Acute renal failure is one of the most dangerous conditions for the body, which all urologists are afraid of. In the event of acute renal failure, a violation of all kidney functions quickly occurs, which, if timely effective assistance is not provided, can lead to irreversible consequences. As you know, the kidneys are a kind of body filter, with the help of which harmful metabolic products are excreted from the body with urine. With renal failure, there is a sharp decrease in urine output, up to anuria, resulting in intoxication of the body and pathological changes in tissues and organs. Acute kidney failure can be fatal.

Causes of acute renal failure

 In accordance with the etiological factors provoking the development of acute renal failure, they distinguish  its three forms:

  • prerenal: the cause is a pathology that does not develop at the level of the kidneys. This can be significant blood loss, swelling, dehydration, severe infection, myocardial infarction or pulmonary embolism, any state of shock in the body, and so on;
  • renal acute renal failure is provoked by any pathology of the kidneys itself: necrosis of the renal structures, traumatic lesions of the kidneys, the action of nephrotoxic substances, blockade of the nephron tubules, and so on;
  • Postrenal renal failure is associated with pathology originating in the urinary system, but below the level of the kidneys. These can be factors such as kidney stones, neoplasms of the pelvic organs, retroperitoneal fibrosis and other pathologies leading to urinary tract obstruction and the impossibility of urine outflow.

Clinical presentation of acute renal failure

The clinical picture of acute renal failure depends on the stage of the disease.  There are four stages in the course of acute renal failure:

  1. The initial stage of acute renal failure: begins spontaneously with a sharp rise in body temperature, vomiting, pain in the abdomen and lower back. Rarely, the patient's consciousness may be disturbed.
  2. The stage of oligoanuria is the most dangerous. The water-electrolyte balance is disturbed and hyperkalemia, hypercalcemia, hypochloremia and hyperphosphatemia occur. The osmotic pressure of the blood increases, and urine changes occur: it is cloudy, with a large amount of protein, cylinders and red blood cells. Clinically, the stage of oligoanuria can be manifested by dry skin and mucous membranes, swelling, thirst, and a decrease in the amount of urine excreted up to its complete absence. Excess potassium provokes changes in the activity of the heart muscle and can lead to the death of the patient.
  3. At the stage of resumption of diuresis, excess potassium is replaced by a state of hypokalemia, the level of sodium in the blood rises, due to the loss of a large amount of fluid, symptoms of dehydration appear: exsicosis, decreased tone, impaired consciousness.
  4. The recovery phase can last up to several years after acute kidney failure. At this stage, the general condition of the patient is satisfactory, but the function of the kidneys is still reduced.

Methods for diagnosing acute renal failure

Diagnosis of acute renal failure is not a difficult process: already from the anamnesis one can learn about the previous factors that could provoke such a condition. Laboratory studies of urine and blood provide information about the violation of water and electrolyte balance and, consequently, kidney function. To determine the form of acute renal failure, that is, at what level the lesion occurred, radionuclide renography is used. In especially severe cases, a puncture biopsy of the kidney is used. Bilateral catheterization  ureters with retrograde ureteropyelography helps in determining the condition of the upper urinary tract.

Methods of treatment of acute renal failure

In the initial stage of acute renal failure, intensive therapy is started to eliminate shock and arterial hypertension. For this purpose, cardiac glycosides, anticoagulants, drugs that improve vascular tone, and even blood products and blood substitutes are prescribed. In the stage of oligoanuria and the resumption of kidney function, first of all, the correction of the water and electrolyte balance is carried out in accordance with the results of laboratory tests. An important point is the appointment of antibiotic therapy, since infection can significantly complicate the course of acute renal failure. With the ineffectiveness of conservative methods of therapy, artificial blood purification is recommended by transferring the patient to hemodialysis. The prognosis of the disease depends on the severity and effectiveness of the therapy provided. In severe cases,

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