Acute Renal Failure (arf)

)Acute renal failure )ARF Beirut arab university Salmtak workshop Done by 5th year M.S Nada Hashwi

)Acute renal failure )ARF Sudden & usually reversible decrease in renal function, resulting in an inability to maintain fluid & electrolyte balance & to .excrete nitrogenous wastes

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Signs & symptoms Non specific symptoms: nausea, vomitting, . malaise & altered sensorium Diffuse abdominal pain . Hypovolemia cause pre-renal disease . Hypervolemia result from intrinsic or post renal . disease crackles on lung auscultation  friction rubPericardial effusion .  arrhythmia Hyperkalaemia .  bleeding Platelet dysfunction . Encephalopathic changes with asterixis & . confusion & maybe seizures

Lab findings Elevated BUN & creatinine Hyperkalemia metabolic acidosis Hyperphosphatemia ECG peaked Twave, PR prolongation, QRS widening

)Chronic renal failure )CRF Irreversible deterioration of kidney function which develops over a period of years

Cockcroft-Gault formula

Causes of CRF

Signs & symptoms Can remain asymptomatic until GFR<1015mL/min Fatigue weakness & malaise GI: anorexia, nausea, vomiting, metallic taste & hiccups Kussmaul’s respiration Pruritus Irritability, difficulty in concentration, insomnia, muscular twitching, fits & coma

Physical exam Chronic ill patient Hypertension Skin maybe yellow with signs of easy bruisability Uremic frost Uremic fetor Crackles, cardiomegaly, pericardial friction rub& edema Mental status: decrease concentration, stupor or coma

lab Elevation of BUN & creatinine Anemia, metabolic acidosis, hyperphosphatemia, hypocalcaemia & hyperkalemia U/S small bilateral echogenic kidneys <10 cm Radiology renal osteodystrophy )dt 2ry hyper )PTH Evidence of subperiosteal resorption along digital bones

Thank You Salamtak workshop • Done By Nada Hashwi •