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07-SEPTEMBER-2008 03:17:44 - failure Renal failure Classification and external resources ICD-10 N17.-N19. ICD-9 584-585 DiseasesDB 26060 MeSH C12.777.419.780.500 Renal failure or kidney failure is a situation in which the kidneys fail to function adequately. It is divided in acute and chronic forms; either form may be due to a large number of other medical problems. Biochemically, it is typically detected by an elevated serum creatinine. In the science of physiology, renal failure is described as a decrease in the glomerular filtration rate. When the kidneys malfunction, problems frequently encountered are abnormal fluid levels in the body, deranged acid levels, abnormal levels of potassium, calcium, phosphate, hematuria blood in the urine and in the longer term anemia. Long-term kidney problems have significant repercussions on other diseases, such as cardiovascular disease. Contents 1 Classification 1.1 Acute renal failure 1.2 Chronic kidney disease 1.3 Acute on chronic renal failure 2 Use of the term uremia 3 References 4 External links Classification Renal failure can broadly be divided into two categories: acute renal failure and chronic kidney disease. Renal failure classification Renal Failure Chronic Acute The type of renal failure acute vs. chronic is determined by the trend in the serum creatinine. Other factors which may help differentiate acute and chronic kidney disease include the presence of anemia and the kidney size on ultrasound. Long-standing, i.e. chronic, kidney disease generally leads to anemia and small kidney size. Acute renal failure Main article: Acute renal failure Acute renal failure ARF is, as the name implies, a rapidly progressive loss of renal function, generally characterized by oliguria decreased urine production, quantified as less than 400 mL per day in adults,1 less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants; body water and body fluids disturbances; and electrolyte derangement. An underlying cause must be identified to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes. ARF can result from a large number of causes. Chronic kidney disease Main article: Chronic kidney disease Stage 5 Chronic Kidney Disease CKD can either develop slowly and show few initial symptoms, be the long term result of irreversible acute disease or be part of a disease progression. There are many causes of CKD. The most common cause is diabetes mellitus. Stage 1 CKD is mildly diminished renal function, with few overt symptoms. Stage 5 CKD is a severe illness and requires some form of renal replacement therapy dialysis or kidney transplant. Acute on chronic renal failure Acute renal failure can be present on top of chronic renal failure. This is called acute-on-chronic renal failure AoCRF. The acute part of AoCRF may be reversible and the aim of treatment, as with ARF, is to return the patient to their baseline renal function, which is typically measured by serum creatinine. AoCRF, like ARF, can be difficult to distinguish from chronic renal failure, if the patient has not been monitored by a physician and no baseline i.e., past blood work is available for comparison. Use of the term uremia Before the advancement of modern medicine, renal failure was often referred to as uremic poisoning. Uremia was the term used to describe the contamination of the blood with urine. Starting around 1847, this term was used to describe reduced urine output, that was thought to be caused by the urine mixing with the blood instead of being voided through the urethra.citation needed The term uremia is now used to loosely describe the illness accompanying kidney failure.2 References ^ Klahr S, Miller S 1998. Acute oliguria. N Engl J Med 338 10: 671-5. doi:10.1056/NEJM199803053381007. PMID 9486997. Free Full Text. ^ Meyer TW and Hostetter, TH 2007. Uremia. N Engl J Med 357 13: 1316. doi:10.1056/NEJMra071313. PMID 17898101. Full text. External links National Kidney Foundation US v d e Urinary system - Pathology - Urologic disease N00-N39, 580-599 Abdominal Kidney/ nephropathy Glomerulus Nephritis/ glomerulonephritis by structure: Membranoproliferative glomerulonephritis - Membranous glomerulonephritis/Membranous nephritis - IgA nephropathy/glomerulonephritis by disease: Post-streptococcal glomerulonephritis - Lupus nephritis other: Rapidly progressive glomerulonephritis - Nephritic syndrome Nephrosis/ noninflammatory Glomerulosclerosis Focal segmental glomerulosclerosis, Diabetic nephropathy/glomerulosclerosis - Nephrotic syndrome Minimal change disease - Familial renal amyloidosis Tubulointerstitial/ Renal tubule Interstitial nephritis Pyelonephritis, Danubian endemic familial nephropathy Uropathy Obstructive uropathy, Hydronephrosis, Pyonephrosis Inborn errors of renal tubular transport Renal tubular acidosis, Gitelman syndrome Reflux nephropathy - Nephrogenic diabetes insipidus - Renal papillary necrosis Renal failure Acute renal failure Acute tubular necrosis - Chronic renal failure Other Renal osteodystrophy - Nephroptosis - Abderhalden-Kaufmann-Lignac syndrome vascular Renal artery stenosis, Hypertensive nephropathy, Renovascular hypertension Ureter Ureteritis - Ureterocele - Megaureter Pelvic Bladder Cystitis Interstitial cystitis, Trigonitis - Neurogenic bladder - Vesicointestinal fistula - Vesicoureteral reflux Urethra Urethritis Non-gonococcal urethritis - Urethral syndrome - Urethral stricture Other/general Urinary tract infection - Retroperitoneal fibrosis - Urolithiasis Kidney stone, Renal colic See also congenital, neoplasia, symptoms/signs Retrieved from http://en..org/wiki/Renal_failure Categories: Nephrology | Organ failureHidden categories: All articles with statements | Articles with statements since September 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Bamanankan Deutsch Español Ù?ارسی Français í•œêµì–´ Italiano Nederlands 日本語 ‪Norsk bokmÃ¥l‬ Polski Português РуÑ?Ñ?кий Simple English Svenska This page was last modified on 7 July 2008, at 13:0
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