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Acute renal failure - that are toxic to the kidneys These...

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Acute renal failure Epidemiology Acute kidney injury is common among hospitalized patients. It affects some 3-7% of patients admitted to the hospital and approximately 25-30% of patients in the intensive care unit. Diagnosis Investigations that should be performed on someone suspected of ARF are: o Bloods – U&E (raised K+), FBC, LFT, clotting, CK, ESR/CRP, blood cultures. Serum Igs and/or antibodies, complement and electrophoresis. o Urine – dipstick for leukocytes, nitrite, blood, protein, glucose. MC&S – for blood cells, casts and pathogens. Chemistry for U&E, creatinine, Osm and Bence Jones protein. o 24hr urine output o CXR o ECG o Renal US Treatment The management of AKI hinges on identification and treatment of the underlying cause. In addition to treatment of the underlying disorder, management of ARF routinely includes the avoidance of substances
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Unformatted text preview: that are toxic to the kidneys. These include NSAIDs such as ibuprofen, iodinated contrasts such as those used for CT scans, and others. o Improve renal function – oxygen, fluids, inotropes o Aim for euvolaemia – fluids/diuretics, monitor input/output o Check for obstruction – catheterise and stent o Treat the underlying cause – antibiotics, stop nephrotoxic drugs, steroids etc. Prognosis Depending on the cause, a proportion of patients will never regain full renal function, thus having end-stage renal failure requiring lifelong dialysis or a kidney transplant. Prevention Preventing ARF is about stopping the underlying cause....
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