Renal Failure:

Definition:

Kidney fails due to any dysfunction of normal renal function.

Types of Renal Failure:

Acute Renal Failure (ARF):

Definition:

It is an acute, severe, short timing duration of kidney disfunctioning in which kidney unable to remove the body metabolic waste products.

Etiology:

Pre_renal cause:

  1. Hemorrhage
  2. Loss of fluid
  3. Heart failure
  4. Myocardial infarction
  5. Anaphylactic shock
  6. Hypo_volumia Intra_renal cause:
  7. Renal ischemia
  8. Acute glomerulonephritis
  9. Pyelonephritis
  10. Kidney infection
  11. NSAIDS
  12. Heavy metal poison Post_renal cause:
  13. Renal tumor
  14. Benign, Prostate hyperplasia
  15. Ureter structure

Clinical features:

  1. Excessive Nitrogen in blood
  2. Dry skin
  3. Drowsiness
  4. Headache
  5. Seizures
  6. Blood in urine
  7. Creatinine level (elevated)
  8. Oliguria
  9. Hyperkalamia

Complications:

  1. Cardiac arrest
  2. Dysrhythmia
  3. Anemia
  4. Shock
  5. Hyperkalamia
  6. Dehydration
  7. Hiccough

Medical management

  1. diurectics
  2. tab:Lasix BD
  3. Chlorothiazide 500mg IV 8-12 hours
  4. Calcium carbonate in case of Hypo-calacimia
  5. Magnesium compound should not be given (Diarrhea)
  6. Aluminum chloride for correction of acidosis
  7. IV maintains
  8. ACE inhibitor

Investigations:

  1. KUB X-ray
  2. Urine DR
  3. CBC
  4. Urinanalysis
  5. CT scan
  6. MRI
  7. Renal ultrasound
  8. Pyelogram

Surgical Management:

  1. Dialysis
  2. Haemodylasis
  3. Peritoneal dialysis
  4. Renal replacement therapy

Nursing Management:

  1. Maintaining fluid & electrolyte balance
  2. Maintains of nutritional status
  3. Restricted for protein
  4. Maintain bed rest in acute case
  5. Prevent from injury, provide bed rails
  6. Avoid source of infection
  7. Identification of preventive environment or health factors contributing to the illness such as: hypertension & Nephrotoxic drugs.

2.. Chronic Renal Failure (CRF):

Definition:

Chronic Renal Failure involves progressive, irreversible destruction of the nephron in both kidneys. The disease process progress until most nephrons are destroyed & replaced by nonfunctional scar tissue.

Etiology:

Glomeruler dysfunction:

  1. Glomerulonephritis
  2. Diabetic Nephropathy
  3. Hypertensive Nephrosclerosis

Systemic disease:

  1. Sickle cell anemia
  2. Scleroderma
  3. Polyarteritis nodosa Urinary tract obstruction:
  4. Prostatic & bladder tumor
  5. Lymphodenopathy
  6. Calculi

Others:

  1. Chronic Pyelonephritis
  2. Nephritic Syndrome
  3. Renal infarction Clinical features:
  4. Hypertension
  5. Fatigue
  6. Pain
  7. Metabolic acidosis
  8. Pulmonary edema
  9. Anorexia
  10. Nausea
  11. Vomiting
  12. Diarrhea
  13. Lethargy
  14. Joint pain
  15. Pruitis Complication:
  16. CCF Investigation:
  17. ECG
  18. EEG
  19. BUN X-ray Medical Management:
  20. Anti-hypertensive drug
  21. Calcium Gluconate
  22. IV maintains Surgical Management:
  23. Dialysis

o Haemodylasis

o Peritoneal dialysis

o Renal replacement therapy Nursing Management:

  1. Maintaining fluids & electrolyte balance
  2. Maintain I/O chart
  3. Prevent infection or injury to promote skin care
  4. Promote comfort as medicate the patient as prescribed by the Doctor
  5. To keep lips moist, give oral hygiene
  6. Assist with coping in life style & self concept
  7. Avoidance of OTC (over-the-counter) drugs, specially aspirin, cold medication & NSAIDS.

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