Scenario 1: 1. Normally the kidney regulates its own blood flow and GFR. When the kidneys become hypoperfused, such as in hypovolemia, shock, heart failure, or narrowing of renal arteries, vessls in the kidney dilate with the helf of prostoglandims to facilitate flow. If this autoregulation of blood flow fails, the GFR can be maintained by selective consriction of post-glomerular (efferent)arteriole by the release of renin and generation of angiotensin II. COntinued hypoperfusion of the kidneys may lead to failure of these compensatory mechanisms and an acute decline in GFR. Renal tubules become hyperfunctional and reabsorption of sodium and water is increased, through the influence of angiotensins, aldosterone and vassopressin. This leads to the formation of a low volume of urine which is concentrated. 2. Acute renal failure does not produce a classic set of symptoms. The most common symptom is decreased urine output,
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Chronic kidney disease, kidney function, Mr. Hodges CRF worses