Renal Calculi & Renal Failure

RENAL CALCULI & RENAL FAILURE Prepared by The boyz 5A

Renal calculi 

are solid concretions (crystal aggregations) formed in the kidneys from dissolved urinary minerals.

Etiology of renal calculi 1. Composed of calcium oxalate crystals - When the amount of calcium intake decreases, the amount of oxalate easy to absorption into the bloodstream increases and then excreted into the urine by the kidney 2. Composed of uric acid - a persistent undue urine acidity 



Sign & Symptoms   





 

Colicky pain - the worst pain Hematuria - blood in the urine Pyuria - pus (white blood cells) in the urine. Dysuria - burning on urination when passing stones. Oliguria - reduced urinary volume caused by obstruction of the bladder or urethra by stone

Continue……………..      

Abdominal distension. Nausea/vomiting Fever and chills. Loss of appetite Loss of weight

Diagnostic test      

X-ray CT scans Ultrasound Urine C & S Blood FBC 24 hours urine collection

Treatment qMedication such as - Analgesia such as morphine sulfate ( to relieve pain and reduce uteral spasm ) - NSAID such as suppository ( may reduce the amount of narcotic analgesia required for acute renal colic) qSurgery - Lithotrispy– using sound or shock waves to crush stone. 

Prevention  





Drinking enough water A diet low in protein, nitrogen and sodium intake. Restriction of oxalate rich foods, such as chocolate plus maintenance of an adequate intake of dietary calcium. Taking drugs such as thiazides, potassium citrate, magnesium citrate and allopurinol, depending on the cause of stone formation.

Continue…….. 

 

Some fruit juices, such as orange, blackcurrant, and cranberry, may be useful for lowering the risk factors for specific types of stones. Avoidance of cola beverages. Avoiding large doses of vitamin C.

Renal failure  



the kidneys fail to function adequately. It is divided in acute and chronic forms due to a large number of other medical problems.

Acute Renal Failure 

a rapidly progressive loss of renal function, generally characterized by oliguria , body water and body fluids disturbances; and electrolyte derangement.

Chronic renal failure 



develop slowly and show few initial symptoms, be the long term result of irreversible acute disease or be part of a disease progression.

symptoms 

High levels of urea in the blood, can result in  Vomiting and/or diarrhea (dehydration)  Nausea  Weight loss  Foamy or bubbly urine  Blood in urine  Dysuria (difficult to urine) 

 

Symptoms 

Failure of kidneys to remove excess fluid may cause  Swelling of the legs, ankles, feet, face and/or hands  Shortness of breath due to extra fluid on the lungs (may also be caused by anemia)  

 

Pathophysiology 







The causes and pathophysiology of acute renal failure (ARF) are commonly categorized as prerenal , intrinsic , and postrenal ARF. In prerenal ARF, hypoperfusion leads to acute renal failure without directly affecting the intergrity of kidney tissues. Intrinsic (or intrarenal) ARF , due to direct damage to functional kidney tissues. Urinary tract obstruction with resulting kidney damage is the precipating factor for postrenal ARF.

Causes of acute renal failure cause

exam ples

-Hypovolemia -Hemorrhage, dehydration, excess fluid prerenal -Low cardiac loss from GIT output -Heart failure, cardiogenic shock -Altered -sepsis, anaphylaxis, vasoactive drugs glomerular/micr -glomerulonephritis, DIC, vascular intrarena ovascular injury hypertension,hemolytic uremic resistance l - Acute tubular syndrome. necrosis -ischemia due to conditions associated -Intersitial -acute pyelonephritis,toxins,metabolic with prerenal failure;toxins such as postrenal nephritis imbalance drugs Calculi, cancer, external compression -ureteral Prostatic enlargement, calculi, cancer , obstruction -uretheral blood clot. obstruction

Treatment qMedication such as loop diuretics ü Example : bumetanide ( bumex ), ethacrynic acid (edecrin ), Furosemide (lasix) qRenal replacement therapy : dialysis