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| MeshNumber = C12.777.419.780.500 | | | MeshNumber = C12.777.419.780.500 | |
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| {{SI}} | | {{Renal insufficiency}} |
| {{CMG}} | | {{CMG}} |
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| ==[[Renal insufficiency overview|Overview]]== | | ==[[Renal insufficiency overview|Overview]]== |
| ''' Renal failure''' or '''kidney failure''' is the condition in which the [[kidney]]s fail to function adequately.
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| 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]].
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| ==[[Renal insufficiency historical perspective|Historical Perspective]]== | | ==[[Renal insufficiency historical perspective|Historical Perspective]]== |
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| ==[[Renal insufficiency classification|Classification]]== | | ==[[Renal insufficiency classification|Classification]]== |
| Renal failure can broadly be divided into two categories (see flowchart below): [[Acute (medical)|acute]] renal failure and [[chronic (medicine)|chronic]] renal failure.
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| '''Renal failure classification'''
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| {{familytree/start}}
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| {{familytree | | | |A11| | | | |A11 =Renal Failure}}
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| {{familytree | |,|-|-|^|-|-|.|}}
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| {{familytree | B11 | | | | B12 |B11=[[Chronic renal failure|Chronic]]|B12=[[Acute renal failure|Acute]]}}
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| {{familytree/end}}
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| 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 [[medical ultrasound|ultrasound]]. Long-standing, i.e. chronic, renal failure generally leads to anemia and small kidney size.
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| ===Acute renal failure===
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| {{main|Acute renal failure}} <!-- FURTHER details should go in the ARF article NOT here -->
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| [[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 [[millilitres|mL]] per day in adults,<ref>{{cite journal | author = Klahr S, Miller S | title = Acute oliguria. | journal = N Engl J Med | volume = 338 | issue = 10 | pages = 671-5 | year = 1998 | id = PMID 9486997}} [http://content.nejm.org/cgi/content/full/338/10/671 Free Full Text].</ref> 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.
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| ===Chronic renal failure===
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| {{main|Chronic renal failure}} <!-- FURTHER details should go in the CRF article NOT here -->
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| [[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 [[Kidney transplantation|renal transplant]] is found.
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| ===Acute on chronic renal failure===
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| 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.
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| ==Use of the term ''uremia''==
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| 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.<ref>{{cite journal | author = Meyer TW and Hostetter, TH| title = Uremia| journal = N Engl J Med | volume = 357 | issue = 13 | pages = 1316 | year = 2007 | id = PMID 17898101}} [http://content.nejm.org/cgi/content/full/357/13/1316 Full text].</ref>
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| ==Reversible Renal Failure==
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| === Differential Diagnosis of Reversible Renal Failure ===
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| In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| *[[Congestive Heart Failure]]
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| *Drugs, toxin
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| *[[Hypercalcemia]]
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| *[[Hyperkalemia]]
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| *[[Hypertension]]
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| *Infection of the urinary tract
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| *Obstruction
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| *Volume depletion
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| ==External links== | | ==External links== |
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| {{Nephrology}} | | {{Nephrology}} |
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| [[Category:Nephrology]] | | [[Category:Nephrology]] |
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| [[simple:Kidney failure]] | | [[simple:Kidney failure]] |
| [[sv:Njursvikt]] | | [[sv:Njursvikt]] |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
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