急性与慢性肾衰竭|急性肾衰竭与慢性肾衰竭|ARF与CRF
Acute renal failure is abrupt deterioration in renal function, which is usually, but not invariably reversible over a period of days or weeks, and usually accompanied by a reduction in urine volume. In contrast; chronic renal failure is the clinical syndrome of the metabolic and systemic consequences of a gradual, substantial and irreversible reduction in the excretory and homeostatic functions of the kidneys.
这两种情况,如果不进行治疗,最终导致末期肾衰竭,可能没有肾脏替代疗法死亡,而本文指出了急性和慢性肾衰竭在其定义,时间关系,原因,临床上,临床上的差异和慢性肾衰竭之间的差异功能,调查结果,管理和预后。
急性肾衰竭(ARF)
它定义为降低几天或几周内发生的肾小球滤过率(GFR)。进行ARF的诊断,如果血清肌酐> 50微米/L的增加,或者血清肌酐的增加> 50%,或者降低计算出的肌酐清除率> 50%,或者需要透析。
ARF的原因广泛归类为肾脏前的肾脏后,肾后原因。肾脏前原因是严重的低血容量,心脏泵效率受损和限制肾脏血流的血管疾病。急性管状坏死,肾实质性疾病,肝肾脏综合征是内在肾衰竭和骨盆恶性肿瘤,放射纤维化,双侧石材疾病的某些原因是肾衰竭后肾衰竭的原因。
在ARF中,通常在早期阶段出现警告标志很少,但可能会发现尿量减少和后期血管内耗竭的特征。
The cause may be obvious like gastrointestinal bleeding, burns, skin disease, and sepsis but can be hidden such as concealed blood losses, which can occur in trauma to the abdomen. Features of metabolic acidosis and hyperkalaemia are often present.
一旦做出临床诊断,请通过尿液完整报告,电解质,血清肌酐,成像研究患者。超声扫描显示肾脏肿胀和减少的皮质 - 美食界限。应在所有患者中进行肾脏活检,并具有正常大小的且未打扰的肾脏,其中急性管状坏死的诊断不怀疑导致急性肾衰竭。
Principles of management of ARF include recognition and treatment of life-threatening complications such as hyperkalaemia and pulmonary oedema, recognition and treatment of intra vascular volume depletion and diagnosis of the cause and treat where possible.
急性肾脏ARF的预后通常取决于潜在障碍和其他并发症的严重程度。
慢性肾衰竭(CRF)
慢性肾功能衰竭定义为肾脏损伤或肾小球过滤率降低了30ml/min/min/1.73m2的3个或更长时间,与ARF相比,这是突然或在短时间内发生的。
最常见的原因可能是慢性glomerulonephritis with ever increasing number of diabetic nephropathy leading to CRF becoming common. Other causes include chronic pyelonephritis, polycystic kidney disease, connective tissue disorders, and amyloidosis.
从临床上讲,患者出现不适,厌食,瘙痒,呕吐,抽搐等。他们的身材矮小,苍白,表现出色素沉着,瘀伤,液体上的液体迹象和近端肌病。
研究患者以进行诊断,分期疾病并评估并发症。
Ultra sound scan of the kidney shows small kidneys, reduced cortical thickness, together with increased echogenecity; though renal size may remain normal in chronic renal failure, diabetic nephropathy, myeloma, adult poly cystic kidney disease, and in amyloidosis.
Principles of management include recognition and treatment of life threatening complications such as metabolic acidosis, hyperkalaemia, pulmonary edema, severe anaemia, identifying the cause and treat where possible and take general measures to reduce the progression of the disease.
慢性肾衰竭患者的预后表明,由于肾功能的降低,所有引起死亡率都会增加,但是肾脏替代疗法已显示出生存率的增加,尽管生活质量受到严重影响。
急性肾衰竭和慢性肾衰竭有什么区别? • In acute renal failure, as its name denotes impairment of renal function occurs sudden or within a short period of time (days to weeks) in contrast to chronic renal failure, which is diagnosed if more than 3 months. •ARF通常是可逆的,但CRF是不可逆的。 •ARF的最常见原因是血容量低血炎,但在CRF中,常见原因是慢性肾小球病和糖尿病性肾病。 • In ARF, patient usually presents with reduced urine output, but CFR can presents with constitutional symptoms or its long term complication. •ARF是医疗紧急情况。 •ARF预后比CFR更好。 |
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