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The Pathophysiology Of Acute Renal Failure
- 3. ACUTE RENAL FAILURE The glomerular filtration rate is reduced, Sudden retention of endogenous and exogenous metabolites (urea, potassium, phosphate, sulfate, creatinine, administered drugs), The urine volume is usually low (under 400 mL/day).
- 4. Prerenal Failure Arrhythmias Antihypertensive Drugs Cardiac Tamponade Sepsis Cardiogenic Shock Arterial Embolism Heart Failure Arterial Or Venous Thrombosis Myocardial Infarction Tumor Burns Disseminated Intravascular Coagulation Dehydration Eclampsia Diuretic Overuse Malignant Hypertension Hemorrhage Vasculitis. Hypovolemic Shock Trauma
- 5. Intrarenal Failure Poorly Treated Prerenal Failure Malignant Nephrosclerosis Nephrotoxins Papillary Necrosis Obstetric Complications Polyarteritis Nodosa Crush Injuries Renal Myeloma Myopathy Sickle Cell Disease Transfusion Reaction Systemic Lupus Erythematosus Acute Glomerulonephritis Vasculitis. Acute Interstitial Nephritis Acute Pyelonephritis Bilateral Renal Vein Thrombosis
- 6. Postrenal Failure Bladder Obstruction Ureteral Obstruction Urethral Obstruction
- 9. Prerenal Failure Prerenal failure blood flow to the kidneys leads to hypoperfusion. Azotemia consequence of renal hypoperfusion excess nitrogenous waste products in the blood develops in 40% to 80% of all cases of acute renal failure. Renal blood flow is interrupted oxygen delivery hypoxemia and ischemia damage the kidney. Glomerular filtration rate (GFR) electrolyte imbalance and metabolic acidosis Tubular reabsorption of sodium and water
- 10. Intrarenal Failure Intrinsic or parenchymal renal failure damage to the filtering structures of the kidneys Causes of intrarenal failure are classified as nephrotoxic, inflammatory, or ischemic. Nephrotoxicity or inflammation the delicate layer under the epithelium irreparably damaged. Severe or prolonged lack of blood flow by ischemia renal damage (ischemic parenchymal injury) + excess nitrogen in the blood (intrinsic renal azotemia). The fluid loss hypotension ischemia ischemic tissue toxic oxygen-free radicals cause swelling, injury, necrosis. The necrosis caused by nephrotoxins tends to be uniform and limited to the proximal tubules, whereas ischemia necrosis tends to be patchy and distributed along various parts of the nephron.
- 11. Postrenal Failure Bilateral obstruction of urine outflow (the bladder, ureters, or urethra) postrenal failure Bladder obstruction anticholinergic drugs, autonomic nerve dysfunction, Infection, tumors. Ureteral obstructions blood clots, Calculi, edema or inflammation, necrotic renal papillae, retroperitoneal fibrosis or hemorrhage, surgery, tumor or uric acid crystals. Urethral obstruction prostatic hyperplasia, tumor, or strictures.