Kidney failure divided into acute renal failure and chronic renal failure, acute renal together today we see pathology.
Oliguria (urine output <500 ml / d) due to the decrease in glomerular filtration rate and sodium and water reabsorption, is a type of hypovolemia normal reaction cycle.
Bladder outflow obstruction may be an adult urine suddenly interrupted (often completely) the most common cause, which causes include benign prostatic hyperplasia, prostate or cervical cancer and retroperitoneal disease. If azotemia, certainly had bilateral urinary tract exit or only one functional kidney patients with unilateral obstruction of urine flow. Less common causes of urinary cavity has bilateral kidney stones, papillary necrosis, blood clotting and bladder cancer; extraluminal retroperitoneal fibrosis causes such as cancer, colorectal cancer and other malignant transformation. Because it can be a collection of urinary tract obstruction and congenital urinary system
Reduce the incidence of renal filtration mechanisms include decreased renal blood flow, decreased glomerular permeability, interstitial cells and cause swelling of the wreckage resulting cell renal tubular obstruction or blockage, and the filtrate diffuses through the glomeruli damaged tubular epithelium renalLa interdependence of these factors, but not all of these factors for each patient, but are different in different patients, and sometimes in the same patient is different. The importance of these factors strongly suggest acute tubular necrosis originally referred to the basic abnormality is inappropriate.
Endothelin is a reduction in renal blood flow and renal GFR potent vasoconstrictor, vascular which is very sensitive. The anti-endothelin receptor antagonists, or endothelin antibodies can protect the kidney against ischemic ARF.
Tubular and changes according to the severity of the damage, interstitial edema and inflammation, but is always present ischemia, proximal tubule cells often form one side of the chamber cavity membrane structure disappears brush border , cell polarity and goes closely between interconnected cells rupture. SEM examination revealed that although the overall structure of blood vessels remain intact but glomerular epithelial cells normally swelling.
Any cause of IRA usually accompanied by hypocalcemia, hyperphosphatemia and secondary hyperparathyroidism. These phenomena in the pathophysiology of damaged kidneys produce temporary reduction calcitriol and phosphorus retention. Myoglobinuria caused ARF in patients with hypocalcemia may seem obvious, apparently due to deposition of calcium in muscle necrosis, decreased production of calcitriol and parathyroid hormone bone (PTH) is no resistance in the United effects. The recovery process in the ARF, with the kidneys produce calcitriol increases, increasing bone response to PTH and calcium deposition removed from tissue damage can be complicated by hypercalcemia ..
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