Presentation
ARF due to other causes as partial obstruction may present as polyuria. ARF due to postrenal obstruction may present as anuria. Diagnosis Renal failure is manifested by the rise of serum creatinine. [doctorslounge.com]
Physical findings Asterixis and myoclonus Pericardial or pleural rub Peripheral edema (if volume overload is present) Pulmonary rales (if volume overload is present) Elevated right atrial pressure (if volume overload is present) TABLE 1 Key Symptoms [aafp.org]
If the kidney concentration is impaired and the patient can achieve a specific gravity of only 1.010, oliguria is present at urine volumes <1000–1500 mL/day. [accessmedicine.mhmedical.com]
Consider, for example, a patient who presents with pneumonia and an abnormal creatinine level. Assume for this example that the patient’s baseline creatinine is 1.0 mg/dl and he presents with a creatinine of 1.3 mg/dl. [clinicaladvisor.com]
A renal biopsy may reveal the specific underlying disease, but crescent formation in >50% of glomeruli is usually present. [unboundmedicine.com]
Entire Body System
- Acutely Ill Patient
Avoidance of nephrotoxic drugs and iodinated contrast agents in these patients reduces the risk of them developing AKI. All acutely ill patients in hospital should be closely monitored for signs of developing AKI. [patient.info]
However, Bouchard et al demonstrated that fluid accumulation in critically ill patients with acute illness is associated with increased mortality, and is not associated with recovery of renal function42. [ncbi.nlm.nih.gov]
[…] of acute kidney injury in critically-ill patients.. [anesthesiology.pubs.asahq.org]
Oliguria as predictive biomarker of acute kidney injury in critically ill patients. [ccforum.biomedcentral.com]
Respiratoric
- Kussmaul Respiration
Rapid respiration Answer: D – Clients with metabolic acidosis caused by acute renal failure may develop kussmaul’s respiration (rapid, large tidal volume breaths) because the lungs is trying to regulate carbon dioxide. [empowern.com]
Liver, Gall & Pancreas
- Jaundice
The most severe form of Leptospirosis, characterized by jaundice, acute kidney injury and haemorrhagic diathesis, is referred as Weil's disease. [elsevier.es]
Skin
- Sweating
Last Update: 2012-04-12 Usage Frequency: 2 Quality: Danish nyreinsufficiens nyresvigt, akut nyresvigt, oliguri, renal tubulær nekrose, toksisk neuropati, vandladningsproblemer, symptomer fra blære og urinveje English pruritus, rash, alopecias, acne, sweating [mymemory.translated.net]
This can happen when you sweat a lot on a hot day or have a stomach bug that causes diarrhea or vomiting. [verywellhealth.com]
Religiously measure gastrointestinal losses and estimate insensible losses (sweating), including wound drainage, nasogastric outputs, and diarrhea .Decrease in output (to less than 400 ml per 24 hours) may indicate acute failure, especially in high-risk [nurseslabs.com]
Disease Acute renal failure (ARF) is a relatively common disease with an incidence of 2.000—3.000 million inhabitants, especially older people and also toddlers can dehydrate quickly when experiencing acute water loss (e.g., due to infections or heavy sweating [lecturio.com]
- Dermatitis
04-12 Usage Frequency: 2 Quality: Danish nyreinsufficiens nyresvigt, akut nyresvigt, oliguri, renal tubulær nekrose, toksisk neuropati, vandladningsproblemer, symptomer fra blære og urinveje English pruritus, rash, alopecias, acne, sweating increased dermatitis [mymemory.translated.net]
Workup
Acute kidney injury 2016: diagnosis and diagnostic workup. Crit Care. 2016;20(1):299. doi: 10.1186/s13054-016-1478-z. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 35. [ncbi.nlm.nih.gov]
Acute kidney injury 2016: diagnosis and diagnostic workup. Crit Care. 2016;20(1):299. [PubMed] 7. Muriithi A, Nasr S, Leung N. Utility of urine eosinophils in the diagnosis of acute interstitial nephritis. [emcrit.org]
Serum
- Potassium Increased
Hyperkalemia Potassium increases 0.5 mmol/l/day during anuria. Hyperkalemia is particularly serious with additional cell disintegration (tumor lysis, hemolysis, rhabdomyolysis). [urology-textbook.com]
Treatment
Treatment Of Oliguria Oliguria does not have a single treatment recommendation. Being a symptom rather than a disease, it calls for treatment appropriate to whatever is causing it. [kidneypedia.net]
If your kidneys fail, you need treatment to replace the work they normally do. The treatment options are dialysis or a kidney transplant. Each treatment has benefits and drawbacks. [icdlist.com]
Removal of nephrotoxins, rapid treatment of the triggering factors, and attention to cardiac output and mean arterial pressure remain the cornerstones of the prevention and treatment of AKI in ICU. [oxfordmedicine.com]
Treatment Treatment of acute renal failure usually should be conservative and largely supportive. It requires careful and precise management. All patients will require close monitoring, many of them within intensive care settings. [doctorslounge.com]
Patients with sepsis, or with a severe heart insufficiency, often require intensive care treatments. [lecturio.com]
Prognosis
Prognosis The prognosis for those suffering from oliguria depends on what is causing the symptom but in most cases is quite good, provided the acute condition is promptly and properly treated. [kidneypedia.net]
CONCLUSIONS: Lactate is an objective parameter that can predict prognosis and contributes to a better management of acute kidney injury in hemodialysis patients. [ncbi.nlm.nih.gov]
Indicators of poor prognosis include older age, multiple organ failure, oliguria, hypotension, number of transfusions and acute on chronic kidney disease. Prognosis is closely related to the underlying cause. [patient.info]
Anemia can also frequently occur and the prognosis depends on the underlying cause. Treatment for chronic renal failure generally includes restricting the patient’s water and protein intake and the usage of diuretics. [availclinical.com]
Etiology
Principal causes of oliguric acute kidney injury in neonates The etiology of oliguria varies with age, and the common causes in neonates and children are listed separately. [emedicine.medscape.com]
(look at etiology) Prognosis lower rates of recovery in patients > 65 years of age increased risk of end-stage renal disease, chronic kidney disease, and mortality Presentation Symptoms may be asymptomatic oliguria anuria polyuria confusion Physical [medbullets.com]
While they may help in the diagnosis and management of very specific etiologies like hepatorenal syndrome, most of the time a fluid challenge or diuresis will be the diagnostic and therapeutic tests of choice. JAMA. 1976 Aug 9;236(6):579-81. [medicine-matters.blogs.hopkinsmedicine.org]
The principal etiologies of acute kidney injury while in hemodialysis were sepsis (39.2%), and severe dehydration (10.8%). [ncbi.nlm.nih.gov]
Epidemiology
In this article we highlight the epidemiology, general causes, and evaluation of acute renal failure in adults. [nejm.org]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Epidemiology/Prognosis Numerous studies have indicated that AKI is common, is increasing in incidence and is associated with considerable morbidity and mortality. [clinicaladvisor.com]
In 2013, Rhone et al 62 evaluated the epidemiology and impact of nephrotoxic medication exposure in 107 very low birth weight (VLBW) infants. [pediatrics.aappublications.org]
Acute kidney injury: epidemiology and diagnostic criteria. Curr Opin Crit Care. 2006; 12: 531-537. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG. Acute Kidney Injury Network. [austinpublishinggroup.com]
Pathophysiology
In the past five decades, several important causes of acute renal failure and the pathophysiologic mechanisms that underlie renal dysfunction have come to be understood. [nejm.org]
Etiology and Pathophysiology of Acute Renal Insult Causes of Acute Renal Insult Because of various pathophysiologic processes, kidney function can diminish rapidly. [lecturio.com]
While some studies have demonstrated that isolated oliguria without a concomitant increase in serum creatinine is associated with higher mortality rates, different underlying pathophysiological mechanisms suggest varied clinical importance of reduced [ncbi.nlm.nih.gov]
The most common trigger in ICU patients is sepsis—the pathophysiology of septic AKI is poorly understood and probably involves intrarenal haemodynamic and inflammatory processes. [oxfordmedicine.com]
You are here: Urology Textbook > Kidneys > Renal insufficiency > Acute renal injury Acute kidney injury – acute renal failure (1/2): causes, pathophysiology and symptoms Acute kidney injury – acute renal failure (2/2): Diagnosis and treatment Review literature [urology-textbook.com]
Prevention
Administering fluids in the setting of radiocontrast exposure may prevent development of AKI. [ncbi.nlm.nih.gov]
Meticulous attention must be paid to preventing or treating complications of AKI. [renalandurologynews.com]
Dialysis is a great treatment for 1 and 2 and prevents 4. Careful conservative management can prevent 1-3 and delay 4, allowing recovery to occur. [edrep.org]
Prevention of post procedural acute kidney injury in the catheterization laboratory in a real-world population. Int J Cardiol. 2016 Oct 11. 226:42-47. [Medline]. Briguori C. [emedicine.medscape.com]