Renal Failure Overview

Study Notes

Renal failure is a significant loss of kidney function, where less than 10-20% of normal glomerular filtration rate (GFR) remains.
It can be acute (rapid onset, potentially reversible) or chronic (slow progression, permanent).
Chronic renal failure results from progressive kidney damage and loss of function, often categorized into stages based on GFR loss.

Dysfunction can be glomerular or tubular.
Glomerular damage affects filtration, leading to reduced GFR and retention of substances normally cleared.
Tubular damage affects reabsorption, resulting in large volumes of dilute urine and electrolyte/nutrient loss.

Neurological: Weakness, fatigue, confusion, seizures, and sleep disturbances.
Integumentary: Gray-bronze skin, dry/flaky skin, uremic frost, itching, bruising.
Cardiovascular: Hypertension, edema, pericarditis, enlarged neck veins.
Hematological: Anemia, bleeding tendency, thrombocytopenia.
Pulmonary: Crackles, thick sputum, shortness of breath.
Gastrointestinal: Ammonia breath, metallic taste, nausea, vomiting, and constipation.

Treatment objectives include early detection, hypertension control, blood glucose control, treatment of other causes, and prevention of complications.
Non-pharmacological treatment includes general health advice, avoiding nephrotoxins, strict fluid control, and maintaining electrolyte balance.
Pharmacological treatment involves various medications to control electrolytes, hypertension, anemia, etc.
Medical treatment may include dialysis and transplant.

Characterized by sudden onset and a significant, frequently reversible reduction in renal function.
Causes include prerenal failure (decreased perfusion), intrarenal failure (renal damage), and postrenal failure (obstruction after filtration).
Key signs and symptoms often include oliguria (low urine output).
Specific types of intrarenal failure include ischaemic acute tubular necrosis and nephrotoxic acute renal failure.

Comprehensive assessment, including patient history, vital signs, neurological signs and symptoms.
Fluid balance monitoring, proper fluid management, and dietary limitations.
Medication monitoring (especially insulin), and management of secondary complications.

Infectious disease caused by Clostridium tetani spores.
Spores are found in soil, dust, and animal feces.
Transmission is through contamination of wounds, such as puncture wounds, burns, and other breaks in the skin.
Symptoms include difficulty opening mouth, muscle spasms, and general stiffness.

Chronic multisystem disease related to abnormal insulin production or impaired insulin utilization.
Types: Type 1 (autoimmune destruction of beta cells), Type 2 (insulin resistance), gestational.
Key symptoms can include excessive thirst, frequent urination, increased appetite.
Diagnosis is based on fasting or postprandial blood glucose measurement (or A1c levels), testing for ketones.

Dangerous complication of diabetes, indicated by high blood glucose, ketosis, acidosis and dehydration.
Causes include, but are not limited to interruptions in treatment or missed insulin doses, undiagnosed diabetes or other stressors.
Manifestations of severe dehydration, electrolyte imbalance, abdominal pain, fruity breath, and altered mental status.