renal calculi & renal failure

8/14/2019 Renal Calculi & Renal Failure

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RENAL CALCULI &RENAL FAILUREPrepared by

The boyz 5A


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Renal calculi

are solid concretions (crystalaggregations) formed in the kidneysfrom dissolved urinary minerals.
http://en.wikipedia.org/wiki/File:Nefrolit.jpg


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Etiology of renal calculi

1. Composed of calcium oxalate crystals

- When the amount of calcium intakedecreases, the amount of oxalate easy

to absorption into the bloodstreamincreases and then excreted into theurine by the kidney

2. Composed of uric acid- a persistent undue urine acidity
http://en.wikipedia.org/wiki/File:Kidney_stones,_Uric_acid.JPGhttp://en.wikipedia.org/wiki/File:Kidney_stones,_Uric_acid.JPG


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Sign & Symptoms

Colicky pain - the worst pain

Hematuria - blood in the urine

Pyuria - pus (white blood cells) in the

urine. Dysuria - burning on urination when

passing stones.

Oliguria - reduced urinary volumecaused by obstruction of the bladder orurethra by stone


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Continue..

Abdominal distension.

Nausea/vomiting

Fever and chills.

Loss of appetite

Loss of weight


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Diagnostic test

X-ray

CT scans

Ultrasound

Urine C & S

Blood FBC

24 hours urine collection


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Treatment

qMedication such as

- Analgesia such as morphine sulfate ( torelieve pain and reduce uteral spasm )

- NSAID such as suppository ( may reducethe amount of narcotic analgesiarequired for acute renal colic)

qSurgery

- Lithotrispy using sound or shock wavesto crush stone.


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Prevention

Drinking enough water

A diet low in protein, nitrogen and sodiumintake.

Restriction of oxalate rich foods, such aschocolate plus maintenance of anadequate intake of dietary calcium.

Taking drugs such as thiazides, potassiumcitrate, magnesium citrate andallopurinol, depending on the cause ofstone formation.


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Continue..

Some fruit juices, such as orange,blackcurrant, and cranberry, may beuseful for lowering the risk factors for

specific types of stones. Avoidance of cola beverages.

Avoiding large doses of vitamin C.


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Renal failure

the kidneys fail to function adequately.

It is divided in acute and chronic formsdue to a large number of other medical

problems.


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Acute Renal Failure

a rapidly progressive loss of renalfunction, generally characterized byoliguria , body water and body fluids

disturbances; and electrolytederangement.


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Chronic renal failure

develop slowly and show few initialsymptoms, be the long term result ofirreversible acute disease or be part of a

disease progression.


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symptoms

High levels of urea in the blood, can resultin Vomiting and/or diarrhea (dehydration)NauseaWeight loss

Foamy or bubbly urine

Blood in urineDysuria (difficult to urine)


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Symptoms

Failure of kidneys to remove excess fluidmay causeSwelling of the legs, ankles, feet, face

and/or handsShortness of breath due to extra fluid

on the lungs (may also be caused byanemia)


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Pathophysiology

The causes and pathophysiology of acuterenal failure (ARF) are commonlycategorized as prerenal , intrinsic , andpostrenal ARF.

In prerenal ARF, hypoperfusion leads toacute renal failure without directlyaffecting the intergrity of kidney tissues.

Intrinsic (or intrarenal) ARF , due to directdamage to functional kidney tissues.

Urinary tract obstruction with resultingkidney damage is the precipating factor

for postrenal ARF.


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Causes of acute renal failure

cause exam ples

prerenal-Hypovolemia-Low cardiacoutput

-Alteredvascularresistance

-Hemorrhage, dehydration, excess fluidloss from GIT-Heart failure, cardiogenic shock

-sepsis, anaphylaxis, vasoactive drugs

intrarenal

glomerular/microvascular injury- Acute tubularnecrosis

-glomerulonephritis, DIC,hypertension,hemolytic uremicsyndrome.-ischemia due to conditions associated

with prerenal failure;toxins such asdrugs

postrenal -Intersitialnephritis-ureteralobstruction-uretheral

obstruction

-acute pyelonephritis,toxins,metabolicimbalanceCalculi, cancer, external compressionProstatic enlargement, calculi, cancer ,

blood clot.


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Treatment

qMedication such as loop diuretics

Example : bumetanide ( bumex ),ethacrynic acid (edecrin ), Furosemide

(lasix)qRenal replacement therapy : dialysis

renal calculi & renal failure

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