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Renal failure kidney failure pathology mbbs
- 1. PRE-RENAL CAUSES RENAL FAILURE SiddhikSharma, 112, MBBS 1 Year st
- 2. RENAL FAILURE Abrupt deteriorationin kidney function Manifested by increase in: Serum creatinine levels Oliguria Rapid fall in GFR Azotemia
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- 4. RENAL FUNCTIONS Waste products excretion: -Nitrogenouscompounds -Creatinine -Urea Steady electrolyte levels Regulate water levels
- 5. PRE RENAL Not relatedto damage or issue in kidney itself Majorly due to fall in Glomerular Filtration Rate Can be due to: Hypovolemia Reduced cardiac output Decreased effective Circulatory volume Pre renal Renal Post renal
- 6. PRE RENAL CAUSES ABSOLUTE LOSSOF FLUID RELATIVE LOSS OF FLUID RENAL ARTERY Major hemorrhage Vomiting Diarrhoea Severe burns Distributive shock Congestive heart failure Renal artery stenosis Embolus
- 7. GFR falls RAAS Sodium andwater reabsorption Urea reabsorption along with it Blood urea levels rise Blood urea : creatinine > 20 (normal range 5-20:1)
- 8. CREATININE A significant risein serum creatinine levels is observed Reason? It is only filtered no reabsorption or secretion in renal tubules occur. Thus, fall in GFR results in decreased excretion of creatinine thus rise in serum creatinine levels Jeffe’s reaction is used to test the serum creatinine levels (normal range- males 0.7-1.4 mg/dl females 0.6-1.2 mg/dl)
- 9. FINDINGS Serum Urine Creatinine rise Urearise Sodium rise High concentration (>500mosm/kg) Sodium low Water low
- 10. TREATMENT Treatment is donebased on cause 1.Hypovolemia IV fluids Blood transfusion 2. Vasodilation Vasopressers like norepinephrin IV fluids in early sepsis
- 11. 3. Renal arterystenosis Angioplasty Stenting 4. Drug induced ACE inhibitors discontinued NSAIDs Discontinue
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