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The three stages of acute renal failure

Apr 26, 2017

This article introduction: the onset of acute renal failure quickly, even in a few hours will occur, causing renal function in patients with severe damage or loss.

Symptom of acute renal failure can be pided into three phases, each phase of the symptoms are different.

Acute renal failure is due to severe kidney damage or loss due to a variety of causes.

It can quickly appear, and even a few hours, oliguria and urine can quickly appear, urine output per hour is less than 17 m1, daily urine output is less than 400 m1 oliguria, urine output per hour is less than 4 m1, less than 100 ml of urine for no urine every day.

Main show is oliguria or anuria, nitrogen qualitative hematic disease, hyperkalemia and metabolic acidosis.

Depending on the etiology and their pathological physiology characteristic, cause kidney before sex can be pided into such as bleeding, shock, severe water and electrolyte balance disorder, such as acute circulatory failure, kidney sex such as acute glomerulonephritis, acute tubular necrosis, massive crush injury, etc.

After the kidney sex such as complete urinary tract obstruction.

With acute tubular necrosis are the most common, is also the most characteristic, sustainable development and sex before kidney failure will be transformed into acute tubular necrosis.

Acute renal failure can be pided into three periods

A, oliguria stage

(1) most of the pioneers in 12 to 24 hours after symptoms begin to appear less urine (50-400 ml) of urine daily or no urine.

Lasts 2-4 weeks.

(2) can have anorexia, nausea, vomiting, diarrhea, hiccups, irritation, dizziness, headache, anemia, bleeding tendency, breathing deep and fast, even coma, convulsions.

(3) the accumulation of metabolites: elevated blood urea nitrogen, creatinine, etc.

Metabolic acidosis.

(4) electrolyte disorder, can have high potassium, low serum sodium, high blood magnesium, high phosphorus and low blood calcium and so on.

Especially hyperkalemia.

Severe cases can lead to cardiac arrest.

(5) water balance disorders, easy to produce too much water storage to slip;

Serious cause heart failure, pulmonary edema and brain edema.

6 Yi Jifa respiratory and urinary tract infections.

Second, the polyuria period

Oliguria urine volume increased gradually, after when the daily urine output more than 500 ml, namely into the urine.

Since then, the urine amount multiplied on a daily basis, the highest daily 3000-6000 ml of urine, and even can reach more than 10000 ml.

In urine period initial, urine volume is increasing, but the renal clearance is still low, the accumulation of metabolites in the body is still exist.

About four to five days later, blood urea nitrogen, creatinine, etc gradually decreases with increase of urine, and the symptoms of uremia is better.

Electrolytes such as potassium, sodium and chloride from urine in large discharge can cause electrolyte disorders or dehydration, oliguria stage should pay attention to the peak stage may shift to hypokalemia.

This period for 1-3 weeks.

Third, convalescence

Urine gradually returned to normal, kidney function recover 3-12 months, the majority of patients renal function can be recovered to normal level, only a minority of patients with chronic renal failure.

The clinical features of acute renal failure, kidney function quickly (for days to weeks) continues to decline (nitrogen mass disease) in clinical situation, oliguria dispensable.

Acute renal failure (ARF) can be pided into before the kidney, renal after sex and sex.

Renal before and after the STD because if treated early, it is possible to reverse;

Some cause acute glomerular vascular and renal tubular interstitial nephropathy venereal disease, such as malignant hypertension, glomerulonephritis, vasculitis, bacterial infection, drug reactions and metabolic diseases (such as hypercalcemia, high uric acid hematic disease), also can be treated.

Kidney sex before nitrogen qualitative hematic disease accounted for about 50% ~ 80% of the ARF causes;

Due to the extracellular fluid is the cause of renal hypoperfusion lost or cardiovascular disease.

After renal sexual nitrogen qualitative hematic disease accounts for about 5% ~ 10%.

Urinary tract micturition and collection of all sorts of obstruction is the cause.

Renal intrinsic causes of ARF and kidney ischemia (bleeding, surgery) for a long time or renal toxins.

Acute tubular interstitial nephritis and acute glomerulonephritis also can appear ARF.

Daily matters needing attention in patients with acute renal failure

Acute renal failure patients should pay attention to usual care, maintaining the patient complete rest in bed, quiet, to reduce the burden of the kidney, lower extremity edema patients raise the lower extremities and disabilities extra bed guardrail of consciousness, coma in coma patients with routine nursing.

When urine volume increased, get better, can gradually increase activity, with patients don't feel tired.

Skin and oral care, pay attention to personal hygiene, keep the skin clean.

To lie in bed and frail patients, should be regularly turn, prevent pressure sores and lung infection.

Strengthen oral care.

The body is the capital of revolution, found that the body is wrong, please check to the hospital as soon as possible, so as not to miss the best treatment time.

Colleagues, cooperate with the doctor treatment optimism in the face of disease, believe that will be helpful to your illness.


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