Renal Failure: An Overview

How do they present

1.     Acumilation of fluid

2.     Reduction in Normal Renal Functions

Accumulation of fluid

 

• Generalized edema

o   Periorbital edema

o   Ascites

o   Ankle edema

• Pulmonary edema

 

Reduction in Normal Renal Functions

·        Uremic Symptoms

o   Nausea

o   Vomiting

o   Loss of apetite

·        In chronic renal failure

o   Anemia

o   Tiredness

o   Tachycardia

·        Hypertensive features

 

Differential Diagnosis

·        Renal Failure

·        Hypovoluemia

 

Immediate Management

·        Maintain an input output chart.

·        Take blood for,

o   Blood urea

o   Serum creatinine

o   Electrolytes

o   Full Blood Count

·        Do a fluid challenge.

·        Give 10 units of insulin along with 50 cc dextrose.

·        Take an ECG – Tall tempted T wawes

 

 How to find out the etiology of Renal Failure?

·        Investigations

   USS Abdomen

   X- Ray KUB

   Renal Biopsy

 

 Renal Failure is of two Types

·        Acute renal failure

·        Chronic renal failure

 

 Causes of Acute Renal Failure

o       Poisoning

• Snake Bites

§     Cobra

§     Viper

§     Hump nosed viper

o         Wasp Bites

o         Leptospirosis

o         Pyelonephritis

o         Bilateral Ureteric Obstruction

o         Heavy Metal Poisoning

o         Organic  compounds – Break Oil

o         Crush Injuries

 

Causes of Chronic Renal Failure

·        Diabetic Nephropathy

·        Persistent Long standing Hypertension

·        Recurrent Pyelonephritis

·        Renal Calculi

 

 

Treatment

·        Dialysis

·        Renal Transplant

·        Dugs

   Erythropoietin

   1 alpha Cholecalciferole

   Phosphate Binders

   Iron Supplements

   Folic acid

·        Management of the underlying Disease/s