Anda di halaman 1dari 8

ACUTE RENAL FAILURE (ARF)

Sudden loss or decreased of


kidneys function
Imbalance of water & electrolyte
blood
Increased of waste products
(Ureum & Creatinin)
1
ETIOLOGY:
A. Prerenal: Decrased blood flow
• Diarrhea dehydration
• Hemorrhage
• Burns
• Septic shock
B. Renal:
• Acute Tubular Necrosis
• Acute Nephritic Syndrome
• Nephrotic syndrome
• Acute Pyelonephritis
C. Postrenal: Urinary tract obstruction
• Tumors
• Kidneystones
• Nephrocalcinosis
2
Etiology of ARF in Newborn:
1. Prerenal:
• Perinatal hemorrhage (birth trauma, placenta
abruption)
• Neonatal hemorrhage (severe intraventricular
hemorrhage, adrenal hemorrhage)
• Perinatal asphyxia
• Hyaline membrane disease
2. Renal :
• Acute Tubular Necrosis (perinatal asphyxia)
• Maternal-fetal transfer:
• Antibodies
• Infections: syphilis, Cytomegalovirus
3. Postrenal: Congenital malformations of urinary
collecting system
3
CLINICAL MANIFESTATIONS:
1. Decreased urine volume (Oligouria  Anuria)
2. Generalized swelling
3. Changes in mental status:
• Unconscious
• Delirium/confusion
• Coma
4. Seizures
5. Nausea, vomiting
6. Anemia
7. Kusmaul respiration
4
DIAGNOSIS
Clinical Manifestations

Lab. Examination:

Serum Ureum increased

Serum Creatinin increased

Creatinin Clearance ↓

Serrum Potasium ↑

5
TREATMENT
1. The goal of the treatment is to identify & treat reversible causes like
prerenal causes (diarrhea dehydration) & post renal causes (e.g.
obstructive uropathy by surgeon procedure)
2. Medical drugs:
• Antibiotics: To prevent infection
• Diuretics: to treat oligouria or anuria
• Diazepam: To handle convulsion
3. Emergency condition:
• Hyperkalemia:
• Ca Glukonas
• Potassium exchange resin (Kayexalate) Oral/rectal
• Metabolic acidosis: Bicarbonate Natricus
6
Any
Questions
?