Signs and related loss of excretory function symptoms, according to the degree of renal failure, renal failure rates and the causes and different. ARF itself produjó in the community of patients, showed that only cola colored urine, followed by Little or no urine, Patients with ARF usually some Recent trauma, surgery or medical event, suspension Signs and Symptoms compatible with esta event.
Urine output is maintained at 1 ~ 2.4 L / Common d, oliguria, anuria caused bilateral renal artery occlusion, obstructive urinary tract disease, acute renal cortical necrosis or rapidly progressive glomerulonephritis.
Prerenal azotemia occurs in other diseases caused by reduced renal perfusion. Renal artery disease may be asymptomatic, although partially occluded sometimes the smell and noise.
If not found prerenal causes, look for the reasons of post-renal azotemia. Difficulty urinating or urinary thinner history, kidneys and bladder or palpable enlargement tips urethra or bladder neck obstruction.
Renal disease that results in acute tubular injury can be divided into three. Prodromal period depends on virulence factors (such as the amount of toxin ingested, the duration and extent of hypotension) .Oliguria average is 10 to 14 days, but can vary from 1 to 2 days at 6 to 8 weeks. Urine is generally 50 ~ 400 ml / d, but many patients never oliguria. Mortality of non-oliguric patients, morbidity and the need for dialysis were lower. Elevated serum creatinine, typically 1 ~ 2 mg / (dl.d) (90 ~ 180μmol / L), elevated blood urea nitrogen 10 ~ 20 mg / dl (3.6 ~ 7.1 mmol / L) .but when the blood urea nitrogen as an early indicator of renal function may be misleading, since in surgery, trauma, burns, transfusion reactions or gastrointestinal bleeding caused by or in vivo when protein catabolism, blood urea nitrogen often can be greater. A late oliguria, urine output gradually returned to normal, but serum creatinine and blood urea nitrogen may be a few days before the fall. Renal tubular dysfunction may persist, expressed as sodium loss, polyuria (urine output may be large) and antidiuretic hormone metabolic acidosis chloride respond or high.
Signs edema, nephrotic syndrome, and retinal arteritis or skin may suggest glomerulonephritis, but often no history of kidney disease inch. Hemoptysis or Goodpasture's syndrome, Wegener granulomatosis advice eruptions caused nodosa and systemic lupus erythematosus. Medication history, and skin rash or purple tips tubule interstitial nephritis and drug allergies.
Start of
Patients often suffer from this period are known causes of ATN, eg hypotension, ischemia, sepsis and renal toxins. However, significant renal parenchymal damage has not yet occurred. At this stage of acute renal failure can be prevented. But with the injury of renal tubular epithelium apparent sudden drop TFG, the clinical manifestations of acute renal failure syndrome is evident, then enter the maintenance phase.
Maintenance phase
Typically 7-14 days but may be as low as a few days time 4-6 weeks. Glomerular filtration rate remained at a low level. Many patients can oliguria, but some patients may not oliguria, urine output at 400 ~ 500 ml / day or more. No oliguric acute renal failure pathophysiology is currently unclear, but regardless of whether the reduced amount of urine, with renal dysfunction, a series of clinical manifestations of uremia.
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