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ACUTE RENAL FAILURE

Non-Modifiable Risk Factor Advanced Age

Modifiable Risk Factor: Atherosclerosis Heart Disorders Low Blood Pressure Kidney Disorders

Prerenal Causes: Hypotension Hypovolemia (Shock) Decreased cardiac output Dehydration Hepatorenal syndrome Liver failure Atheroembolic disease Renal vein thrombosis Nephrotic syndrome Obstetrical Complications Diabetes type I and type II

Intrarenal Causes: Nephrotoxic episodes Infection Systemic inflammation Injured red blood cells Hemolytic blood transfusion reactions Glomerular diseases (systemic lupus, glomerulonephritits) Rhabdomylolysis Pancreatitis Hypercalcemia

Postrenal Causes: Medication that interferes with normal bladder emptying. Benign prostatic hypertrophy (BPH) Prostate cancer Ovarian cancer Obstruction of a urinary catheter Renal calculi Bladder/pelvic neoplasms Urethral strictures Spinal disease

Constriction of urethra

Obstruction in urine flow

oliguria

Fluid accumulation and retention in the bladder

Bladder distension

Urine backflow to the Kidneys

Damage of cells in the tubules

Trauma to the bladder

GFR

Pain in the Lower abdomen

Filtrate components are not filtered Cell necrosis and ischemia

Blood filtrates are excreted

hematuria

blood volume

Creatinine, urea, uric acid retained and backflow to system

serum Creatinine and BUN

Nausea, Vomiting, bitter taste

uremia ANEMIA Edema esp. in lower extremities

Mr. Oriented is a 66-year-old male and was diagnosed having Benign Prostate Hyperplasia. Prostate enlargement obstructs the urine flow out of the bladder. Excretion then is impaired. Oliguria is present. As urine accumulates in the bladder, fluid retention and abdominal distention occur. Pain is present in the lower midline abdomen. Bladder cannot accommodate urine volume. Urine moves back ward going to the kidney causing the tubular cells to slough and blocks the membrane. GFR decreases. As it decreases, nitrogeneous waste are retained and while blood components are excreted. Increase nitrogeneous waste will cause increase serum BUN and Creatinine. Blood urea will cause nausea, vomiting, anemia, and when severe seizure and pruritus. Blood components that cross the semi permeable membrane will be excreted and hematuria will manifest. There will be increase in fluid volume due to impaired urinary elimination. Third spacing may occur.