Download Acute Renal Insufficiency Made Ridiculously Simple by Carlos Rotellar PDF

By Carlos Rotellar

A short, transparent, sensible, and funny method of acute renal insufficiency.

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Extra info for Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition)

Example text

28 CHAPTER IV DIFFERENTIAL DIAGNOSIS AND PROGNOSIS 29 Differential Diagnosis The differential diagnosis includes prerenal, intrinsic and postrenal acute renal failure. First obtain a good medical history and perform a physical examination. , excessive fluid losses (diarrhea), weight loss and orthostatic hypotension suggests dehydration (Fig. 35) . A history of heart disease with acute f\. R. F. DEH'IDRATION ... Low FLV\[) INTAKE 'Z 0 I- a:: DC Q :>:::J: w Q IL 0 ~ :fj ~ ~ • •. l VI HIG-H LoW HEMATOCRIT.

During this period, the kidney cannot concentrate the urine and loses a lot of water with electrolytes (polyuric phase) . Furthermore, the urea and toxins are acting as osmotic diuretics increasing even more the water and electrolyte excretion. The therapeutic measures at this point are directed toward adequate fluid and electrolyte replacement to compensate for the excessive losses. As a rule, aim for a negative fluid balance of about 500 mI to 1000 m1/24 hours (Fig. This decreases the amount of fluid accumulated during the oliguric phase and avoids continuous polyuria secondary to excessive fluid intake.

Idiopathic rapid progressive glomerulonephritis, Wegener's granulomatosis, polyarteritis nodosa etc). Transplanted kidneys can suffer acute renal failure due to any of the etiologies discussed previously and the approach to diagnosis and treatment are the same as for native kidneys. However, in the differential diagnosis we have to add two major situations in which the acute renal failure is directly related to the fact that we are dealing with a transplanted kidney. These are: acute transplant rejection and acute cyclosporine toxicity.

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