MS. DEEPLATA SAHU, acute renal failure

1. Acute renal failure
Presented by: Deeplata Sahu
Msc Nursing 1st year
Era’s college of nursing
Era university
lucknow

2. INTRODUCTION
RENAL FAILURE RESULTS WHEN THE KIDNEYS CANNOT REMOVE THE BODY’S
METABOLIC WASTES OR PERFORM THEIR REGULATORY FUNCTIONS.
ACUTE RENAL FAILURE (ARF) IS A RAPID LOSS OF RENAL FUNCTION DUE TO
DAMAGE TO THE KIDNEYS.
ACUTE RENAL FAILURE IS ALSO KNOWN TODAY AS ACUTE KIDNEY INJURY
(AKI)
A HEALTHY ADULT EATING A NORMAL DIET NEEDS A MINIMUM DAILY URINE
OUTPUT OF APPROXIMATELY 400 ML TO EXCRETE THE BODY’S WASTE
PRODUCTS THROUGH THE KIDNEYS. AN AMOUNT LOWER THAN THIS INDICATES
A DECREASED GFR.

3. DEFINITION
“ACUTE RENAL FAILURE IS THE SUDDEN &
COMPLETE LOSS OF THE ABILITY OF THE
KIDNEY TO REMOVE WASTE & CONCENTRATE
URINE WITHOUT LOSING ELECTROLYTES.”

4. ANATOMYAND PHYSIOLOGY OF KIDNEY

5. CLASSIFICATIONS
Prerenal
Intrarenal
Postrenal

6. PHASES OFACUTE RENAL FAILURE
Initiation
Oliguria
Diuresis
Recovery

7. RISK FACTORS
Kidney disease
Liver disease
Diabetes, especially if it’s not well controlled
High blood pressure
Heart failure
Morbid obesity

8. ETIOLOGICAL FACTORS
THE CAUSES OF A RF DEPEND ON ITS CATEGORIES: PRERENAL,
INTRARENAL, AND POSTRENAL.
 Prerenal: examples of prerenal causes are volume depletion,
impaired cardiac efficiency, and vasodilation.
 Intrarenal: examples of intrarenal causes are prolonged renal
ischemia, nephrotoxic agents, and infectious processes.
 Postrenal: an example of postrenal cause is urinary tract
obstruction.

9. PATHOPHYSIOLOGY

10. CLINICAL MANIFESTATIONS
 OLIGURIA
 LETHARGY: Since waste products cannot be filtered, it slowly
accumulates in the different parts of the body.
 DRYNESS: The skin and mucous membrane are dry from dehydration.
 CENTRAL NERVOUS SYSTEM SYMPTOMS: This include
drowsiness, headache, muscle twitching, and seizures.
 INCREASED CREATININE: All phases of ARF exhibit an increase in
creatinine.
 CENTRAL NERVOUS SYSTEM SIGNS AND SYMPTOMS: Include
drowsiness, headache, muscle twitching, and seizures.

11. PREVENTION:
HYDRATION: Provide adequate hydration to patients at risk for dehydration.
SHOCK: Prevent and treat shock promptly with blood and fluid replacement.
CLOSE MONITORING: Monitor central venous and arterial pressures and
hourly urine output of critically ill patients to detect the onset of renal failure
as early as possible.
BLOOD ADMINISTRATION: Take precautions to ensure that the appropriate
blood is administered to the correct patient in order to avoid severe
transfusion reactions.
INFECTIONS: Prevent and treat infections promptly because they can
produce progressive renal damage.
TOXIC DRUG EFFECTS: To prevent toxic drug effects, closely monitor
dosage, duration of use, and blood levels of all medications metabolized or
excreted by the kidneys.

12. COMPLICATIONS
 METABOLIC ACIDOSIS:
Waste products could not be eliminated by the kidneys and
they can contribute to metabolic acidosis.
 FLUID AND EL ECTROLYTE IMBALANCES:
Imbalances may occur due to haemorrhage, renal losses, and
gastrointestinal losses.

13. ASSESSMENT AND
DIAGNOSTIC FINDINGS

14. MEDICAL MANAGEMENT

15. PHARMACOLOGIC THERAPY
• ANTIBIOTICS: To prevent or treat infections.
• DIURETICS (WATER PILLS): Quickly increase urine
output. Examples include: lasix (furosemide), bumex
(bumetanide)
• OTHER MEDICATIONS: To get rid of extra fluid and
prevent electrolyte imbalances.

16. NUTRITIONAL THERAPY

17. NURSING MANAGEMENT

18. RESEARCH INPUT
Conducted by M. Nagarathnam, vishnubotla sivakumar, and S. A. A. Latheef and
published on august 2019.
Aim:
This study aims to comparatively evaluate the burden, coping mechanisms, and
quality of life (QOL) among caregivers of haemodialysis (HD) and peritoneal
dialysis (PD) undergoing and renal transplant patients.
Setting and design:
Tertiary care hospital, cross-sectional and descriptive study.
Subjects and methods:
Burden, coping mechanisms, and QOL in caregivers of HD and PD undergoing and
RT patients were investigated using zarit burden interview, revised ways of coping
and short-form 36 in 30 each caregivers of HD and PD undergoing and RT patients.

19. RESULTS:
Moderate to severe burden, mild to moderate burden, and no
burden were observed in the majority of caregivers of HD and
PD undergoing and RT patients. Significantly higher mean
burden score in caregivers of HD undergoing than RT patients
(P < 0.01); accepting responsibility in caregivers of RT than
PD undergoing patients; social functioning in caregivers of HD
than PD undergoing patients; and general health in caregivers
of RT than HD undergoing patients, was observed. Lower
physical component was common in each group, whereas
accepting responsibility in HD, self-controlling in PD, and age
and escape avoidance in RT were found to be the specific
predictors of the burden score.

21. CONCLUSION