports the experience, during a six-year period, of the Aberdeen Renal Unit in the treatment of patients with acute renal failure. The combination of a relatively stable population base and a single regional dialysis centre has allowed the incidence of acute renal failure to be assessed. Approximately 30 patients per million population were dialysed annually for acute renal failure; 69 per cent of these patients (20.5 per million population per year) were dialysed for acute reversible intrinsic renal failure (ARIRF) and mortality in this group was 44 per cent. Patients with more severe disease at the time of presentation to the renal unit, as defined by a clinical severity score, had significantly reduced survival rates. However, it was not possible to predict the outcome in individual cases; ten of 24 patients with clinical severity scores which indicated a poor prognosis survived the period of oliguria and were discharged from hospital. The fact that other renal units dialyse fewer patients per million population per year for ARIRF probably reflects a reluctance to refer patients whose general condition appears poor. As the overall mortality rate reported in this study does not differ significantly from rates reported previously from centres treating a smaller proportion of patients, such decisions may not be correct. It is well known that facilities in Britain for treating patients with end-stage renal disease are inadequate; it now appears likely that some patients who might benefit from acute dialysis are being denied treatment for a potentially reversible disease process.

Pulsatile gonadotropin secretion in pubertal children with chronic renal failure

1989 ◽  
Vol 120 (1) ◽  
pp. 14-19 ◽  
Author(s):  
F. Schaefer ◽  
R. Stanhope ◽  
H. Scheil ◽  
D. Schönberg ◽  
M. A. Preece ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Gonadotropin Secretion ◽  
Pubertal Maturation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Nocturnal Rise

Abstract. We have examined physiological nocturnal secretion of gonadotropins in 6 boys and 2 girls with end-stage renal disease, who had either delayed or disturbed puberty. The 5 patients treated by dialysis had reduced gonadotropin pulsatility for their stage of pubertal maturation, whereas the 3 patients with successful kidney grafts demonstrated a higher nocturnal rise and increased amplitude of gonadotropin pulsatility. It is suggested that the improved gonadotropin pulsatility of transplanted patients is due to their restored renal function.

Clinical-epidemiological study of patients with acute renal failure

2012 ◽  
Vol 6 (2) ◽  
pp. 317
Author(s):  
Luciana Ramalho Rolim ◽  
Natasha Marques Frota ◽  
Natália Gondim De Almeida ◽  
Islene Victor Barbosa ◽  
Elizabeth Mesquita Melo
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Retrospective Study ◽  
Ethics Committee ◽  
Multiple Organ ◽  
Electrolyte Imbalance ◽  
Private Institution ◽  
Epidemiological Profile ◽  
Underlying Diseases

ABSTRACTObjective: to analyze the clinical and epidemiological profile of patients with Acute Renal Failure (ARF). Method: A descriptive, retrospective study with a quantitative approach. The sample consisted of 106 patients with ARF who underwent hemodialysis at a private institution during the year 2009. Data were collected from February to March 2010, from patients' records, after the Research Ethics Committee of the Universidade de Fortaleza has approved the project (Protocol 97/2010, CAAE 0726.0.000.037-10). Results: the majority were male, married and raised in the capital, 40.6% were aged 61 to 80 years. Dyspnea was the prevalent clinical manifestation. The electrolyte imbalance and sepsis stood out as the main causes of ARF and the most frequent underlying diseases were hypertension and diabetes, 66% died, primarily by multiple organ failure, 34% left the hospital, and 69, 4% recovered renal function and 30.6% had chronic renal failure. Conclusion: on the findings, it is convenient to stress the importance of knowing the profile of patients with ARF, with a view to possibilities of monitoring this population and prevention of complications associated with the disease. Descriptors: epidemiology; nursing, acute renal failure.RESUMOObjetivo: analisar o perfil clínico-epidemiológico de pacientes com Insuficiência Renal Aguda (IRA). Método: estudo descritivo, retrospectivo, com abordagem quantitativa. A amostra foi composta por 106 pacientes portadores de IRA, que realizaram tratamento hemodialítico em uma instituição privada, durante o ano de 2009. Os dados foram coletados de fevereiro a março de 2010, a partir dos prontuários dos pacientes. O projeto foi encaminhado ao Comitê de Ética em Pesquisa da Universidade de Fortaleza, aprovado com protocolo no. 97/2010, CAAE 0726.0.000.037-10. Resultados: a maioria era do sexo masculino, casado e procedente da capital; 40,6% estavam na faixa etária de 61 a 80 anos. A dispnéia consistiu na manifestação clínica prevalente. O desequilíbrio hidroeletrolítico e a sepse destacaram-se como as principais causas da IRA e as doenças de base mais citadas foram hipertensão e diabetes; 66% evoluíram para óbito, principalmente por falência de múltiplos órgãos; 34% saíram de alta hospitalar, sendo que 69,4% recuperaram a função renal e 30,6% tornaram-se renais crônicos. Conclusão: diante dos achados, é conveniente ressaltar a importância do conhecimento do perfil do paciente portador de IRA, com vistas a possibilidades de acompanhamento dessa população e prevenção de complicações associadas à doença. Descritores: epidemiologia; enfermagem; insuficiência renal aguda.RESUMENObjetivo: analizar el perfil clínico-epidemiológico de pacientes con Insuficiencia Renal Aguda (IRA). Método: estudio descriptivo, retrospectivo, con abordaje cuantitativo. La muestra fue compuesta por 106 pacientes portadores de IRA, que realizaron tratamiento hemodialítico en una institución privada, durante el año 2009. Los datos fueron recolectados de febrero a marzo de 2010, a partir de los historiales de los pacientes. El proyecto fue encaminado al Comité de Ética en Investigación de la Universidad de Fortaleza, aprobado con el protocolo 97/2010, CAAE 0726.0.000.037-10). Resultados: la mayoría era de sexo masculino, casado y procedente de la capital; 40,6% estaban en la franja de edad de 61 a 80 años. La disnea resultó la manifestación clínica prevalente. El desequilibrio hidroelectrolítico y la sepsis  se destacaron como las principales causas de la IRA y las enfermedades de base más citadas fueron hipertensión y diabetes; 66% evolucionaron para óbito, principalmente por falencia de múltiples órganos; 34% salieron de alta hospitalaria, siendo que 69,4% recuperaron la función renal y el 30,6% se convirtieron en renales crónicos. Conclusión: frente a estos resultados, es conveniente resaltar la importancia del conocimiento del perfil del paciente portador de IRA, con vistas a posibilidades de seguimiento de esta población y prevención de complicaciones asociadas a la enfermedad. Descriptores: epidemiología; enfermería; insuficiencia renal aguda.

Renal therapy techniques

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Replacement Treatment ◽  
Post War ◽  
The 1960S ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Haemodialysis 64Haemo(dia)filtration 68Peritoneal dialysis (PD) 70The first human haemodialysis was performed in 1943 by Willem Kolff in The Netherlands for the treatment of acute renal failure. Following this, haemodialysis was adopted for the treatment of acute renal failure in the immediate post-war years and then for chronic renal failure from the 1960s. Currently haemodialysis is the most common form of replacement treatment for end-stage renal disease (ESRD). Haemodialysis is one method used for treatment of acute renal failure, and ESRD patients will develop critical illness. An understanding of the principles of haemodialysis and how it is carried out is therefore essential....

Effect of Cuscuta chinensis on Renal Function in Ischemia/Reperfusion-Induced Acute Renal Failure Rats

2011 ◽  
Vol 39 (05) ◽  
pp. 889-902 ◽  
Author(s):  
Sun Shin ◽  
Yun Jung Lee ◽  
Eun Ju Kim ◽  
An Sook Lee ◽  
Dae Gill Kang ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Ischemia Reperfusion ◽  
Periodic Acid ◽  
Water Channel ◽  
Free Water ◽  
Tubular Damage ◽  
Waste Products ◽  
Cuscuta Chinensis

The kidneys play a central role in regulating water, ion composition and excretion of metabolic waste products in the urine. Cuscuta chinensis has been known as an important traditional Oriental medicine for the treatment of liver and kidney disorders. Thus, we studied whether an aqueous extract of Cuscuta chinensis (ACC) seeds has an effect on renal function parameters in ischemia/reperfusion-induced acute renal failure (ARF) rats. Administration of 250 mg/kg/day ACC showed that renal functional parameters including urinary excretion rate, osmolality, Na +, K +, Cl -, creatinine clearance, solute-free water reabsorption were significantly recovered in ischemia/reperfusion-induced ARF. Periodic acid Schiff staining showed that administration of ACC improved tubular damage in ischemia/reperfusion-induced ARF. In immunoblot and immunohistological examinations, ischemia/reperfusion-induced ARF decreased the expressions of water channel AQP 2, 3 and sodium potassium pump Na , K -ATPase in the renal medulla. However, administration of ACC markedly incremented AQP 2, 3 and Na , K -ATPase expressions. Therefore, these data indicate that administration of ACC ameliorates regulation of the urine concentration and renal functions in rats with ischemia/reperfusion-induced ARF.

Recovery of Renal Function and the Discontinuation of Dialysis in Patients Treated with Continuous Peritoneal Dialysis

2003 ◽  
Vol 23 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Adam Goldstein ◽  
Alan S. Kliger ◽  
Fredric O. Finkelstein
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
New England ◽  
The United States ◽  
New Haven ◽  
Continuous Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Criteria For Selection

Objective Previous studies have shown that patients with end-stage renal disease (ESRD) treated with continuous peritoneal dialysis (CPD) have better preservation of endogenous renal function than patients treated with hemodialysis (HD). We wondered if this better preservation of endogenous renal function seen with CPD patients translates into the improved likelihood of recovery of endogenous renal function in those patients with potentially reversible causes of renal failure. Methods To evaluate this question, we reviewed the records of all 1200 patients that completed CPD training at a large, freestanding peritoneal dialysis center in New Haven, Connecticut, between 1979 and 1999, and the records of all patients completing CPD training in New England between 1993 and 1998. In New Haven, about half the new patients with ESRD were started on CPD compared to only 15% in New England. We then compared the chances of recovery of renal function in these two cohorts of CPD patients to the chances of recovery of renal function in two groups of HD patients. The first group consisted of all patients that started on HD in New England between 1993 and 1998. The second group consisted of all patients that started HD in our HD unit in New Haven, Connecticut, between 1993 and 1999. The data on the New England patients were provided by the ESRD Network of New England. All patients entered into the present study had to have been on dialysis for a minimum of 3 months, as in the United States Renal Data System database, and had to have recovered sufficient renal function to be able to be maintained off dialysis for a minimum of 30 days. Results 29 of 1200 CPD patients (2.4%) trained in New Haven recovered sufficient renal function to permit the discontinuation of dialysis for a minimum of 30 days. In comparison, only 305 of 19 032 patients (1.6%) managed with HD in New England ( p < 0.05 compared to New Haven CPD patients) and 3 of 430 patients (0.7%) in our HD center ( p < 0.05 compared to New Haven CPD patients) recovered sufficient glomerular filtration rate (GFR) to allow the discontinuation of dialysis for at least 30 days. If only those CPD patients that initiated dialysis between 1993 and 1999 in New Haven were analyzed, 15 of 369 (4.1%) recovered sufficient GFR to allow discontinuation of dialysis for at least 30 days ( p < 0.025 compared to both groups of HD patients). Of the 2924 patients completing CPD training in New England, 60 (2.1%) recovered renal function; this percentage is not significantly different from the percent of HD patients in New England recovering renal function. Conclusion Although the present study is a retrospective study and the actual criteria for selection of CPD and HD therapy are not controlled for, the data raise the question of whether there may be a therapeutic advantage to treating newly diagnosed ESRD patients, that have a potentially reversible cause of renal failure, with CPD.

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