Renal insufficiency

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Renal insufficiency
ICD-10 N17-N19
ICD-9 584-585
DiseasesDB 26060
MeSH C12.777.419.780.500

Template:Renal insufficiency Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Renal failure; azotemia; kidney failure; kidney insufficiency; renal disease; kidney injury; renal injury

For more detailed information please see the chapters on acute kidney injury and chronic kidney disease. This page is simply an overview of these more specific disease states.

Overview

Renal insufficiency may broadly be divided into two categories: Acute kidney injury vs. chronic kidney disease:

 
 
 
Renal Insufficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Defined as any of the following:
❑ Increase in serum creatinine concentration by 0.3 mg/dL in 48 hours, OR
❑ Increase in serum creatinine concentration by more than 50% of baseline or 1.5 times baseline concentration within the past 7 days, OR
❑ Decrease in urine volume <0.5 mL/kg/h for 6 or more hours
 
 
 

Defined as any of the following:
❑ Kidney damage for ≥ 3 months as defined by structural or functional abnormalities of the kidney, with or without decreased GFR, manifest by either pathological abnormalities or markers of kidney damage (including abnormalities in the composition of the blood or urine or imaging abnormalities), OR
❑ GFR <60 mL/min/1.73 m2 for ≥3 months with or without kidney damage

Definition of Terms

Acute kidney injury (AKI)

Acute kidney injury (AKI), formerly known as acute renal failure, is characterized by an abrupt loss of kidney function resulting in a failure to excrete nitrogenous waste products (among others), and a disruption of fluid and electrolyte homeostasis. AKI is defined as any of the following:

  • Increase in serum creatinine concentration by 0.3 mg/dL in 48 hours, OR
  • Increase in serum creatinine concentration by more than 50% of baseline or 1.5 times baseline concentration within the past 7 days, OR
  • Decrease in urine volume <0.5 mL/kg/h for 6 or more hours

Chronic kidney disease (CKD)

Chronic kidney disease (or chronic renal insufficiency) is a broad spectrum of disorders that disturb the structural or functional integrity of the kidney for more than 3 months. CKD is defined as any of the following:

  • Kidney damage for ≥ 3 months as defined by structural or functional abnormalities of the kidney, with or without decreased GFR, manifest by either pathological abnormalities or markers of kidney damage (including abnormalities in the composition of the blood or urine or imaging abnormalities), OR
  • GFR <60 mL/min/1.73 m2 for ≥3 months with or without kidney damage

Acute-on-chronic renal failure (AoCRF)

Acute-on-chronic renal failure (AoCRF) is defined as the presence of acute kidney injury on top of chronic renal disease. AKI of AoCRF may be reversible, and the aim of treatment is to return the patient to baseline renal function prior to the acute insult.

Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Balsalazide, Beractant, Cefadroxil, Ceftazidime, Cladribine, Cytarabine, Dalfampridine, Desogestrel and Ethinyl Estradiol, Dolutegravir, Flurbiprofen, Ixabepilone, Meropenem, Oprelvekin, Oxaprozin, Pamidronic acid, Pegylated interferon alfa-2b, Piperacillin, Ritonavir, Siltuximab, Sorafenib, Suprofen, Tiagabine, Trametinib, Tolmetin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References


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