Renal Failure

Renal Failure
Causes and Management
Definition of Terms

 Renal Failure- abnormal kidney function in which the

kidneys are unable to adequately excrete toxic substances
from the body.
 Acute (sudden) kidney failure is the sudden loss of
the ability of the kidneys to remove waste and concentrate
urine without losing electrolytes
 Chronic renal failure (ESRD) is the progressive,
irreversible deterioration in renal function in which the
body’s ability to maintain metabolic and fluid and
electrolyte balance fails.
 Septic shock-shock caused by bacteria. Severe
systemic infection
 Acute Tubular Necrosis-acute damage to the renal
tubules usually due to ischemia associated with shock.
 Acute Nephrotic Syndrome-condition that seriously
damages the glomerular capillary membrane and results in
increased glomerular permeability to plasma protein
 Septicemia-presence of pathogenic bacteria in the
blood.
 Dialysis-process of diffusing blood across a semi-
permeable membrane to remove toxic materials and to
maintain fluid, electrolytes and acid base balance.
 Glomerulonephritis-inflammation of the glomerular
capillaries
 Scleroderma-sclerosis of the skin and certain organs
like GIT, lungs, heart and kidneys
 Hemolytic Uremic Syndrome-An acute condition
consisting of microangiopathic hemolytic anemia,
thrombocytopenia and acute nephropathy
 Placenta abruption-premature separation of placenta
 Placenta previa-low lying placenta/implanted in the
lower uterine segment
 Hyperkalemia-excessive amount of potassium in the
blood
 Diabetes Mellitus-disorder of carbohydrates
metabolism, characterized by hyperglycemia and glycosuria
and resulting from inadequate production or utilization of
insulin
 
Causes of Renal Failure

There are many possible causes of Acute Kidney Failure. They

include:
 Decreased blood flow, which may occur with extremely low
blood pressure caused by trauma, surgery, serious illnesses,
septic shock, hemorrhage, burns, or dehydration
 Acute tubular necrosis (ATN)
 Infections that directly injury the kidney such as acute
pyelonephritis or septicemia
 Urinary tract obstruction (obstructive uropathy)
 Autoimmune kidney disease such as interstitial nephritis or
acute nephritic syndrome
 Disorders that cause clotting within the thin blood vessels of
the kidney
 Transfusion reaction
 Malignant hypertension
 Scleroderma,
 Hemolytic-uremic syndrome
 Disorders of childbirth, such as bleeding placenta
abruptio or placenta previa
Causes of Chronic Renal failure
 
 High blood pressure
 Urinary Tract Obstruction
 Glomerulonephritis
 Diabetes Mellitus
 Kidney abnormalities such as polycystic kidney disease.
Treatment and Management
 Once the cause is found, the goal of treatment is to
restore kidney function and prevent fluid and waste from
building up in the body while the kidneys heal. Usually, you
have to stay overnight in the hospital for treatment.
The amount of liquid you eat (such as soup) or drink
will be limited to the amount of urine you can produce. You
will be told what you may and may not eat to reduce the
build-up of toxins normally handled by the kidneys. This diet
may be high in carbohydrates and low in protein, salt, and
potassium.
You may need antibiotics to treat or prevent
infection. Diuretics ("water pills") may be used to help the
kidneys lose fluid.
l
It will be very important to avoid dangerous
hyperkalemia (increased blood potassium levels) by using
IV (intravenous) calcium, glucose/insulin, or potassium
exchange resin (Kayexalate).
Dialysis may be needed, and can make you feel
better. It is not always necessary, but it can save your life if
your serum potassium is dangerously high. Dialysis will also
be used if your mental status changes, your potassium level
starts to rise, you stop urinating, develop pericarditis,
become overloaded with fluid, or cannot eliminate nitrogen
waste products from your body.
 The need for dialysis may be acute or chronic

Acute Dialysis is indicated when there is a high and

increasing level of serum potassium, fluid over load, severe
confusion, pericarditis. It may also be used to remove
certain medications or other toxins from the blood.
Chronic Dialysis or maintenance dialysis is for ESRD.

Types of Dialysis
Hemodialysis – most common method. It is used for patients
who are acutely ill and require short term dialysis and for
pts with ESRD who require long term or permanent
theraphy.
For patients with CRF, this method prevents death,
although it does not cure renal disease and doe not
compensate for the loss of endocrine and metabolic
 Peritoneal Dialysis- may be the treatment of choice for
patients with renal failure who are unable or unwilling to
undergo hemodialysis or renal transplantation.
Thank You and Good Day

 Presentor
Charina L. Pou
IV-Modesty