12.04.2018 · 👁 2,546
Acute renal failure: what is important to know
Acute renal failure (ARF) - a condition characterized by suddenly developing azotemia, changes in water-salt balance and acid-base balance. These changes are the result of acute severe damage to the blood flow in the kidneys, glomerular filtration, and tubular reabsorption. There are prerenal (“prerenal”), renal (renal) and postrenal (“postrenal”) ARF. The first type includes acute renal failure, which develops with a sharp drop in blood pressure (shock, cardiogenic shock during myocardial infarction), severe dehydration. Renal acute renal failure is caused by toxic effects (sublimate, lead, carbon tetrachloride, aniline, gasoline, antifreeze), toxic-allergic reactions (antibiotics, administration of radiocontrast agents, sulfonamides, pitrofurans, salicylates), acute kidney diseases (glomerulonephritis, pyelonephritis). Postrenal acute renal failure develops when the ureters are blocked by a stone, tumor, or acute urinary retention (prostate adenoma, bladder tumor, etc.). Frequent causes of acute renal failure are obstetric pathology (septic abortion, pathological), prolonged crush syndrome, diseases of the heart and great vessels (myocardial infarction, dissecting aortic aneurysm).
Symptoms and course of acute renal failure
There are 4 periods: the stage of initial action of the cause that caused acute renal failure, oligoanuric (sharp decrease in the amount of urine and its complete absence), the stage of restoration of urine output (diuresis) and recovery. In the first period, there may be an increase in temperature, chills, a drop in pressure, a decrease in hemoglobin levels, and hemolytic jaundice with sepsis associated with out-of-hospital abortion. The second period - a sharp decrease or complete cessation of diuresis - occurs after exposure to the causative factor. The level of nitrogenous waste in the blood increases, nausea and vomiting appear, and coma (unconsciousness) may develop. Due to the retention of sodium and water ions in the body, various edema (lungs, brain) and ascites (fluid accumulation in the abdominal cavity) are possible. After 2-3 weeks, diuresis is gradually restored. The amount of urine during this period can exceed 2 liters per day. After 3-4 weeks, the level of nitrogenous waste in the blood decreases and a recovery period of 6-12 months begins.
Recognition of acute renal failure - clinical picture, study of diuresis, level of nitrogenous wastes in the blood, level of electrolytes and acid-base balance of the blood.
Treatment of acute renal failure. Mandatory hospitalization. Methods of extrarenal blood purification can be used (hemodialysis - “artificial kidney”, peritoneal dialysis, hemosorption). A diet with a sharp restriction of protein (15-20 g per day), a large amount of carbohydrates, fruits and vegetables. Conservative therapy is possible: administration of polyglucin, rheopolyglucin, albumin solutions, calcium gluconate, diuretics, sodium bicarbonate solution.
For questions, you can contact us by phone +(998 71) 140-03-03, +(998 71) 140-01-60 and at Chilanzar, 12th block, st. M. Shaykhzoda, no. 7.