Acute Renal Failure is a rapid deterioration of the ability of the kidneys in clearing the blood of toxic materials, which leads to accumulation of metabolic wastes in the blood (eg urea).
CAUSE
This disease is a result of various circumstances that led to:
- Reduced blood flow to the kidneys
- Blockage of urine flow after the left kidney
- Trauma to the kidney.
SYMPTOMS
The symptoms were found in renal failure are: - Decreased urine production (oliguria = urine volume decreased or anuria = not at all to form urine)
- Nocturia (urination at night)
- Swelling of the leg, foot or ankle
- Swelling of the whole (due to fluid retention)
- Decreased taste, especially in the hands or feet
- Mental or mood changes
- Seizures
- Hand tremor
- Nausea, vomiting
The symptoms depend on the severity of renal failure, progression of the disease and its causes. Circumstances that lead to the occurrence of renal damage usually produce serious symptoms that are not related to the kidney. For example, high fever, shock, heart failure and liver failure, kidney failure can occur before and could be more serious than the symptoms of kidney failure.
Some conditions that cause kidney failure also affect other body parts. For example Wegener's granulomatosis, which causes damage to blood vessels in the kidneys, also cause damage to blood vessels in the lungs, so that the patient experienced coughing up blood. Skin rashes are typical symptoms for some causes of kidney failure, namely polyarteritis, systemic lupus erythematosus and some drugs that are toxic.
Hydronephrosis can cause acute renal failure due to blockage of urine flow. Backflow of urine in the kidneys causing urinary collecting area in the kidney (renal pelvis) stretched, causing painful cramps (can be mild or very severe) on the affected side. In about 10% of patients, bladder containing blood.
DIAGNOSIS
If urine production is reduced, then it is suspect as acute renal failure. Blood tests indicate the presence of urea and creatinine levels are high, accompanied by metabolic disorders (eg, acidosis, hyperkalemia, hyponatremia).
On physical examination, carried out an assessment of the kidneys; whether there is swelling or tenderness. Narrowing of the main renal artery can cause noise (bruit) that will be heard at the examination with a stethoscope. If the blockage is suspected, digital rectal examination or a vaginal plug to determine the existence of mass in both places.
Laboratory examinations of the urine can help determine the cause and severity of renal failure. If the cause is reduced blood flow to the kidneys or urinary tract blockage, then the urine will look normal. If the cause is an abnormality in the kidney, the urine will contain a collection of blood or red blood cells and white blood cells. Urine also contains a large number of proteins or different types of proteins that are normally not found in the urine.
Angiography (X-ray examination of the artery and vein) is done if the suspected cause is a blockage of blood vessels. Other tests that may help is a CT scan and MRI. If the examination can not show the cause of acute renal failure, then do a biopsy (removal of tissue for microscopic examination).
TREATMENT
The goal of treatment is to find and treat the cause of acute renal failure. In addition to centralized treatment of fluid retention and prevent excessive metabolic wastes. Restricted fluid intake and adjusted the volume of urine expelled. Salt intake and substances that are normally removed by the kidneys, is also restricted. Patients are encouraged to undergo a diet rich in carbohydrates and low in protein, sodium and potassium.
Antibiotics can be given to prevent or treat infeksi.Untuk increase the amount of fluid excreted through the kidneys, can be given a diuretic. Sometimes given sodium polystyrene sulfonate for hyperkalemia overcome. To remove excess fluid and metabolic waste can be done dialysis. With the dialysis patient will feel better and easier to control renal failure. Dialysis should not be undertaken by each patient, but often can prolong survival, especially if serum potassium levels are very high.
Indications do dialysis are:
- The state of mental decline
- Pericarditis
- Hyperkalemia
- Anuria
- Fluid overload
- Creatinine levels> 10 mg / dL and BUN> 120 mg / dL.
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