Acute Renal Failure

Clinical manifestation of ARF is decreased urine output (contrast with above: in CRF the patient will have increased urine output due to inability to concentrate, until the kidney totally gives up and scleroses.)

Causes of ARF: (remember our 3(or 4) major categories of renal diseases?):

1. glomerular

2. tubulo-interstitual

3. vascular

ATN is the most common cause of ARF (the most common cause of CRF was glomerulonephritis, remember?) ATN is caused by nephrotoxins or ischemia. More of this later . This is just a glimpse.

Clinical course of ARF (note, it’s opposite from CRF, as stated above):

A. Onset – after initial event (whatever the cause is), one has acute suppression of urine production and increase in K. This person will have hyperkalemia b/c he/she can’t excrete enough K.

B.Later stages: polyuric phase when patient can become dehydrated due to fluid loss (one eventually loses tubular function and ability to concentrate urine). It is essential to replace fluids.

Category: Nephrology Notes , Pathology Notes