Can Acute Kidney Failure Be Cured

Can acute renal failure be cured? This is probably the question that all acute renal failure patients want to know the answer to when they learn that they have the disease. Here, listen to the answer to a question from a nephrologist. If you want to know if acute renal failure can be cured? You need to know more about acute renal failure. Here is to introduce some common sense of acute renal failure, so that everyone can better understand acute renal failure.

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1. Causes of acute kidney failure:

1. Prerenal

a. Decreased cardiac output: heart failure and low cardiac output syndrome; systemic vasodilation (application of vasodilators).

b. Hypovolemia: vomiting and diarrhea; burns and profuse sweating; application of diuretics and osmotic diuretics (diabetes).

2. Postrenal

Urinary tract obstruction due to: urinary tract stones, bilateral hydronephrosis, prostatic hypertrophy and tumor, and urethral stricture.

3. Kidney parenchyma

Renal parenchymal damage caused by:

a. Acute renal interstitial lesions: allergies, infections, metabolic abnormalities and tumors.

b. Glomeruli and tubules: acute and rapidly progressive nephritis, multiple small vessel vasculitis, renal cortical necrosis.

c. Acute tubular necrosis: ischemia, poisoning, abnormal HB.

2. The pathogenesis of acute renal failure

1. Renal hemodynamic changes: renal cortical ischemia and renal medulla congestion lead to decreased glomerular filtration and renal tubular necrosis.

2. The theory of renal tubule blockage: The blockage of the renal tubule causes the pressure in the renal capsule to increase, and the glomerular filtration stops.

3. Disseminated intravascular coagulation: caused by severe infection or blood loss.

4. Leakage theory: the reflux of renal tubular fluid into the renal interstitium causes interstitial edema, compresses the nephron, and aggravates renal ischemia.

3. Symptoms of acute renal failure:

(1) Beginning period

When the above-mentioned shock and other causes occur in the body, the blood volume is insufficient, the blood pressure drops, the renal blood vessels contract, the renal blood flow decreases, the glomerular filtration rate also decreases, and the urine volume decreases. The secretion of aldosterone and adrenocorticotropic hormone further reduces urine output, increases specific gravity, and reduces urinary sodium. In this stage, hypovolemia and renal vasospasm are the main symptoms, and only the symptoms of the primary disease and oliguria are clinical. This stage is very important to prevent the progression of acute renal failure. If it can be properly handled in time, it can avoid the development of the stage of organic renal failure.

(2) Oliguria or anuria period

The persistent existence of pathogenic factors can cause damage to the renal parenchyma, mainly the degeneration and necrosis of renal tubular epithelial cells, thus entering the oliguria or anuric stage. Those with less than 400 ml of urine in 24 hours are called oliguria, and those with less than 100 ml of urine are called anuria. The main clinical manifestations of this period are:

Disordered excretion of water

(1) Water intoxication: In the case of excessive endogenous water production due to reduced urination of the kidneys and vigorous metabolisms, such as excessive intake of liquid and sodium salts, water intoxication can occur. This is a serious complication of the oliguria phase, and its clinical manifestations are generalized soft-tissue edema, acute pulmonary edema, and cerebral edema. In the early stage of pulmonary edema, only rales and breath sounds at the bottom of the lungs are reduced. Headache, vomiting, confusion, and convulsions with cerebral edema. On the one hand, water intoxication can increase the burden on the heart and cause heart failure due to excessive water retention in the body; on the other hand, it can also lead to electrolyte imbalance, thus endangering the patient's life. Therefore, water intoxication is one of the leading causes of death in acute renal failure.

What are the common and important complications of acute renal failure?

    Acute kidney failure mostly goes through three stages of development: oliguria (or anuria), polyuria, and recovery. The complications that may occur in the oliguric stage of acute renal failure are:

    (1) Infection is one of the most common and serious complications, which is more common in highly decomposable acute renal failure caused by severe trauma and burns.

    (2) Complications of the cardiovascular system, including heart rhythm disorders, heart failure, pericarditis, hypertension, etc.,

    (3) Nervous system complications manifested as headache, drowsiness, muscle twitching, coma, epilepsy, etc. Neurological complications are associated with the retention of toxins in the body as well as water intoxication, electrolyte disturbances, and acid-base imbalances.

    (4) Digestive system complications manifested as anorexia, nausea, vomiting, abdominal distension, hematemesis or blood in the stool, etc. Bleeding is mostly caused by gastrointestinal mucosal erosion or stress ulcers.

    (5) Complications of the blood system Due to the sharp decline of renal function, erythropoietin can be reduced, which can cause anemia, but most of them are not serious. A small number of cases may have bleeding tendencies due to decreased coagulation factors.

    (6) Electrolyte imbalance, metabolic acidosis, hyperkalemia, hyponatremia, and severe acidosis can occur, which is one of the most dangerous complications of acute renal failure.

    In the polyuria period, the daily urine output of the patient can reach 3000-5000ml. Due to the excretion of a large amount of water and electrolytes, dehydration, hypokalemia, hyponatremia, etc. may occur. If it is not replenished in time, the patient may die of severe dehydration and electrolyte disturbances.

    In the recovery period, the serum urea nitrogen and creatinine levels returned to normal, the symptoms of uremia subsided, and the renal tubular epithelial cells were regenerated and repaired. The renal function of most patients could be completely recovered, and a small number of patients could be left with different degrees of renal function damage.

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