Acute renal insufficiency
Release time : 01/18/2025 18:13:27
Renal insufficiency (renal insufficiency) is a clinical syndrome characterized by severe glomerular damage, leading to disturbances in the body's excretion of metabolic waste products and regulation of water and electrolyte balance, as well as acid-base homeostasis.
Categorized into acute renal failure and chronic renal failure.
Prognosis is severe and one of the main diseases that threaten life.
What are the symptoms of acute renal failure? How is it treated? Let's take a look! What is acute renal failure? In modern society, there are an increasing number of diseases.
You might be unfamiliar with "acute renal failure". Don't worry, Mawangbaike will explain what it is to you! What is acute renal failure? Acute renal failure is a type of acute kidney injury caused by various etiologies that can lead to rapid decline in the regulatory function of renal units within a few hours to several days. This results in inability to maintain body fluid and electrolyte balance and excretion of metabolic waste products, leading to hyperkalemia, metabolic acidosis, and the syndrome known as acute renal failure.
Patients with acute renal failure should strengthen self-care, exercise to enhance resistance to illness, promptly treat upper respiratory tract infections, eliminate infection foci, and address the underlying diseases such as diabetes, systemic lupus erythematosus, hypertension, etc. Additionally, it is important to prevent drug damage to the kidneys.
The treatment of renal diseases is mainly divided into general treatment and special treatment.
During general treatment, it is advisable to rest, the extent of which depends on the condition.
Based on the different types of diseases and their severity, adopt corresponding dietary therapy.
Control infection, eliminate primary focus, treat primary diseases, adjust water and electrolyte balance, enhance the body's resistance to disease.
In special treatment, the same treatment plans are adopted according to different types of nephropathy.
Acute renal failure is caused by the following factors: prerenal, intrinsic and postrenal.
As for the causes of acute renal failure, there are several specific situations.
The common causes include: 1. Kidney damage caused by metabolic abnormalities such as diabetic nephropathy, gouty nephropathy, and amyloidosis.
2. Vascular nephropathies, such as hypertension, renal arterial hypertension, and renal arteriosclerosis.
3. Hereditary kidney diseases, such as polycystic kidney disease and Alport syndrome.
4. Infectious nephritis, such as chronic pyelonephritis and tuberculosis of the kidney.
5. Systemic diseases, such as lupus nephritis, vasculitis kidney damage, multiple myeloma, etc.
6. Nephrotoxicity, such as analgesic nephropathy and heavy metal nephrotoxicity.
7. Obstructive nephropathy, such as ureteral obstruction.
Reflux nephropathy, urinary calculi, and so on.
Additionally, approximately 6% -9% of patients have unexplained etiology.
In the early stages of acute renal failure, clinical symptoms are solely those of the primary disease, affecting various organs and tissues and presenting with corresponding symptoms: 1. Gastrointestinal manifestations are among the earliest and most common symptoms observed in uremia.
The initial complaint is anorexia and abdominal discomfort, followed by nausea, vomiting, diarrhea, glossitis, foul-smelling mouth odor, and oral mucosal ulceration, even leading to gastrointestinal bleeding.
II. Psychological and Nervous System Manifestations: Mental lethargy, fatigue, dizziness, headaches, impaired memory, insomnia, numbness, burning pain, skin itching, and even severe pruritus that cannot be alleviated by movement. In the advanced stage, symptoms may include somnolence, irritability, delusional speech, muscle tremors, convulsions, seizures, coma, etc.
III. Cardiovascular system manifestations often include elevated blood pressure, long-term hypertension can cause left ventricular hypertrophy and enlargement, myocardial damage, heart failure, retained toxic substances can cause myocardial damage, and occur uremia-induced pericarditis.
IV. Hematopoietic System Manifestations: Anemia is a common symptom in patients with uremia.
Apart from anemia, there is also easy bruising, such as petechiae in the subcutaneous tissue, nosebleeds, gum bleeding, and melena.
V. Respiratory System Manifestations Acidosis results in deep and prolonged breathing.
Retention of metabolic products can cause uremia-induced bronchiolitis, pneumonia, and pericarditis, accompanied by corresponding clinical symptoms and signs.
VI. Cutaneous Manifestations: The skin appears dull, dry and flaking.
VII. Disorders of Electrolyte Balance (1) Hyponatremia and Sodium Retention (2) Hypocalcemia and Hyperphosphatemia
Acute renal failure how to treat? With the rapid increase of population and life pressure, the number of patients with acute renal failure is increasing.
Therefore, how to treat acute renal failure and delay the occurrence and progression of renal failure are very important problems in clinical practice.
1. Firstly, treat the underlying condition, such as hypertension or diabetes.
Prevent the aggravation of renal artery and glomerular sclerosis.
2. Actively control infections, especially those in the urinary tract and respiratory tract, to prevent dual infections.
3. Actively correct disturbances in water and electricity balance, acid-base balance.
4. Diuretic and cardiac failure correction.
5. Dietary recommendations include a high-calorie, high-quality low-protein, low-phosphorus diet supplemented with essential amino acids, appropriate vitamins, minerals, and trace elements.
6. Avoid exposure to cold, dampness, and overexertion to prevent catching a cold. Do not use medications that harm the kidneys.
7. Comprehensive and efficient dialysis.
8. Complications require comprehensive treatment, including the correction of anemia and prevention of gastrointestinal bleeding. For those with hypercoagulable states, anticoagulation therapy is required.
In cases of progressive disease, it is advisable to promptly switch to blood purification therapy.
In the context of acute renal failure, diet therapy can be employed during medication administration. The following are some dietary strategies: 1. In the kidney disease diet, to ensure that the protein intake is utilized optimally and not converted into energy, it is essential to supplement energy even when adopting a low-protein diet.
At least 35 kilocalories per kg body weight daily, mainly from sugar, can be eaten fruit, sucrose products, chocolate, jam, honey etc.
Second, it is important to have a reasonable amount of protein intake.
The body's metabolic waste products are primarily derived from the protein components in the diet, thus to reduce the burden of the kidneys, the intake of protein must be adapted to their excretory capacity.
For example, when serum creatinine is between 170 and 440 micromoles/L, protein is excreted at a rate of 0.
6g is preferable, and for patients with significant proteinuria, each gram of lost urinary protein should be supplemented with an additional 1.
5 grams of protein.
When serum creatinine levels exceed 440 micromoles per litre, the protein intake should be further reduced to not more than 30 g per day.
However, it must be emphasized that if one solely pursues the restriction of protein intake, this will lead to malnutrition and a decline in physical condition in patients, and the results are not effective.
3. The salt intake in the renal insufficiency diet should be adjusted according to the condition, and for those with hypertension or edema, a low-salt diet should be used, with a daily salt intake of 2g.
Fourth, it should be noted that although some foods meet the conditions mentioned before, such as egg yolks, meat paste, animal organs, dairy products, and bone marrow, they are not suitable for consumption because their high phosphorus content can further worsen kidney function.
To reduce the phosphorus content in food, fish, meat and potatoes should be boiled first and then further cooked.
Fifth, drugs excreted through the kidneys can also damage the kidneys. These include antibiotics such as gentamicin and sulfonamides, penicillins, anti-inflammatory pain relievers like ibuprofen, and steroids, as well as contrast agents.
Furthermore, if there are hypertension, diabetes, infection, it must be strictly guarded against the damage of these diseases to the kidney.
*The medical content mentioned in this text is for reference only.
If you feel unwell, it is recommended to seek medical attention immediately. Please consult a healthcare professional in person for accurate diagnosis and treatment.