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Acute renal failure
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Reversible Determining prognosis- kidneys respond to diuretic with good
output; this indicates that kidneys are functioning well
>>Acute Pyelonephritis
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Diagnosing by clinical symptoms alone can be difficult; can be similar to
cystitis Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be
present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract
,imaging
>>Renal Calculi (Renal Stones)
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Goals of Treatment: Manage acute pain Promote passage of stone Reduce
size of stone Prevent new stone formation
>>Chronic Renal Failure
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Chronic Kidney Disease (CKD) is a progressive loss of renal function
associated with systemic disease such as hypertension, diabetes mellitus
(most significant risk factor), systemic lupus erythematosus or intrinsic
kidney disease CKD stage is determined by estimates of GFR and
albuminuria
>>Who is a candidate for dialysis?
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End-stage renal disease (ESRD) is the final stage of CKD with the number
one cause being diabetes mellitus combined with hypertension. At this
point, the patient is completely dependent on dialysis to survive. CKD is
classified into five stages and is based on the patient's GFR rather than
, symptoms. Patients will need dialysis when the following symptoms are
present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked
T-waves) is an indication for dialysis.
--Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for
dialysis and include salicylates, Lithium, Isopropanol, Methanol and
Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
>>Stage I CKD
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There is kidney damage with normal or elevated GFR 90-120
>>Stage II CKD
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There is kidney damage with mild decrease in GFR 60-89
>>Stage III CKD