ACUTE RENAL FAILURE SYSTEMIC PATHOLOGY .pptx

Acute kidney injury happens when the kidneys suddenly can't filter waste products from the blood. When the kidneys can't filter wastes, harmful levels of wastes may build up. The blood's chemical makeup may get out of balance.

Acute kidney injury used to be called acute kidney failure. Acute kidney injury is most common in people who are in the hospital, mostly in people who need intensive care.

Acute kidney injury ranges from mild to severe. If severe, ongoing, and not treated, it can be fatal. But it also can be reversed. People in otherwise good health may get back typical or nearly typical use of their kidneys. In this PPT you will know about clinical features of acute renal failure.

1. ACUTE RENAL FAILURE PATHOLOGY B.Sc.(N) 4 th sem. SHIVANGI KUSHWAHA (ASSIST.LECTURER)

2. OBJECTIVE To explain the underlying mechanisms of acute renal failure (acute kidney injury). To identify the causes and types (prerenal, intrinsic, postrenal) of acute renal failure. To discuss the physiological changes in kidney function, including impaired filtration, fluid retention, and electrolyte imbalance .

3. ACUTE RENAL FAILURE Acute renal failure (ARF), also known as acute kidney injury (AKI), is a sudden and rapid decline in kidney function, resulting in the inability to filter waste products from the blood, regulate fluid balance, and maintain electrolyte homeostasis, typically occurring over hours to days .

4. CAUSES OF ARF PRE-RENAL CAUSES INTRA-RENAL CAUSES POST-RENAL CAUSES Decrease in blood flow to the nephron. Renal Ischemia Vascular disease Disease of renal tissue Vascular disease of arteries and arterioles disease of glomeruli, acute tubular necrosis. Nephrotoxins. Obstruction to the flow of urine.

5. CLINICAL FEATURES It depends on the cause. Based on causes there are three patterns of ARF- SYNDROME OF ACUTE NEPHRITIS SYNDROME ACCOMPANYING TUBULAR PATHOLOGY PRE-RENAL SYNDROME

6. 1. SYNDROME OF ACUTE NEPHRITIS Associated with acute post-streptococcal glomerulonephritis. Renal dysfunction results from the extensive proliferation of epithelial cells in the glomeruli with a mild increase in glomerular permeability and a decrease in GFR. Mild proteinuria, oedema, mild hypertension Fluid retention in acute nephritis syndrome results from decreased GFR and enhanced salt and water reabsorption in the distal nephron.

7. 2. SYNDROME ACCOMPANYING TUBULAR PATHOLOGY When the AFR is caused by the destruction of the tubular cells of the nephron as occurs in acute tubular necrosis. The disease typically progresses through 3 characteristic stages from oliguria to diuresis to recovery- OLIGURIC PHASE – Lasting on an average from 7 to 10 days is characterised by a urinary output of less than 400ml per day. The decline in the formation of the urine leads to the accumulation of waste products of protein metabolism in the blood and resultant AZOTAEMIA, METABOLIC ACIDOSIS, HYPERKALAEMIA, HYPERVOLAEMIA due to secondary effects of circulatory overload and pulmonary oedema. SpG low but increased sodium in the urine. Azotaemia- Increased levels of urea and other nitrogen compounds in blood. Hypervolaemia- Increased plasma level

8. II. Diuretic phase - With the onset of healing of tubules, there is an improvement in urinary output. This occurs due to water and sodium being drawn by elevated creatinine and urea levels as they pass through the nephron for excretion. Due to impaired tubular cell function, the urine has a low or fixed specific gravity. III. Phase of recovery – Full recovery with healing of tubular epithelial cells occurs in about half of cases. It may take 1 year to restore normal tubular function.

9. 3. PRE-RENAL SYNDROME Occur due to secondary disorders in which neither the glomerulus nor the tubules are damaged resulting in pre-renal syndrome. Seen in marginal ischemia caused by renal arterial obstruction, hypovolaemia, hypotension, or cardiac insufficiency. Decrease renal blood flow resulting in low GFR, OLIGURIA, AZOTAEMIA, fluid retention, and edema .

10. BIBILIOGRAPHY TEXTBOOK OF PATHOLOGY BY HARSH MOHAN https://www.researchgate.net/figure/Main-causes-of-renal-failure-Renal-failure-is-categorized-into-pre-renal-red-intrinsic_fig1_361423250 https://images.app.goo.gl/fTfNm7d6BYsorVQ28