ARF - Acute Renal Failure Anil Menon 11/27/06 A simple...

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Acute Renal Failure Anil Menon 11/27/06
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A simple algorithm Malingering Rapid fall in GFR leading to increased waste products
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Relevance Complicates up to 7% of admissions Mortality when dialysis is required ranges 50%-75%
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DDX
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Diagnostic Approach Cr/BUN, UOP, serum cystatin K, IL18 H&P Meds Labs Imaging
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Acute or Chronic? History Previous creatinine Small kidneys on u/s
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Obstruction excluded? History Complete anuria Palpable bladder Renal u/s
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Euvolemic? Pulse, JVP/CVP, orthostatic, wgt, I/O Disproportionate inc in urea:Cr ratio FENA Fluid challenge
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Evidence of parenchymal dz? Other than ATN H+P (systemic factors) Urine dipstick and micro (red cells, red cell casts, eosinophils, prot)
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Major vascular occlusion? Athreosclerosis Renal Assymetry Groin pain Complete Anuria Macro Hematuria
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Treatment Prevention Risk factors (age,DM,HTN,Vasc,renal) Maintain BP and Volume, avoid neprhotox Measure plasma aminoglycoside Allopurinol/urine alk in cancer
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This note was uploaded on 12/21/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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ARF - Acute Renal Failure Anil Menon 11/27/06 A simple...

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