Acute Renal Failure

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Pathophysiology of Acute Renal Failure Hannah Allison Davidson County Community College Pathophysiology of Acute Renal Failure Acute renal failure, or ARF, refers to the sudden loss of kidney function. Over a period of hours to a few days, the GFR falls, accompanied by a rise in serum creatinine and urea nitrogen. A healthy adult eating a normal diet needs a minimum daily urine output of approximately 400 ml to excrete the body’s waste products through the kidneys. An amount lower than this indicates a decreased GFR. ARF affects 1% of patients on admission to the hospital (Nursing, 2011). Acute renal failure generally has four stages: onset, oliguric, diuretic, and convalescent. Treatment depends on the stage and severity of renal compromise. ARF can be divided into three major classifications, depending on site. One site being prerenal failure is caused by interference with renal perfusion, manifested by decreased glomerular filtration rate. Disorders that lead to prerenal failure include cardiogenic shock, heart failure, myocardial infarction, burns, trauma, hemorrhage, septic or anaphylactic shock, and renal artery obstruction. Intrarenal causes for renal failure are associated with parenchymal changes caused by ischemia or nephrotoxic substances. Postrenal failure occurs as the result of an obstruction in the urinary tract anywhere from the tubules to the urethral meatus (Louise Cole, 2000). Obstruction most commonly occurs with stones in the ureters, bladder, or urethra; however, trauma, edema associated with infection, and prostate enlargement also cause postrenal failure.1 Statistics In the United States, the annual incidence of acute renal failure is 100 cases for every million people. It’s diagnosed in 1% of hospital admissions. Pathophysiology There is a generally unexpected decrease in kidney function, which may or may not be associated with a

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