RENAL FAILURE

RENAL FAILURE

DEFINATION

  • it is the impairment of renal function over days or week which often results in increase plasma urea , creatinine , and oliguria.
  • it may be reversible or irreversible.
  • if it is reversible than it is called as acute renal failure.
  • if it is irreversible than it is called as chronic renal failure.

CLASSIFICATION

  • ACUTE RENAL FAILURE
  • CHRONIC RENAL FAILURE

ACUTE RENAL FAILURE

  • FUNCTIONALLY – Decrease GFR , Decrease urine output , Increase Nitrogenous waste.
  • STRUCTURALLY – Cell death due to necrosis/apoptosis , Loss of adhesion in intrinsic renal cell.

CAUSES OF ACUTE RENAL FAILURE

PRE-RENAL

  • Due to Sudden decrease in blood pressure.
  • flow obstruction to kidney
  • due to Atherosclerosis

INTRA-RENAL

  • Due to direct damage
  • inflammation
  • infection
  • drug
  • Autoimmune disease

POST-RENAL

  • Mainly Include obstruction of urine flow
  • Benign prostatic hyperplasia
  • Kidney stone
  • Bladder injury or tumor.

INTRA-RENAL CAUSES

A) Acute Glomerular Nephritis

  • Inflammation of glomerulus
  • it is due to Autoimmune condition such as systemic lupus erythromatosis

B) Acute Tubular Necrosis

  • Necrosis of proximal convoluted tube
  • 50% of acute renal cases due to this condition

C) Acute Interstitial Nephritis

  • Mostly due to Allergy & Infection

D) Post renal + prerenal cause Intrarenal cause

  • Vascular changes – decrease GFR , Endothelial dysfunction , Vasoconstriction in Afferent arteriole , Increase Adhesion of inflammatory cells such as neutrophils and it may produce Agg. and Inflammation.
  • Tubular changes – Cell loss + Damage Cell due to Necrosis -> Necrotic body cause obstruction in tube and is results the Filtration the back leak .(Back leak of urine ).

CHRONIC RENAL FAILURE

CAUSES

  • Acute renal causes
  • Hypertension
  • Diabetes type 1 & 2
  • Other kidney Disease such as polycystic ovarian disease.

MECHANISM

HYPERTENSION

DIABETES

Diabetic nephropathy

1) Mesangial cell expansion and cell proliferation

2) Podocytopathy -podocyte hypertrophy and atrophy

3) GBM Thickening

4) Sclerosis

SIGN AND SYMPTOMS

  • Decreased urine output, although occasionally urine output remains normal
  • Fluid retention, causing swelling in your legs, ankles or feet
  • Shortness of breath
  • Fatigue
  • Confusion
  • Nausea
  • Weakness
  • Irregular heartbeat
  • Chest pain or pressure
  • Seizures or coma in severe cases

RISK FACTOR

  • Diabetes
  • High blood pressure
  • Heart and blood vessel (cardiovascular) disease
  • Smoking
  • Obesity
  • Being African-American, Native American or Asian-American
  • Family history of kidney disease
  • Abnormal kidney structure
  • Older age

COMPLICATION

  • Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
  • A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart’s ability to function and may be life-threatening
  • Heart and blood vessel (cardiovascular) disease
  • Weak bones and an increased risk of bone fractures
  • Anemia
  • Decreased sex drive, erectile dysfunction or reduced fertility
  • Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
  • Decreased immune response, which makes you more vulnerable to infection
  • Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
  • Pregnancy complications that carry risks for the mother and the developing fetus
  • Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

DIAGNOSIS AND INVESTIGATION

  • Blood tests Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
  • Urine tests Analyzing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
  • Imaging tests Your doctor may use ultrasound to assess your kidneys’ structure and size. Other imaging tests may be used in some cases.
  • Removing a sample of kidney tissue for testing Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that’s inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what’s causing your kidney problem.

HOMOEOPATHIC THERAPEUTICS

  • Renal calculi – berb. vulgaris
  • Nephritis – Apis.
  • Cystitis – clematis erecta , cantharis
  • UTI – Cantharis
  • Urine retention – Caust. , Nux-v , Hell.
  • Nocturnal enuresis – Puls.

Leave a Comment

Your email address will not be published. Required fields are marked *