Acute Renal Failure (ARF)
To the tune of Alexander’s Ragtime Band
Renal Failure, Renal Failure When acute there are 3 main causes.
Prerenal failure, Prerenal failure Impaired perfusion is the major problem here.
Volume depletion, diuretics, dehydration, GI losses, hemorrhage,
MI, Heart Failure, abnormal rhythms, anaphylaxis, or shock.
What do you do with pre-renal? Identify and treat the cause.
Replace volume, replace the blood, and review the patient’s drugs.
Maintain the pump, the proper rate, and treat the shock before it’s late
Check BUN, GFR, creatinine, I & O, and osmolality.
This is reversible!
Intrarenal, Intrarenal The kidney structures are involved
Ischemia, Ischemia to glomeruli and tubes
Injuries cause sludgy sediments and pigmentation.
Intrarenal, Crush injuries, intrarenal, trauma and burns
Myoglobin is released.
NSAIDs and gent, IV contrast, any Nephrotoxic drugs
Infections too can harm the tubes
Hemoglobinuria caused by blood reactions or hemolytic anemia
Acute Tubular Necrosis will occur
Preserve all kidney structures, Please Be sure the toxins leave
In post renal, in post renal There is an interrupted flow
Perfusion’s fine Structures align
Urine production is OK
BPH, stones, tumors, strictures
Prevent urine from flowing
Identify and treat the cause for all Acute Renal Failure
Copyright D.D. Kincheloe 2010