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Acute renal failure is now being called _____
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Acute kidney injury
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What is the definition of acute renal failure?
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Sudden loss of renal fxn over several hrs to several days, resulting in derangements in ECF balance, acid base, and electrolyte regulation
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What are the major hallmarks of acute renal failure (ARF)?
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Inc serum creatinine and BUNaccumulation of nitrogenous-based wastesdecline in urinary output (but may not occur)
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Define acute kidney injury (AKI).
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An abrupt (w/in 48 hrs) reduction in kidney fxn currently defined as:an absolute increase in serum creatinine of either > 0.3 mg/dl or a
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Azotemia
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Accumulation of nitrogenous wastes
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Uremia
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Symptomatic renal failure
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Oliguria
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Urine output < 400-500 mL/24 hrs
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Anuria
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Urine output < 100 mL/24 hrs
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What are the 6 main consequences of ARF?
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1. Azotemia progressing to uremia2. Hyperkalemia3. Metabolic acidosis4. Volume overload5. Hyperphosphatemia6. Accumulation and toxicity of medications excreted by the kidney
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What are the 3 types of acute renal failure?
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1. Prerenal ARF2. Intrinsic ARF3. Postrenal ARF
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What are the 5 examples of intrinsic ARF?
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Acute tubular necrosis (ATN)Acute interstitial nephritis (AIN)Acute GN Acute vascular syndromesIntratubular obstruction
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WHat is prerenal ARF?
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Nothing is wrong with the kidneys structurally; the problem is functional (and thus reversible). Just a problem w/ perfusion to the kidneys. Characterized by hyaline casts.
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What is intrinsic ARF?
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Part of the kidneys are damaged.
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Prerenal azotemia is caused by ___________
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Decreased renal blood flow
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What are the 3 causes of decreased renal blood flow that can cause prerenal azotemia?
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1. True intravascular depletion2. Decreased effective circulating volume3. Agents that impair renal blood flow
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