Presentation
Ureteral metastasis can be presented with various symptoms such as lumbar or flank pain, urinary obstruction, hematuria, and oliguria or anuria. [karger.com]
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]
Urine output still may be present if overflow (in bladder outlet obstruction) or partial ureteral obstruction is present. A Foley catheter should be inserted as part of the initial evaluation to rule out obstruction below the bladder outlet. [emedicine.medscape.com]
Uremic frost present on the forehead and scalp Kidneys are very important organs of the human body as they carry out many vital functions. [differencebetween.net]
Entire Body System
- Malnutrition
[…] production, seen in dehydration, shock, ↓ blood volume, and CHF; (2) renal, with ↓ GFR due to acute or chronic renal failure; (3) postrenal, due to urinary tract obstruction or perforation with extravasation of urine; ↓ BUN occurs in pregnancy–due to ↑ GFR, malnutrition [medical-dictionary.thefreedictionary.com]
INCREASED UREA:CREATININE RATIO – (Drivers Can use GPS) dehydration/prerenal failure corticosteroids GI haemorrhage protein-rich diet severe catabolic state DECREASED UREA:CREATININE RATIO (I am a SIMPLE SR) severe liver dysfunction intrinsic renal damage malnutrition [lifeinthefastlane.com]
[…] nucleic acid catabolism -evaluates glomerular function (urea synthesized in liver and >90% excreted through kidneys) -more volatile than creatinine; need to use ratio BUN levels -increase with impaired kidney function -declines with liver failure or malnutrition [freezingblue.com]
Jaw & Teeth
- Xerostomia
Signs and symptoms Oliguria or anuria (decreased or absent urine output) Fatigue Asterixis (flapping tremor) Decreased alertness Confusion Pale skin Tachycardia (rapid pulse) Xerostomia (dry mouth) Thirst Edema, anasarca (swelling) Orthostatic blood pressure [ipfs.io]
Asterixis Decreased alertness Confusion Pale skin Tachycardia (rapid pulse) Xerostomia (dry mouth) Thirst Edema(edema, anasarca) (swelling) Orthostatic blood pressure (rises or falls, significantly depending on position) Uremic frost, a condition when [slideshare.net]
Signs and symptoms [ edit ] Oliguria or anuria (decreased or absent urine output) Fatigue Asterixis (flapping tremor) Decreased alertness Confusion Pale skin Tachycardia (rapid pulse) Xerostomia (dry mouth) Thirst Edema, anasarca (swelling) Orthostatic [en.wikipedia.org]
Psychiatrical
- Suggestibility
BUN/Creatinine ratio is decreased, suggestive of: This is rare and seen in: Dietary protein deficiency Severe liver disease Prerenal acute failure = BUN/Creatinine ratio > 20 : 1 Renal acute failure = BUN/Creatinine ratio < 20 : 1 Suggest renal azotemia [labpedia.net]
Disclaimer The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. [globalrph.com]
A history of vomiting, diarrhea, or poor oral intake may suggest pre-renal azotemia. A history of prostatic disease, nephrolithiasis, or pelvic or para-aortic malignancy would suggest obstruction. [renalandurologynews.com]
Urogenital
- Flank Pain
Ureteral metastasis can be presented with various symptoms such as lumbar or flank pain, urinary obstruction, hematuria, and oliguria or anuria. [karger.com]
pain abdominal pain nausea / vomiting anuria suggest complete obstruction oliguria, polyuria, or nocturia may accompany partial obstruction Laboratory BUN/creatinine may be elevated secondary to increased tubular urea resorption check serum K+ for hyperkalemia [anvita.info]
How does Renal Papillary Necrosis present (2) gross hematuria, flank pain 4 causes of Renal Papillary Necrosis 1. Chronic analgesic abuse (phenacetin or aspirin) 2. Diabetes Mellitus 3. Sickle cell trait or disease 4. Acute pyelonephritis [brainscape.com]
pain, concerning for pyelonephritis; colicky pain concern for nephrolithiasis; boggy prostate, urinary hesitancy, anuria, concerning for BPH; smoking history, concerning for bladder cancer; spinal cord trauma, concerning for neurogenic bladder. [statpearls.com]
- Bilateral Flank Pain
Bilateral flank pain in our patient is attributed to pyelonephritis and hydronephrosis (pyonephrosis) caused by a ureteral stone in the left side and ureteral metastasis in the right side. [karger.com]
Neurologic
- Seizure
Some of these are: Pain or urgency with urination Difficulty in urinating Urine that is dark or red blood-tinged Chills and fever if you have an infection Swelling in your ankles or feet Confusion Weakness and fatigue with extreme muscle weakness A seizure [disabilitycasereview.com]
You may become confused, or have a seizure. These are all symptoms of kidney problems. Things You Can Do to Treat Azotemia Symptoms: Prevention of Dehydration: Drink two to three quarts of fluid every 24 hours, unless you are instructed otherwise. [chemocare.com]
[…] sitting and doing nothing Rapid heart rate Lightheaded Decreased urine production and/or having trouble urinating that may or may not be painful Skin turning pale Joints that become inflamed and swollen Nausea and/or vomiting Decreased appetite Dry mouth Seizures [healthool.com]
[…] ankles, and feet (caused by your body holding on to fluid) Drowsiness or feeling very tired Shortness of breath Itching Joint pain, swelling Loss of appetite Confusion Throwing up or feeling like you’re going to Chest pain or pressure Muscle twitching Seizures [webmd.com]
Dialysis Severe hyperkalemia, acidosis not easily controlled by medical treatment, or both Fluid overload not responsive to fluid restriction, diuretics, or both Signs or symptoms of uremia (e.g., pericardial friction rub, asterixis, mental status changes, seizure [enotes.tripod.com]
Workup
Even though such indices are useful but because it is not in the compulsion workup plan demand, these tests are not performed on every patient. [drugsdetails.com]
[…] session the reader should be able to: Identify the most common non-protein nitrogenous substances in serum Describe the influence of diet on serum urea-nitrogen Discuss the use of serum urea-nitrogen, serum creatine, and glomerular filtration rate in the workup [ucsdlabmed.wikidot.com]
Serum
- Creatinine Increased
*A threefold increase in serum creatinine or a serum creatinine level ≥ 4.0mg/dL with an acute rise > 0.5 mg/dL indicates renal failure. †Likewise, anuria for 12 hours indicates renal failure. Figure 1. [jaoa.org]
Decreased BUN/Creatinine ratio <10:1 with increased creatinine level is seen in: Rhabdomyolysis (There is the release of muscle creatinine). Drugs like phenacemide therapy (Will increase the conversion of creatine to creatinine). [labpedia.net]
[…] normal -varies daily -affected by blood in GI tract, protein intake, hydration (dehydration increases BUN) increased in prerenal/postrenal azotemia BUN/creatinine ratio -to differentiate prerenal/postrenal azotemia from renal azotemia -ratio is used [freezingblue.com]
Diagnostic Considerations for azotemia Besides differential diagnosis which is done, it is necessary to monitor and evaluate the causes of increased levels of BUN and creatinine levels. [drugsdetails.com]
- Creatinine Increased
*A threefold increase in serum creatinine or a serum creatinine level ≥ 4.0mg/dL with an acute rise > 0.5 mg/dL indicates renal failure. †Likewise, anuria for 12 hours indicates renal failure. Figure 1. [jaoa.org]
Decreased BUN/Creatinine ratio <10:1 with increased creatinine level is seen in: Rhabdomyolysis (There is the release of muscle creatinine). Drugs like phenacemide therapy (Will increase the conversion of creatine to creatinine). [labpedia.net]
[…] normal -varies daily -affected by blood in GI tract, protein intake, hydration (dehydration increases BUN) increased in prerenal/postrenal azotemia BUN/creatinine ratio -to differentiate prerenal/postrenal azotemia from renal azotemia -ratio is used [freezingblue.com]
Diagnostic Considerations for azotemia Besides differential diagnosis which is done, it is necessary to monitor and evaluate the causes of increased levels of BUN and creatinine levels. [drugsdetails.com]
- Abnormal Renal Function
"Uremia" is the clinical syndrome that occurs as a result of severe azotemia due to abnormal renal function. • Causes: ◦ Reduced glomerular filtration rate: - Reduced renal perfusion (pre-renal azotemia Pre-renal azotemia). - Intrinsic renal disease [researchonline.jcu.edu.au]
"Uremia" is the clinical syndrome that occurs as a result of severe azotemia due to abnormal renal function. [vetstream.com]
[…] or venous thrombosis or obstruction Best Therapy for Acute Renal Failure Prevention of Acute Renal Failure * Identify patients with risk factors Advanced age Abnormal renal function or diabetes Volume depletion Recent vascular surgery Recent trauma * [enotes.tripod.com]
Treatment
Prompt treatment of some causes of azotemia can result in restoration of kidney function; delayed treatment may result in permanent loss of renal function. [ipfs.io]
Treatment The goal of treatment for prerenal azotemia is to restore normal blood flow to the kidneys. Time is of the essence in this treatment, as permanent kidney damage could result from the loss of blood if it continues for too long. [kidneypedia.net]
With this in mind, some of the treatments may include: dialysis (for late-stage progression, and may only be temporary) delivery of the baby in the case of pregnancy early treatment of postrenal azotemia treatment of the underlying condition or disease [healthline.com]
Hundreds of new, full-color photographs and quick reference tables throughout Completely updated drug and treatment guidelines tables [books.google.ro]
Prognosis
Otherwise, predicting prognosis of ARF/AKI from a heterogenous group of patients with renal dysfunction would be problematic. [academic.oup.com]
[…] nitrogen (bun) and creatinine values. urine specific gravity is usually normal. postrenal azotemia, however, can progress to intrinsic renal disease due to increased pressure in the urinary system or due to a sustained decrease in renal blood flow. the prognosis [proprofs.com]
[…] anterograde or retrograde pyelography rarely used Management relieve obstruction, monitor input & output - foley catheter fluid restriction if euvolemic or volume overloaded 1 to 1.5 L/day postobstructive diuresis may occur after relief of obstruction prognosis [anvita.info]
Postrenal ARF Prognosis The rate of recovery is largely determined by the duration and severity of obstructive disease. In general, the extent of recovery is determined within 7 to 14 days after the obstruction has been removed. [healthcommunities.com]
Although another commonly used test, urine microscopy, can be useful in AKI for both diagnosis ( 4 ) and prognosis ( 5 ), it is operator dependent and requires expertise. [cjasn.asnjournals.org]
Etiology
Etiology For each classification of azotemia, there are unique etiologies. Pre-renal azotemia manifests from some insult/injury source before the kidney. [statpearls.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]
@article{Fischer2009AcutePA, title={Acute postrenal azotemia: etiology, clinicopathology, and pathophysiology.}, author={Julia Fischer and India F Lane and Jennifer Stokes}, journal={Compendium}, year={2009}, volume={31 11}, pages={ 520-30, 533; quiz [semanticscholar.org]
Any etiology leading to decreased synthesis of urea. Repeated dialysis. Pregnancy. Decreased BUN/Creatinine ratio <10:1 with increased creatinine level is seen in: Rhabdomyolysis (There is the release of muscle creatinine). [labpedia.net]
General guidelines for differentiating the etiology of acute kidney injury (ie, prerenal vs renal) using laboratory studies. Figure 3. [jaoa.org]
Epidemiology
In this article we highlight the epidemiology, general causes, and evaluation of acute renal failure in adults. [nejm.org]
The RIFLE criteria, however, has allowed for a more systematic approach which is useful in epidemiological and research studies [ 3 ]. [academic.oup.com]
Epidemiology Interestingly, many aspects of the natural history of azotemia remain unclear to this day. [statpearls.com]
(Renal atheroemboli) Introduction Clinical definition acute reduction in glomerular filtration rate (GFR) recall that GFR represents the sum of the filtration rates of nephrons therefore, GFR reflects functioning renal mass Epidemiology risk factors hypertension [medbullets.com]
The RIFLE and AKIN definitions have been shown by several epidemiological studies to be useful in predicting mortality risk in AKI. These definitions do not, however, distinguish between prerenal, postrenal, or intrarenal causes of injury. [nature.com]
Pathophysiology
This edition has been thoroughly revised by world-renowned contributors to reflect recent developments in renal pathophysiology. [books.google.com]
Affiliations PMID: 20180222 Review Acute postrenal azotemia: etiology, clinicopathology, and pathophysiology Julia Fischer et al. Compend Contin Educ Vet. 2009 Nov. [pubmed.ncbi.nlm.nih.gov]
@article{Fischer2009AcutePA, title={Acute postrenal azotemia: etiology, clinicopathology, and pathophysiology.}, author={Julia Fischer and India F Lane and Jennifer Stokes}, journal={Compendium}, year={2009}, volume={31 11}, pages={ 520-30, 533; quiz [semanticscholar.org]
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]
Prevention
[…] and India F Lane and Jennifer Stokes}, journal={Compendium}, year={2009}, volume={31 11}, pages={ 520-30, 533; quiz p. 530 } } Julia Fischer, India F Lane, Jennifer Stokes Published 2009 in Compendium When rupture or obstruction of the urinary tract prevents [semanticscholar.org]
Dense granules (calcium and ATP) Alpha granules(lots of ****) Urea prevents plateletes from degranulating and releasing all this stuff GET: superficial bleeding (platelet bleeding) Tx for uremia induced bleeding Give them DDAVP(desmopresin) -causes the [quizlet.com]
Meticulous attention must be paid to preventing or treating complications of AKI. [renalandurologynews.com]
Following the prescribed treatment plan is essential to prevent more severe kidney damage or loss of life. [medicalnewstoday.com]
(see specific symptoms for management tips that may help to prevent symptoms of kidney problems). [chemocare.com]