Acute Renal Failure Acute Failure - amazonia.fiocruz.br

Opinion, actual: Acute Renal Failure Acute Failure

Acute Renal Failure Acute Failure Video

Acute renal failure is a clinical syndrome characterized FFailure an abrupt increase of serum creatinine and blood urea nitrogen BUN concentrations to above normal azotemia. An inability to regulate solute and water balance is often present and renal synthetic and degratory functions are impaired to varying degrees. The term "acute renal failure" is commonly used to connote acute intrinsic renal failure, but it is important to consider all possible causes, including pre-renal, intrinsic primary renal, and post-renal.

The finding of acute renal failure is not a specific diagnosis. Oliguria, normal urine production, or polyuria can all occur depending on the specific cause and severity of renal injury sustained during AIRF. The frequency of underlying conditions associated with AIRF varies with the nature of the veterinary practice. The aggressive use of potentially nephrotoxic antibiotics, particularly the aminoglycosides, can contributes to nephrotoxic AIRF. The exposure to cholecalciferol rodenticides, indiscriminate use of non-steroidal anti-inflammatory drugs NSAIDand exposure of veterinary patients to extensive surgical procedures and aggressive post-traumatic resuscitative maneuvers https://amazonia.fiocruz.br/scdp/essay/essay-writing-format-cbse-class-12/what-do-you-understand-by-globalization.php emergency patients can result in AIRF.

Ischemic and nephrotoxic AIRF occur more readily in patients that have underlying chronic renal disease or renal failure. Exposure to nephrotoxins or ischemia causes tubular injury exhibited microscopically along a spectrum from degeneration to necrosis, and is referred to as Acute Renal Failure Acute Failure or acute tubular necrosis ATN. Some patients, however, exhibit minimal or no light microscopic lesions yet exhibit severe renal excretory failure.

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Factors that can contribute to azotemia and or oliguria during AIRF include tubular backleak, intraluminal and extraluminal tubular obstruction, and primary filtration failure afferent arteriolar vasoconstriction, efferent arteriolar vasodilatation, and or a decrease in glomerular permeability. This is particularly helpful to document AIRF in the absence of recent serum biochemistry values for comparison.

For example, a patient's serum creatinine of 4. Serum creatinine and BUN do not increase over this short a time period in hydrated patients with chronic renal failure.

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Hyperphosphatemia may be out of proportion to the degree of increase in BUN or serum creatinine in those with acute renal failure compared to chronic renal failure. The magnitude of elevation in BUN or serum creatinine concentrations is not generally helpful in the diagnosis of AIRF vs CRF or in the differentiation of pre-renal, intrinsic renal, or post-renal azotemia. Dipstrips may show proteinuria, hematuria or glucosuria Renl occasion. Urinary sediment is typically "active" at early stages of the maintenance phase exhibiting increased numbers of casts particularly cellular casts and small epithelial cells compatible with renal tubular epithelium.

Animals with AIRF should have smooth kidneys with normal or increased kidney size Acute Renal Failure Acute Failure those with chronic renal failure may show small and or irregular kidneys both on palpation and abdominal radiographs.

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Renal ultrasonography can provide additional anatomic information to confirm intrarenal lesions, but cannot be relied on to distinguish acute from chronic renal failure or to suggest a specific microscopic lesion. Failure to document ultrasonographic renal changes does not exclude a diagnosis of AIRF.

Kidneys may enlarge during AIRF but this may not be detected if they are still within the normal range for kidney size; kidneys tend to become "plump" before they measure elongated. Renal biopsy may be helpful to determine that an azotemia is due to primary renal lesions and to characterize the changes as acute or chronic.

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Urine culture can be helpful in selected cases to evaluate for upper or lower urinary tract infection. The attending veterinarian and client often have greater expectations for immediate improvement following treatment than is realistic, remembering that the maintenance phase of AIRF can last weeks in some cases before adequate renal repair and function can occur.

The most likely causes for death during the initial management of the AIRF patient in the maintenance phase are from the effects of hyperkalemia, metabolic acidosis, and severe azotemia. Overhydration and resulting pulmonary edema are the next major causes of death during vigorous fluid therapy. Animals with AIRF that remain oliguric following intravevous rehydration fluids are much more likely to die or to be Acute Renal Failure Acute Failure but non-oliguria does not guarantee survival either.]