Definition:- Abrupt onset decrease in urine output (<400 ml/day or <15 ml/h) with a concomitantincrease in serum creat. >1.5mg/dL.
Investigating an acute renal failure:- Urine microscopy-
WBCs- UTI
RBCs- Glomerulonephritis Eosinophils- Interstitial nephritis
S. Creatinine , Urea, S. electrolytes (potassium).
CVP line- to measure volume status
USG/KUB x-ray to look for kidney size/obstruction/hydronephrosis if symptoms are suggestive of thesame.
Pre-renal failure | Vs | Renal failure |
Urea/ creat ratio > 40 |
| Urea/creat ratio < 40 |
Urine spot sodium < 20 meq/L |
| >@) meq/L |
Reversal of failure on treating |
| Absent |
the pre-renal factor |
|
|
Urine Osmolality>600 |
| Urine Osmolality <350 |
If POST-RENAL failure is suspected………….
Catheterise distended bladder
Per-speculum and Per-vaginal examination to rule out carcinoma cervix in women. X-ray KUB abdomen, USG abdomen to look for hydronephrosis and hydroureter.
Per-rectal examination to feel for prostatic enlargement.
Management of acute renal failure
References
No references available