[Applause] [Music] now for renal failure we're covering acute versus chronic so for chronic kidney failure also called chronic kidney disease or just CKD this is longterm chronic damage to the kidneys we're talking over years and years of Destruction typically resulting in permanent damage an acute kidney failure also called acute kidney injury is that sudden short-term loss of kidney function but if not stopped or reversed it can lead to chronic renal failure so a Kaplan question asks about acute kidney injury what is the correct understanding and the answer is sudden loss of kidney function due to loss of renal system circulation or glomular or tubular damage so what's really going on in the body for pathophysiology and causes let's cover the acute kidney failure first in acute kidney failure it can result from three types we have prerenal that decrease blood flow to the kidney so the memory trick we use is think of decreasing of prefusion with prerenal and then next is intrarenal that damage inside the renal think in the renal for intrarenal and if the cause is after the renal that's post renal so just think post for past renal now let's dig into the specifics here so for pre-renal just think of that decreased profusion for prerenal oxygen-rich blood flow can't get to the kidneys this decreased blood flow means decreased oxygen so remember oxygen is the money of the body no money no honey no oxygen and the body goes broke and dies kind of like the kidney is suffocating to death you like that did you well click here and get access to over a th000 fun visual videos 300 study guide cheat sheets and a massive quiz Bank loaded with detailed rationals to test your knowledge neatly organized in our new app click here to get started for free now this is typically caused by obstruction or vessel occlusion where we have a blockage of blood flow which blocks oxygen now this is typically from an emilii or blood clot or even a tumor that blocks profusion into the kidneys another cause is from low blood pressure that low perfusion with prerenal like patients with shock hypovolemia from that major blood loss or volume loss resulting in dehydration which results in decreased map that mean arterial pressure fancy words for low blood pressure meaning low perfusion less than 65 map for mean arterial pressure lastly low cardiac output we get low perfusion so just think low cardiac output means low oxygen put out of the heart resulting in low perfusion to the kidneys typically from when the heart can't pump correctly which decreases blood being pumped out of the heart so we see this with ECG D rhythmia with those funky beats and even clients in heart failure which is a little bit tricky so listen close even though we may have high blood pressure with heart failure clients the big problem is low cardiac output we get low volume of oxygen-rich blood out of the heart this results in less perfusion and less oxygen to the kidneys next we have intrarenal that direct damage inside the kidney itself again think intrarenal for inside the ring now this is far more serious because it's more intense with intrarenal now it's also referred to as ATN acute tubular necrosis so just think ATN requires immediate attention now typically it's caused from infections resulting from glomerular nephritis or even autoimmune diseases like lupus where the body attacks itself resulting in nephrotic syndrome which we cover both in a separate video but really the most tested top two causes for exams write these down is CT contrast die like with a heart cath so just remember contrast kills the kidneys and even antibiotics ending in mein like Venom myosin and gentamycin so just think it's a sin to give a myin since it's so damaging to the kidneys lastly untreated infections and even long-term use of nids like naproxin iuo and even curac can cause damage to the kidneys it's kind of like overloading two delicate washing machines with thick cement we literally clogged the kidneys here with these medications and in result the creatinine lab value shoots up Sky High so the key number to know is creatinine over 1.3 is bad kidney and the memory trick we use just think of the three C's creatinine is the most critical lab value since it shows clogging of the kidneys and last but not least we have postrenal just think past the renals there's a renal blockage after the kidneys which basically blocks the outflow of urine so urine can't get out of the kidney itself causing a lot of pressure pain and strain on the renals like with clients with renal calculi AKA those kidney stones or even a tumor or even BPH that benign prostatic hyperplasia we see a big swollen prostate in our older men populations so just think the memory trick BPH as a big prostate that holds back urine and now we have an outflow problem as far as assessment findings these are pretty simple so remember from our anatomy video what are the three waste products that the kidneys filter well remember we use our acronym hook hu since the kidneys sort of kind of look like a pirate hook H is for hydrogen ions which are very U is for Ura and C is for creatinine for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos all right guys see you next time