By Carlos Rotellar
A short, transparent, useful, and funny method of acute renal insufficiency.
Read Online or Download Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition) PDF
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Extra resources for Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition)
Peritoneal Dialysis. Performed continuously with hourly exchanges as needed. CAVH. (Continuous arteriovenous hemofiltration). Continuous blood « 100 ml/rnin) filtration through a high permeability membrane to accomplish ultrafiltration rates between 200-800 ml/hr, Requires continuous fluid replacement and does not need dialysis fluid. This technique is based on the physical principle of filtration and it can be performed continuously (twenty four hours a day, seven days a week). Filtration is the simultaneous transfer of a solvent, with a part of the solutes it contains, across a membrane .
V. fluids to keep up with the urine output that can be as high as 10 liters/day or even more. 46 Figure 46 During the polyuric phase the patient should be kept in relative negative fluid balance. NTA"E Figure 47 OUTPUT Aim for a negative fluid balance. PERIOD V (The Kidney is Back to Normal) This period may be a long one, in which the renal function is almost normal but the kidney is not yet able to control excessive water (Fig. 48) and salt intake (Fig. 49) . 47 L-- - - Figure 48 Avoid fluid overload.
L VI HIG-H LoW HEMATOCRIT. HEMATOcRIT. (Heh\O,"ONCENTRAiION) Figure 35 Differential diagnosis between ARF and dehydration. 31 decrease in cardiac function will make renal hypoperfusion secondary to decrease in cardiac output very likely (Table I). Table I: PRERENAL Diseases of Renal Artery Thrombosis Stenosis, etc. P. Tamponade, etc. Good fluid balance, normal heart function and use of nephrotoxic drugs suggests intrinsic acute renal failure (Table II). Table II: INTRINSIC ACUTE RENAL FAILURE Glomeruli Vessels Interstitium Tubule (ATN) Glomerulonephritis Vasculitis Allergic interstitial nephritis Prolonged renal ischemia Nephrotoxins Once we have an idea of what is happening clinically, we should proceed to order a few tests that will help us to make a final diagnosis.