Stages of acute renal failure
Urology / / May 05, 2016
The clinical course of acute renal failure are 4 stages.
I stage - the initial action of stress factors (poisoning, blood loss, shock and other causes).Specific symptoms are absent.The clinical picture depends on the cause of acute renal failure.
II stage - oligoanuria.If the amount of daily urine is 300-500 ml, speak of oliguria;if the urine less than 50 ml - about anuria.The blood metabolites accumulate final metabolic products, which are normally excreted through the kidneys.Basically it is the nitrogenous wastes (urea, creatinine).Disturbed regulation of renal water and electrolyte balance - Potassium excretion is significantly reduced.Turn off the renal mechanisms for maintaining acid-base balance - impaired excretion of H + ions, resulting in metabolic acidosis develops.
Patients concerned about lack of appetite, nausea, frequent vomiting;there are peripheral edema;may develop ascites, hydrothorax, pulmonary edema;observed various violations of neuro-psychic activity, from headaches and dro
oligoanuria stage lasts from a few days to a few weeks (on average 10-14 days).The duration of this period depends on the amount of damage to the kidneys, the adequacy of treatment and capacity for regeneration of renal epithelium.
III stage - restoration of diuresis.This step consists of an initial phase diuresis (daily amount of less than 400 ml of urine), polyuria which is replaced by a phase (daily amount of more than 800 ml of urine).However, the content of urea and creatinine remained high urine specific gravity is low, the precipitate contains many proteins and erythrocytes.Isolation of a large amount of urine hypotonic indicates that only restored glomerular renal function and pathological changes in tubule epithelium still preserved.
potassium content gradually returning to normal.It must be remembered that the polyuria can quickly lead to hypokalemia, which is no less dangerous than hyperkalemia.Polyuria stage lasts from 2-3 to 10-12 days depending on the speed of regeneration of tubular epithelium.
IV stage - recovery.At this stage the normal volume of urine output and, most importantly, - azotemia.In severe cases the nitrogen content of the slag is increased, then passes acute renal failure to chronic renal failure.