Synonyms the broadest sense
Acute renal failure
sudden kidney failure
Damage to blood vessels in the kidneys (z. B. vasculitis)
Toxins and more.
It often occurs after severe trauma, surgery, shock or sepsis (med. Deadline for blood infection). As part of a multi-organ failure, has a particularly poor prognosis.
Figure: flat part of the right kidney ahead
renal cortex – renal cortex
Marrow (consisting of
renal pyramids) – kidney medulla
Niernversagen acute dialysis with a frequency of approximately 30 patients / million inhabitants / year occurs, acute renal failure not on dialysis also occurs frequently.
Especially in the context of multiple organ failure (failure of several internal organs at the same time), there are cases increase, particularly in septic patients (patients = toxemia MIIT) with systemic (= the body of the respective infection ) infection (systemic inflammatory response syndrome – SIRS).
prerenal acute renal failure is usually caused by severe hypovolemia (z. B. by bleeding / blood loss) or in an accident. If all its aspect emphasized in the context of multiple organ failure, often septic patients (blood infection by microbes seedlings) are affected. Other causes include acute circulatory disorders such as arterial embolism, venous thrombosis (blood clots) by coagulation, therefore, the vessel or aneurysm occlusive diseases (circumscribes a blood vessel expansion).
Symptoms depend on the particular cause. This can be insidious as acute renal failure is recognized immediately.It depends Limited (oliguria) or diuresis (anuria) and subsequent complications such as acidosis (acidosis), hyperkalemia (potassium increase in the blood) existing, etc. The advantage of laboratory values can comorbidities liver, heart or kidneys are limited, and diuretics (drugs to stimulate renal function (diuresis)).
Acute renal failure caused by glomerular acute (rapidly progressive glomerulonephritis) and interstitial lung disease (interstitial nephritis) (see kidney).
Moreover, toxins or vasculitis may be based (vasculitis). Especially in the latter disease should as soon as possible, and a sample of kidney tissue (renal biopsy) for diagnostic evaluation.In this case group, it includes hemolytic uremic syndrome (HUS) and acute rejection of kidney transplants.
The symptoms are varied and often include here signs of systemic disease, such as:
or anemia (anemia).
kidney postrenal acute barriers flow caused by errors in the urinary tract. (See, for example, changes in prostate prostate). In this case, the obstacle can be both inside the urethra and compressed from the outside.
Do not worry (mycelium) pain in the urinary system. The exact cause can know ultrasound.
The amount of urine can not be often used to diagnose because the symptoms oliguria (low urine output), as mentioned above, may not be present.
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give crucial evidence blood tests (especially focusing on laboratory values such as urea, creatinine, blood gases, acid-base status) and. urinalysis
An examination of the urine in red precipitated cells (erythrocytes) and proteins (called proteinuria.) Must necessarily do! This allows the location of the damage to determine what further action is of great importance.
Learn more about: kidney values
The cause is still uncertain renal biopsy should be considered.
Other conditions that can lead to similar causes,
acute deterioration of renal function associated with chronic renal failure
acute bacterial nephritis
Treatment of renal failure
If an existing acute renal failure have assured the diagnosis, the most urgent measure is the immediate enlargement of the cause of loss is (bleeding, fluid loss through the gastrointestinal tract, burns, etc.) .
adequate caloric intake (Being respected and, in particular glucose), particularly in existing dialysis should too.
Drugs that have now removed because it can be dangerous, and the loop of dopamine and osmotic diuretics (permeability of drugs).
Since the body can tolerate hydration now limited, the administration of hypertonic solutions necessary infusion (of fat intake).
In laboratory values and clinical signs of corresponding renal replacement therapy, it is essential. This should be taken as a rule in the following characters:
Hyperkalemia (6.5 mmol / l) = high potassium levels in the blood
Urea> 180-200 mg / dl
Creatinine> 8 mg / dl
Urämiesymptome as pericarditis (pericarditis), nausea, encephalopathy (brain poisoning)
Pulmonary edema, fluid overload treatable
severe hyperphosphatemia (phosphate in the blood is too high), particularly with concomitant hypercalcemia (calcium in the blood is too high)
As forms of renal replacement therapy Hemodialysis / dialysis, hemofiltration and hemodiafiltration are available.
As part of a parent who has more information about organ failure (such as multiple organ failure), acute renal failure (AVN) is still a high mortality rate (> 75%) .The, real is linked only in the kidney, the prognosis is very good. The transition to chronic renal failure is rare.
If urine output is obtained, the prognosis is more favorable. In cases of acute renal failure, such as circulatory disorders or phase during toxins can occur:
Oliguria / anuria (little or no urine production)
Polyuria (excessive urination)
Normalizing the renal function
The distance between each part is variable over time.
Acute renal failure (AVN), but can be fraught with many complications.
The balance of water and electrolytes (potassium, calcium) and the acid-base body by depleting urine production very upset balance. fluid overload by edema and hypertension (high blood pressure) occurs.
In this context, it is particularly dangerous the “liquid medium”, ie, shortness of breath. With water (interstitial edema) in the lungs, which can not be seen on the X-ray
Below you can hyperkalemia (excessive potassium – blood) set, and take it as an emergency, because they can form very quickly. favors and cause serious arrhythmias from the values of 7 mmol / l – is regulated by metabolic acidosis (acidification secretion by the kidneys due to a lack of H +).
In addition, it can lead to stomach ulcers (gastric ulcer) and duodenal ulcer (duodenal ulcer) and associated bleeding.