The acute renal failure secondary to shock, trauma, severe infection, poisoning and other causes of hemolysis and acute kidney injury in general, is a syndrome. Its main pathological changes of renal tubular necrosis, clinical oliguria or anuria, accompanied by severe water, electrolyte and metabolic disorders and uremia. In recent years, another normal urine or urine more acute renal failure, which is characterized by normal or urine, but increased day by day azotemia and even uremia, known as non-oliguric acute renal failure.
Acute renal failure, renal failure quickly (a few days to several weeks) continued to decline (azotemia) when the clinical situation, oliguria dispensable.
Classification and aetiology
Acute renal failure (ARF) can be divided into pre-renal, renal and post-renal. And pre-renal causes post-renal, diagnosis and treatment of early and reversible if possible. Some acute renal vascular and tubular interstitial etiology causes, such as malignant hypertension, glomerulonephritis, vasculitis, bacterial infections, drug reactions and metabolic disorders (such as hypercalcemia, hyperlipidemia, hyperuricemia) nephropathy can also be treated. Prerenal azotemia ARF causes account for 50% to 80%, renal hypoperfusion is due to extracellular fluid loss or cardiovascular disease. Post-renal azotemia: about 5% to 10%, urination and urinary tract obstruction is a collection of some of the various reasons. In the etiology of ARF renal failure, often associated with prolonged renal ischemia (hemorrhage, surgery) or kidney toxins. Acute tubulointerstitial nephritis and acute glomerulonephritis can occur ARF. Many patients with ARF may find there are more than one cause, promote and sustain the ARF ARF factors may be different.
Diagnostic criteria
1, The following information is available clinical data to identify Reference: ① has a history of bedwetting? Nocturnal enuresis refers to urine urine during the night the day 1/2, suggesting that the concentrated distal renal tubular dysfunction, is not history more for CRF.
2, Although a variety of image imaging test can detect the size of the kidney, but commonly used for clinical ultrasound B. ARF is often much renal congestion, edema, renal often increases the volume; volume Renal CRF, glomerulosclerosis , tubular atrophy, and interstitial fibrosis, and therefore often is reduced. To this end, the kidney increases more volume in the IRA (renal amyloidosis caused by CRF or early diabetic nephropathy, renal and sometimes large volume, must be identified), and volume reduced renal therefore CRF. However, care must sometimes FRA and FRC early, the patient does not increase or decrease the volume of the kidney, then imaging studies for identification does not help chronic and acute renal failure, but must rely on other controls.
3 Laboratory tests can be used for acute and chronic renal failure is a nail creatinine test identification checks, recent reports have controls creatinine hair. Nails (hair) creatinine tests often only in the kidney imaging test in the differentiation of acute and chronic renal failure without help when (ie the size of the kidney is normal) before application.
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