Acute renal failure (ARF)
Introduction
Is an abrupt or rapid decline in renal filtration function This is (usually) reversible kidney failure, most commonly as a result of:
• Dehydration and fluid loss
• Drugs/toxins,
• Urinary tract obstruction, and
• Acute glomerulonephritis in older children
Risk factors
Signs and Symptoms
Diagnostic criteria
• Oedema
• Oluguria/anuria
• Convulsions in children
Investigation
• Serum electrolytes, Urea and Creatinine tests
• Ultrasound
• Urinalysis
Management
• Give oxygen, and nurse in semi-Fowlers’ position if patient has respiratory distress.
• Stop intake of all salt and potassium containing foods and fluids
• Restrict fluid intake to 10 mL/kg/day daily plus visible fluid losses
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Pharmacological
- Adults
If diastolic blood pressure is greater than 100 mmHg or systolic blood pressure is above 150 mmHg:
• Amlodipine (PO) 5 mg as a single dose.
If there is respiratory distress (rapid respiration, orthopnoea)
• Furosemide, as an IV bolus, 80 mg.
Note: Do not put up a drip and do not give a fluid infusion.
Referral. All cases where adequate laboratory and clinical resources exists, management according to the hospital level guidelines may be instituted .
-
Non-pharmacological
- • Give oxygen, and nurse in semi-Fowlers’ position if patient has respiratory distress.
• Stop intake of all salt and potassium containing foods and fluids
• Restrict fluid intake to 10 mL/kg/day daily plus visible fluid losses
Prevention
Updated on,
23 Novemba 2020 11:49:42
References
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