Acute Kidney Failure is a sudden reduction in kidney function that results in nitrogenous wastes accumulating in the blood. Chronic renal failure is a Progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic, fluid and electrolyte balance fails resulting in Uremia and Azotemia. Definition, Etiology, Risk Factors, Stages, Clinical Manifestations, Management, Surgical Management, Prevention, Complications. Nursing Management

1. Renal
Failure
Disease
Presented by:-
•Ankita Roy
•Ishita Das

2. Anatomy & Physiology

4. Acute
Renal
Failure

5. Definition
Acute renal failure is a sudden reduction
in kidney function that results in
nitrogenous wastes accumulating in the
blood.

6. Causes
•Pre renal:

7. 1) Dehydration
-Vomiting, diarrhea, water pills, or blood loss.
2) Disruption of blood flow to the kidneys .
-Major surgery with blood loss, severe injury or burns, or
infection in the bloodstream.
-Heart failure or heart attacks causing low blood flow.
-Liver failure causing changes in hormones that affect blood
flow and pressure to the kidney

8. Post Renal:

9. a) Kidney stone: usually only on one side.
b) Cancer of the urinary tract organs or structures near
the urinary tract that may obstruct the outflow of
urine.
c) Medications.
d) Bladder stone.
e) Benign prostate hyperplasia
f) Blood clot.
g) Bladder cancer.

10. Renal Damage or Intrarenal

11. 1. Blood vessel diseases
2. Blood clot in a vessel in the kidneys
3. Injury to kidney tissue and cells

12. •Glomerulonephritis
e.g., Streptococcal bacterial infections may damage the glomeruli.
•Acute interstitial nephritis
 Medications such as antibiotics, anti-inflammatory medicines (for
example, aspirin, brufen), and water pills .

13. Acute tubular necrosis

14. Acute tubular necrosis
 Causes include shock (decreased blood supply to the kidneys),
drugs (especially antibiotics) and chemotherapy agents, toxins
and poisons, and dyes used in certain kinds of x-rays.
 Accidents, injuries
 complications from surgeries (e g . Heart-bypass surgery)
 Polycystic kidney.

16. Risk Factors
• Advanced age
• Blockages in the blood vessels in your arms or legs
• Diabetes
• High blood pressure
• Heart failure
• Kidney diseases
• Liver disease

17. Phases
• Initiation
• Oliguria
• Diuresis
• Recovery

18. Symptoms
• Vomiting and/or diarrhea, which may lead to dehydration
• Nausea
• Weight loss
• Pale urine
• Haematuria
• Pressure, or difficulty urinating
• Bone damage
• Muscle paralysis
• Low blood pressure
• Pain in the back or side

19. Diagnosis
 History collection.
 Kidney ,Ureter, bladder X ray.
 Serum creatinine and BUN level .(n 7-18mg/dl)
 Serum electrolytes.
 Urine analysis.
 Renal bladder ultra sound.
 Renal scan.
 CT scans and MRI scan (to identify lesion and masses)
 Biopsy

20. Management
Medical and pharmacological treatment
 Correcting fluid and electrolyte
 Correct dehydration
 Dialysis
 Cation exchange resins or Kayexalate
 IV dextrose50% , insulin and calcium replacement .
Nutritional therapy
 Provide protein diet
 Foods and fluid containing potassium or phosphorous are restricted
 Patient may require parenteral nutrition

21. Prevention
 Hydration
 Close monitoring
 Blood administration
 Infections
 Toxic drug effects

22. Nursing Management
 Monitoring fluid and electrolyte balance
 Reduce metabolic rate
 Prevent infection
 Provide psychological support
 Improve nutritional intake

23. Chronic
Renal
Failure

24. Definition
CRF or ESRD is a progressive, irreversible deterioration in
renal function in which the body’s ability to maintain
metabolic, fluid and electrolyte balance fails resulting in
Uremia and Azotemia.

25. Etiology & Risk Factors
Diabetes Mellitus
Hypertension
Pyelonephritis
UTI
Nephrotoxic Agents
Decreased renal blood flow
Environmental and occupational agents
•Lead
•Cadnium
•Mercury
•Chromium

26. Stages
1. Reduced renal reserve
 BUN is high or normal
 Client has no C/M
 40 to 75 % loss of nephrons
function

27. 2. Renal Insufficiency
 75 to 90 % loss of nephrons
function
 Impaired urine
concentration
 Nocturia, mild anemia,
increased creatinine and
BUN

28. 3. Renal failure
 Severe Azotemia
 Impaired urine dilution
 Severe anemia
 Electrolyte Imbalances

29. 4. ESRD (End stage renal disease)
 10 percentage nephrons
functioning
 Multisystem dysfunction

30. Clinical Manifestations
• Increased blood urea and serum creatinine level
• Fluid overload, edema
• Weight gain
• Reduction in urine output
• Anemia
• Demineralization of bones
• Nausea, vomiting, anorexia

31. Management
Medical and Pharmacologic therapy:
 Calcium and phosphorus binders
 Antihypertensive and cardiovascular agents
 Anti-seizure agents
 Erythropoietin

32. Nutritional therapy
 Dietary intervention includes careful
regulation of protein intake, fluid
intake to balance fluid losses, sodium
intake to balance sodium losses, and
some restriction of potassium.
Dialysis
 Dialysis is usually initiated if the
patient cannot maintain a reasonable
lifestyle with conservative treatment.

33. Surgical Management
KIDNEY
TRANSPLANTATION:
A kidney transplant is often the
treatment of choice for kidney
failure, compared with a lifetime
on dialysis. A kidney
transplant can treat chronic
kidney disease or end-stage renal
disease to help you feel better
and live longer.

34. Complications
 Hyperkalemia
 Hypertension
 Anemia
 Bone disease

35. Prevention
• Controlling blood pressure
• Regular exercise
• Avoid smoking
• Avoid on-set of diabetes
• Regular annual checkups

36. Nursing Management
• Assessing fluid status and identifying potential
sources of imbalance
• Implementing a dietary program to ensure proper
nutritional intake
• Promoting positive feelings by encouraging
increased self care and greater independence
• Provide explanations and information to the patient
and family concerning ESRD
• Provide emotional support to the patient and family

37. Conclusion
In this presentation we have discussed about two types of
renal failure: Acute and Chronic Renal Failure. Their causes,
clinical manifestations, risk factors, phases & stages. We
hope through this presentation we have let everyone to know
a thing or two about the kidney failure and how fatal it can be
if not treated.

38. Thank
You