Symptoms of acute renal failure

summary

In recent days, the circle of friends has been swiped by the saying that "a man almost died of renal failure after eating 54 popsicles in one night". When can he eat popsicles. Of course, this pot, popsicle is not back, because 54 popsicles is only a cause, not the direct cause of renal failure. So let's take a look at the symptoms of acute renal failure?

Symptoms of acute renal failure

First, decrease of urine volume: the urine volume decreases suddenly or gradually, and the urine volume less than 400ml per day is called oliguria, and the urine volume less than 50ml is called anuria. Patients with ATN rarely have complete anuria, and the prognosis of patients with persistent anuria is poor, and the extrarenal obstruction and bilateral renal cortical necrosis should be excluded. Due to the different etiology and severity of the disease, the duration of oliguria is inconsistent, generally 1-3 weeks, However, few cases of oliguria continue for more than 3 months. Generally speaking, the duration of renal toxicity is short, and the duration of ischemia is longer. If ATN is diagnosed for 12 weeks or more, there may be renal cortical necrosis or necrosis of renal papilla. For patients with oliguria, we should pay attention to fluid retention, congestive heart failure and hyperkalemia. * Hypertension and various complications.

Second: progressive azotemia: the decrease of glomerular filtration rate leads to oliguria or anuria, resulting in the reduction of excreted nitrogen and other metabolic wastes, and the increase of plasma creatinine and urea nitrogen. The increase rate is related to the state of proteolysis in the body. In patients without complications and treated correctly, the increase rate of blood urea nitrogen is slow, about 3.6mmol/l (10mg / dl), The increase of plasma creatinine concentration was only 44.2-88.4% μ However, in hyperdecomposing state, such as with extensive tissue trauma, sepsis, etc., urea nitrogen can increase by 7.1 mmol / L (20 mg / dl) or more per day, and plasma creatinine can increase by 176.8% per day μ The factors that promote protein decomposition include insufficient heat supply, muscle necrosis, hematoma, gastrointestinal bleeding, infection, fever, application of adrenocortical hormone, etc.

Third: water, electrolyte disorder and acid-base balance disorder: ① excessive water: it is found in water control is not strict, intake or rehydration volume is too much, water volume such as vomiting, sweating, wound permeability estimation is not accurate, and endogenous water is ignored in fluid volume supplement. With the extension of oliguria period, excessive water is prone to occur, which is manifested as diluted hyponatremia, soft tissue edema and weight gain, Hypertension, acute heart failure and brain edema. ③ Metabolic acidosis: in normal people, the daily fixed acid metabolites are 50-100 mmol, 20% of which are combined with bicarbonate ion, 80% of which are excreted by the kidney. In acute renal failure, due to the reduction of acid metabolites excretion, the ability of renal tubular acid secretion and sodium bicarbonate preservation, the daily plasma bicarbonate concentration decreases in varying degrees; Most of the endogenous fixed acids come from proteolysis, and a small part from the oxidation of sugar and fat. Phosphate and other organic anions are released and accumulated in the body fluid, resulting in the increase of anion gap in patients with this disease. If the metabolic acidosis is not fully corrected in patients with persistent oliguria, the body muscle decomposes faster, Acidosis can also reduce ventricular fibrillation threshold, ectopic rhythm, hyperkalemia, severe acidosis and hypocalcemia. Hyponatremia is a serious condition of acute renal failure. Although it is rare in patients who have received dialysis treatment, some patients still need drugs to correct metabolic acidosis during the dialysis interval.

matters needing attention

In this way, when we have some symptoms in our body, we can at least notice and judge them, and then we can persuade them to go to the hospital for diagnosis and treatment as soon as possible.