Acute Renal Failure - Page 1
A 27 year old female was seen by medical personnel at an after hours clinic. She complained of nausea and weakness. Physical examination showed the patient had some edema. Since the patient's medical record showed a history of diabetes, her family physician was notified. Further patient history revealed the patient had been treated 2 weeks prior for a recurring urinary tract infection with two types of antibiotics. However, over the past week, the patient's urine output began to decrease markedly (oliguria). Alarmed by this information, the family's physician ordered several series of blood tests STAT and asked the patient's husband to transport her to the hospital for admission and further evaluation.
The following tests were ordered:
Complete blood chemistry
CBC
Urinalysis (Be sure to view the photos of the cells and casts at this site.)
urine clearance test to test for glomerular filtration rate
In addition to the links below, review the urinary system, kidney anatomy, and the nephron in the workbook.
The Kidney and Kidney disease
Urinary Sytem: The Nephron
1. What are the 3 important functions of the kidney?
2. What things can cause a change in the structure or function of the kidney, causing kidney disease?
3. List symptoms that may be present if the kidneys are failing?
4. What treatment method will be used if kidney function can't be restored?
This patient's symptoms may well indicate the serious and life-threatening condition know as acute renal failure. (Make sure to click on the different topics under 'Acute Renal Failure Basics.'
The broad definition certainly means the loss of kidney function to some degree and is usually of sudden onset. At the kidney level, this means a loss in the glomerular filtration rate. The link above presents a good overview of the key points of renal failure and links to basic kidney function. In this case study, we will focus on acute tubular necrosis (ATN) as a toxic side-effect of the antibiotics administered previously.
Fron the link "acute renal failure" answer the following questions:
5. Define acute renal failure.
6. What is the difference between oliguric and nonoliguric patients with acute renal failure?
7. What is prerenal acute renal failure and what might cause this?
8. What is postrenal acute renal failure and what might cause this?
9. What causes intrinsic acute renal failure?
From the link "acute tubular necrosis" answer the following questions:
10. Define acute tubular necrosis
11. What are the risk factors (or possible causes) of ATN?
Case questions 12-20 can be found by linking to "Blood Chemistry and Urinalysis results