Renal Calculi & Renal Failure
Transcript of Renal Calculi & Renal Failure
-
8/14/2019 Renal Calculi & Renal Failure
1/17
RENAL CALCULI &RENAL FAILUREPrepared by
The boyz 5A
-
8/14/2019 Renal Calculi & Renal Failure
2/17
Renal calculi
are solid concretions (crystalaggregations) formed in the kidneysfrom dissolved urinary minerals.
http://en.wikipedia.org/wiki/File:Nefrolit.jpg -
8/14/2019 Renal Calculi & Renal Failure
3/17
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 -
8/14/2019 Renal Calculi & Renal Failure
4/17
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
-
8/14/2019 Renal Calculi & Renal Failure
5/17
Continue..
Abdominal distension.
Nausea/vomiting
Fever and chills.
Loss of appetite
Loss of weight
-
8/14/2019 Renal Calculi & Renal Failure
6/17
Diagnostic test
X-ray
CT scans
Ultrasound
Urine C & S
Blood FBC
24 hours urine collection
-
8/14/2019 Renal Calculi & Renal Failure
7/17
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.
-
8/14/2019 Renal Calculi & Renal Failure
8/17
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.
-
8/14/2019 Renal Calculi & Renal Failure
9/17
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.
-
8/14/2019 Renal Calculi & Renal Failure
10/17
Renal failure
the kidneys fail to function adequately.
It is divided in acute and chronic formsdue to a large number of other medical
problems.
-
8/14/2019 Renal Calculi & Renal Failure
11/17
Acute Renal Failure
a rapidly progressive loss of renalfunction, generally characterized byoliguria , body water and body fluids
disturbances; and electrolytederangement.
-
8/14/2019 Renal Calculi & Renal Failure
12/17
Chronic renal failure
develop slowly and show few initialsymptoms, be the long term result ofirreversible acute disease or be part of a
disease progression.
-
8/14/2019 Renal Calculi & Renal Failure
13/17
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)
-
8/14/2019 Renal Calculi & Renal Failure
14/17
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)
-
8/14/2019 Renal Calculi & Renal Failure
15/17
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.
-
8/14/2019 Renal Calculi & Renal Failure
16/17
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.
-
8/14/2019 Renal Calculi & Renal Failure
17/17
Treatment
qMedication such as loop diuretics
Example : bumetanide ( bumex ),ethacrynic acid (edecrin ), Furosemide
(lasix)qRenal replacement therapy : dialysis