Renal Failure

Introduction

Introduction Renal failure is a pathological condition in which part or all of kidney function is lost. According to the rapid onset of the attack, it is divided into acute and chronic. Acute renal failure is caused by a variety of diseases, causing the two kidneys to lose excretory function in a short time, referred to as acute renal failure. Chronic renal failure is a syndrome that consists of a group of clinical symptoms that arise from the development of chronic kidney disease caused by various causes to the advanced stage. Chronic renal failure is divided into 4 stages according to the degree of renal dysfunction: 1 kidney storage function decreased, the patient was asymptomatic. 2 renal insufficiency compensation period. 3 renal decompensation (nitrogenemia), patients with fatigue, loss of appetite and anemia. 4 uremia stage, there are symptoms of uremia.

Cause

Cause

For renal ischemia and renal poisoning, various factors causing pre-renal azotemia continue to cause renal ischemia and hypoxia; various nephrotoxic substances such as drugs, bacterial endotoxin, heavy metal poisons and biological toxicity Can cause disease in the kidneys. In addition, mistype of blood transfusion and drugs can cause acute intravascular hemolysis, crush injury, burns and severe myopathy, which can cause acute tubular necrosis and acute renal failure due to hemoglobin and myoglobin occluding the renal tubules. The pathogenesis of acute renal failure remains unclear, and the theory of acute tubular injury cannot be satisfactorily explained. In recent years, intrarenal hemodynamic changes caused by vasoconstrictor release disorder and calcium influx and oxygen free radicals in acute renal failure have been considered. It plays an important role in the pathogenesis.

Examine

an examination

Related inspection

Renal function test urine routine renal blood flow erythrocyte acetylcholinesterase

According to the history of chronic kidney disease, relevant clinical manifestations and urine and blood biochemical tests can be diagnosed. B-mode ultrasound and serum creatinine assays are available.

Diagnosis

Differential diagnosis

To be differentiated from hemolytic uremic syndrome, this disease is one of the common causes of acute renal failure in children. It is a syndrome characterized by hemolytic anemia, thrombocytopenia and acute renal failure.

Acute renal failure (ARF) refers to a clinical syndrome characterized by a sharp decline in renal function caused by various causes, resulting in a series of metabolite retention, water and electrolytes, and acid-base balance disorders.

It is currently accepted that the diagnostic criteria for ARF are: a progressive decline in glomerular filtration function over a period of days to weeks, and a daily increase in serum creatinine of 44-88 umol/L (0.5-1.0 mg/dl). Clinically, in the case of any patient with azotemia who is progressively aggravated, before the diagnosis of ARF, it is necessary to first rule out chronic renal failure and certain causes of chronic renal insufficiency to cause a sharp deterioration of renal function. The situation is different for ABF and chronic renal failure with unclear medical history. At this time, B-mode ultrasound examination of kidney size (especially renal cortical thickness) and serum creatinine (which can reflect 3-4 months before blood creatinine level) will be very good help. Kidney enlargement or normal, normal nail creatinine is acute renal failure, kidneys shrink or normal, and nail creatinine levels are elevated, it is chronic renal failure. In addition, abnormal calcium and phosphorus metabolism, anemia degree, etc. are also available for reference.

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