We will focus primarily on the diagnosis and management of the causes of acute and chronic renal failure and glomerular diseases. Acute Renal Failure Renal failure is categrorized as acute or chronic, either of which wil result in ESRD if not reversed. Prerenal ARF Structurally, the kidneys are normal and respond appropriately to the various prerenal causes, in particular, sudden marked decrease in vascular volume and or cardiac output, which leads to hormonal changes.
Renal ultrasound is normal.
Oliguria or anuria interspersed with polyuria are indicators of urinary tract obstruction. Further decrease in GFR Management comprises removal of obstruction surgically or by percutaneous nephrostomy. The 2 basic pathogenic mechanisms for ATN are ischemia and nephrotoxicity. Ischemia is caused by the mechanisms listed. If the hypoperfusion that causes prerenal failure continues,a second mechanism sets in that maintains oliguria.