Renal insufficiency
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| Renal insufficiency Classification and external resources | ||
| ICD-10 | N17.-N19. | |
|---|---|---|
| ICD-9 | 584-585 | |
| DiseasesDB | 26060 | |
| MeSH | C12.777.419.780.500 | |
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For more detailed information please see the chapters on acute renal failure and chronic renal failure. This chapter is simply an overview of these more specific disease states.
Renal failure or kidney failure is the condition in which the kidneys fail to function adequately.
Biochemically, it is typically detected by an elevated serum creatinine. In the science of physiology, renal failure is described as a decrease in the glomerular filtration rate.
Classification
Renal failure can broadly be divided into two categories (see flowchart below): acute renal failure and chronic renal failure.
Renal failure classification
| Renal Failure | |||||||||||||||||||
| Chronic | Acute | ||||||||||||||||||
The type of renal failure (acute vs. chronic) is determined by the trend in the serum creatinine. Other factors which may help differentiate acute and chronic renal failure include the presence of anemia and the kidney size on ultrasound. Long-standing, i.e. chronic, renal failure generally leads to anemia and small kidney size.
Acute renal failure
Acute renal failure (ARF) is, as the name implies, a rapidly progressive loss of renal function, generally characterised by oliguria (decreased urine production, quantified as less than 400 mL per day in adults,[1] less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants); body water and body fluids disturbances; and electrolyte derangement. An underlying cause must be identified to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes. ARF can result from a large number of causes.
Chronic renal failure
Chronic renal failure (CRF) can either develop slowly and show few initial symptoms, be the long term result of irreversible acute disease or be part of a disease progression. There are many causes of CRF. The most common cause is diabetes mellitus. End-stage renal failure (ESRF) is the ultimate consequence, in which case dialysis is required unless a donor for a renal transplant is found.
Acute on chronic renal failure
Acute renal failure can be present on top of chronic renal failure. This is called acute-on-chronic renal failure (AoCRF). The acute part of AoCRF may be reversible and the aim of treatment, as with ARF, is to return the patient to their baseline renal function, which is typically measured by serum creatinine. AoCRF, like ARF, can be difficult to distinguish from chronic renal failure, if the patient has not been monitored by a physician and no baseline (i.e., past) blood work is available for comparison.
Use of the term uremia
Before the advancement of modern medicine, renal failure was often referred to as uremic poisoning. Uremia was the term used to describe the contamination of the blood with urine. Starting around 1847, this term was used to describe reduced urine output, that was thought to be caused by the urine mixing with the blood instead of being voided through the urethra. The term uremia is now used to loosely describe the illness accompanying kidney failure.[2]
Reversible Renal Failure
Differential Diagnosis of Reversible Renal Failure
In alphabetical order. [3] [4]
- Congestive Heart Failure
- Drugs, toxin
- Hypercalcemia
- Hyperkalemia
- Hypertension
- Infection of the urinary tract
- Obstruction
- Volume depletion
References
- ↑ Klahr S, Miller S (1998). "Acute oliguria.". N Engl J Med 338 (10): 671-5. PMID 9486997. Free Full Text.
- ↑ Meyer TW and Hostetter, TH (2007). "Uremia". N Engl J Med 357 (13): 1316. PMID 17898101. Full text.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
External links
WikiDoc Research Resources for Renal insufficiency | |
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| Articles on Renal insufficiency | Most recent articles on Renal insufficiency • Most cited articles on Renal insufficiency • Review articles on Renal insufficiency • Articles on Renal insufficiency in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Renal insufficiency | Powerpoint slides on Renal insufficiency • Images of Renal insufficiency • Photos of Renal insufficiency • Podcasts & MP3s on Renal insufficiency • Videos on Renal insufficiency |
| Evidence Based Medicine Regarding Renal insufficiency | Cochrane Collaboration on Renal insufficiency • Bandolier on Renal insufficiency • TRIP on Renal insufficiency |
| Cost Effectiveness of Renal insufficiency | Cost Effectiveness of Renal insufficiency |
| Clinical Trials Involving Renal insufficiency | Ongoing Trials on Renal insufficiency at Clinical Trials.gov • Trial results on Renal insufficiency • Clinical Trials on Renal insufficiency at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Renal insufficiency | US National Guidelines Clearinghouse on Renal insufficiency • NICE Guidance on Renal insufficiency • NHS PRODIGY Guidance • FDA on Renal insufficiency • CDC on Renal insufficiency |
| Textbook Information on Renal insufficiency | Books and Textbook Information on Renal insufficiency |
| Pharmacology Resources on Renal insufficiency | Dosing of Renal insufficiency • Drug interactions with Renal insufficiency • Side effects of Renal insufficiency • Allergic reactions to Renal insufficiency • Overdose information on Renal insufficiency • Carcinogenicity information on Renal insufficiency • Renal insufficiency in pregnancy • Pharmacokinetics of Renal insufficiency • |
| Genetics, Pharmacogenomics, and Proteinomics of Renal insufficiency | Genetics of Renal insufficiency • Pharmacogenomics of Renal insufficiency • Proteomics of Renal insufficiency |
| Newstories on Renal insufficiency | Renal insufficiency in the news • Be alerted to news on Renal insufficiency • News trends on Renal insufficiency |
| Commentary on Renal insufficiency | Blogs on Renal insufficiency |
| Patient Resources on Renal insufficiency | Patient resources on Renal insufficiency • Discussion groups on Renal insufficiency • Patient Handouts on Renal insufficiency • Directions to Hospitals Treating Renal insufficiency • Risk calculators and risk factors for Renal insufficiency |
| Healthcare Provider Resources on Renal insufficiency | Symptoms of Renal insufficiency • Causes & Risk Factors for Renal insufficiency • Diagnostic studies for Renal insufficiency • Treatment of Renal insufficiency |
| Continuing Medical Education (CME) Programs on Renal insufficiency | CME Programs on Renal insufficiency |
| International Resources on Renal insufficiency | Renal insufficiency en Espanol • Renal insufficiency en Francais |
| Business Resources on Renal insufficiency | Renal insufficiency in the Marketplace • Patents on Renal insufficiency |
| Informatics Resources on Renal insufficiency | List of terms related to Renal insufficiency |
de:Nierenversagensimple:Kidney failure sv:Njursvikt
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
