Renal failure comes in two different forms, acute and chronic. Acute is when the signs and symptoms last for less than 3 months, and chronic is when they last for longer than 3-6 months. The pathophysiology of acute renal failure is the sudden stopping or slowing down of renal function that occurs due to blood flow to the kidneys is compromised. There are three phases in which acute renal failure is categorized, prerenal, intrarenal, and postrenal.
The pathophysiology for the three stages are as followed. The prerenal stage is a sudden and sever drop in blood pressure or interruption of blood flow to the kidneys from severe injury or illness. It is the most common resulting in hypoperfusion and ischemia, which allows the integrity of renal tissue to be preserved (Brady, Singer, 1995).
Pathology for intrarenal, also known as intrinsic, is the direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply. This is a consequence from direct damage to the kidney, and the glomerular filtration rate falls due to impaired renal blood flow disrupting the integrity of the tubule epithelium leading to a backleak (Brady, Singer, 1995).
The last pathological stage is the postrenal. In this stage there is a sudden obstruction of urine flow due to an enlarged prostate, kidney stones, bladder tumor, or injury. This stage is the least common to acquire that leads to kidney damage. Prerenal azotemia is by definition according to Brady and Singer (1995) “rapidly reversible after restoration of renal blood flow and glomerular ultrafiltration pressure”.
What diagnostic exams would be used to diagnose acute renal failure, and how do these tests change as renal failure progresses through its stages? Well, with every diagnosis and health concern comes diagnostic exams and test that need to be done to make sure that the health care team can rule out or confirm possibilities. The diagnostic exams to be used for acute renal failure are BUN, creatinine, phosphorus, potassium, hemoglobin, hematocrit, bicarbonate level, GFR, urine specific gravity. These are some of the tests that are done to monitor and have the knowledge of knowing where a persons liver function is currently at, and how well it is functioning in their body. These exams differ from which type of stage that the client is in. For the prerenal stage, the diagnostics ran would be BUN, creatinine, urine osmolality, and specific gravity. With the intrarenal stage, the tests that we would run are going to be BUN, creatnine, potassium, and phosphorus. Lastly the diagnostics left for postrenal are, hematocrit, hemoglobin, BUN, and creatinine. These diagnostic tests allow us as the health care provider to determine first of all, if the client has any type of renal failure and if so what type, and if it’s chronic renal failure then what stage between 1-5, or if it’s acute to see what stage its in, prerenal, intrarenal, or postrenal.
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