Lecture Notes on Renal Failure

Introduction

• Renal Failure Types: Acute vs. Chronic
  • Chronic Kidney Disease (CKD): Long-term, often permanent damage to kidneys over years.
  • Acute Kidney Injury (AKI): Sudden, short-term loss of kidney function.

Acute Kidney Injury (AKI)

• Definition: Sudden loss of kidney function due to problems in renal circulation or damage.
• Pathophysiology and Causes:
  • Types of Acute Kidney Failure:
    1. Prerenal: Decrease in blood flow to the kidneys.
    2. Intrarenal: Damage inside the kidneys.
    3. Postrenal: Obstruction after the kidneys.

Prerenal Causes

• Decreased Perfusion: Oxygen-rich blood can't reach kidneys.
• Causes:
  • Obstruction/Vessel Occlusion: Blockages like emboli, blood clots, or tumors.
  • Low Blood Pressure: Shock or hypovolemia leading to dehydration and decreased mean arterial pressure (MAP < 65).
  • Low Cardiac Output: Heart can't pump efficiently, affecting kidney perfusion; issues seen in heart failure.

Intrarenal Causes

• Direct Damage to Kidneys: Known as Acute Tubular Necrosis (ATN).
• Causes:
  • Infections: Glomerulonephritis or autoimmune diseases (e.g., lupus causing nephrotic syndrome).
  • Medications:
    • CT Contrast Dye: Toxic to kidneys.
    • Antibiotics ending in -mycin: e.g., vancomycin, gentamicin.
  • Other Drugs: Long-term NSAIDs use (e.g., naproxen, ibuprofen) causing kidney damage.
• Key Lab Value: Creatinine > 1.3 indicates bad kidney function.

Postrenal Causes

• Obstructions after Kidneys: Prevents urine outflow, increasing pressure on kidneys.
• Causes:
  • Renal Calculi (Kidney Stones)
  • Tumors
  • Benign Prostatic Hyperplasia (BPH): Enlarged prostate preventing urine outflow.

Assessment Findings

• Key Waste Products Filtered by Kidneys:
  • Hydrogen ions (H)
  • Urea (U)
  • Creatinine (C)
• Acronym: HUC (Hook) to remember these waste products.

Conclusion

• Additional Resources: Mention of video resources and quizzes for further study.
• Credits: Acknowledgement of the team behind the educational content.

• Note: This summary provides an overview of the key points discussed in the lecture on renal failure, focusing on acute and chronic kidney issues, their causes, and physiological effects on the body.