Diagnosis of renal failure

Symptoms of acute renal failure
Acute renal failure (ARF) clinical manifestations generally can be summarized into three types:
( 1 ) Type of urine to oliguric ARF ( urine output less than 400ml / day ) or no urine ( urine output of less than lOOml / day ) was notable features generally have been oliguria ( or anuria ) polyuria and recovery oliguric phase three clinical stage usually lasts 3 days to 1 month on average , ranging from about 10 days or so mainly oliguria as follows: ① Shuinazhuliu : performance for high blood pressure and other systemic edema cerebral edema and pulmonary edema, heart failure often life-threatening is the main cause of death of former resistance ; ② electrolyte imbalance : hyponatremia, hypocalcemia , including hyperkalemia and hyperphosphatemia , etc. ; oliguric hyperkalemia often leading cause of death ; ③ Metabolism acidosis : acidic metabolites accumulate in the body and tissue destruction caused by infection can aggravate acidosis acidosis may manifest as nausea, vomiting, fatigue, drowsiness , such as deep breathing severe drop in blood pressure can occur in shock ; ④ uremic symptoms: for all toxins accumulate in the body causing systemic symptoms of various systems including nitrification anorexia , nausea and vomiting , abdominal distension and diarrhea ; respiratory system include chest pain, cough, dyspnea uremic pneumonia ; circulatory system , including arrhythmia ; heart failure ; nervous system , including consciousness restlessness , delirium and convulsions after entering the urine of urine per day up to 3000 to 5000mL gradual decline in serum urea nitrogen and creatinine uremic symptoms gradually subsided polyuria due to large amounts of water and electrolytic
Dehydration can occur qualitative discharge hypokalemia hyponatremia , etc. If you do not replenish the recovered patients may die from dehydration and electrolyte imbalance into the convalescent serum urea nitrogen and creatinine levels to normal renal tubular epithelial cell regeneration and repair of renal function fully restored takes about six months to a few patients can be left in the time varying degrees of renal impairment
( 2 ) a portion of the non- oliguric ARF cases little or no urine without clinical manifestations showed only a short time creatinine clearance decreased rapidly decrease of 50 % or less of normal serum urea nitrogen and creatinine serum creatinine increased rapidly every day rise faster than 44-88mmol / L, this type is called non- oliguric ARF relatively mild clinical manifestations often misdiagnosed
(3 ) a portion of the high resolution type ARF tissue catabolism occurs in cases of extreme conditions of increased blood urea nitrogen and creatinine increased daily speeds > 14.3mmol / L and > lUmol / L is called a high resolution type is commonly found in large ARF trauma ; like major surgery and severe burns after infection cases showed severe metabolic acidosis and electrolyte imbalance symptoms significantly especially in the nervous system can be expressed as drowsiness coma prominent convulsive epileptic seizures or loss and other hyperreflexia
Two symptoms of chronic renal failure
Renal failure early clinical manifestations easily missed but obvious to advanced disease can affect various body organs can have many manifestations
A poison and symptoms caused by the accumulation of metabolites :
( 1 ) Digestive performance : digestive performance is one of the earliest and most common manifestations are severe indigestion, anorexia may have glossitis oral erosion if peptic ulcer involving the blood vessels may have vomiting blood in the stool
( 2 ) the performance of the hematopoietic system : chronic renal failure patients had varying severity of anemia and more from chronic malnutrition reduction in erythropoietin -induced renal failure and hemolytic patients have bleeding tendencies manifested as skin bruising , bleeding gums bleeding epistaxis severe gastrointestinal bleeding and death can occur but can also have abnormal white blood cells due to the " uremic toxin " role and function of leukocytes to generate both disorders decreased leukocyte count ( which mainly lymphocytes decreased production ) neutrophil chemotaxis ability of phagocytosis and killing of bacteria also reduce
( 3 ) the performance of the cardiovascular system : a common hypertension myocarditis and pericarditis uremic various arrhythmias and heart failure
( 4 ) the performance of the respiratory system : respiratory difficulty in breathing are generally produced by uremia bronchitis pneumonia and pleurisy when acidosis performance
( 5 ) Skin manifestations: can be expressed as dry and itchy skin, pale and " urea cream"
( 6 ) the skeletal system : calcium and phosphorus metabolism disorders can occur due to osteoporosis or osteomalacia and osteitis pseudo- fracture pain
( 7 ) neuropsychiatric symptoms : central manifestations of depression, irritability, excitability unresponsive coma, convulsions and lethargy and peripheral lesions showed peripheral nerve degeneration and other manifestations of allergic skin burning sensation and movement disorder , such as limb weakness
( 8 ) endocrine dysfunction :
1 ) the performance of parathyroid dysfunction : primarily for the performance of hyperparathyroidism may occur calcium and phosphorus metabolism change the above uremic osteodystrophy
2 ) Thyroid dysfunction: Because T3 and free T3 index fell more performance for hypothyroidism symptoms such as fatigue , dry skin , fatigue lethargy diminished tendon reflexes, hearing loss , low body temperature
3 ) sexual dysfunction : Women showed reduced by irregular menstruation or amenorrhea men mainly as impotence and decreased sperm motility in children showed delayed sexual maturity