Acute renal failure: ICD-10 code, causes, symptoms, diagnosis, treatment

Acute renal failure( ARF) is a rapid, but reversible, inhibition of renal function, sometimes until the stage of complete failure of one or both organs. Pathology is deservedly described as a critical condition that requires immediate medical intervention. Otherwise, the risk of an unfavorable outcome in the form of loss of working capacity of organs is greatly increased.

Acute renal failure

Kidneys are the main "filters" of the human body, the nephrons of which continuously pass blood through their membranes, removing excess fluid and toxins with urine, sending back the necessary substances back to the bloodstream.

Kidneys are organs without which human life is impossible. Therefore, in a situation when, under the influence of provoking factors, they cease to fulfill their functional task, doctors give the person emergency medical help, diagnosing him - acute renal failure. The code of somatic pathology according to ICD-10 is N17.

To date, statistical information makes it clear that the number of people experiencing this pathology is growing every year.

Etiology

The causes of djpybryjdtybz acute renal failure are as follows:

1. Pathologies of the cardiovascular system that disrupt the blood supply of all organs, including the kidneys:
   • arrhythmia;
   • atherosclerosis;
   • heart failure.
2. Dehydration against the background of the following ailments, which is the cause of the change in blood counts, more precisely - the increase in its prothrombin index, and as a result, the difficulty of the glomeruli:
   • dyspeptic syndrome;
   • extensive burns;
   • blood loss.
3. Anaphylactic shock, which is accompanied by a sharp drop in blood pressure, which adversely affects the work of the kidneys.
4. Acute inflammatory conditions in the kidneys that lead to tissue damage to organs:
   • glomerulonephritis;
   • pyelonephritis.
5. Physical obstruction for urinary outflow in urolithiasis, which first leads to hydronephrosis, and then, due to pressure on the kidney tissue, to damage to their tissues.
6. Receiving nephrotoxic drugs, which include the contrast composition for carrying out an X-ray, causes poisoning of the body, with which the kidneys can not cope.

Classification of acute renal failure

The process of acute kidney failure is divided into three types:

1. Prerenal OPN - the cause of the disease is not directly related to the kidneys. The most popular example of prerenal type of acute renal failure can be called disturbances in the work of the heart, therefore pathology is often called hemodynamic. Less often, it occurs against dehydration.
2. Renal acute renal failure - the root cause of the pathology can be found in the kidneys themselves, in connection with which the second category name is parenchymal. Renal functional insufficiency in most cases results from acute glomerulonephritis.
3. An acute obstruction( obstructive) - a form that occurs when the urinary tract is obstructed by concrements and a subsequent disturbance in the outflow of urine.

Pathogenesis of

ARF develops over four periods that always follow in this order:

• initial stage;
• oligurical stage;
• polyuric stage;
• recovery.

The duration of the first stage can last from several hours to several days, depending on what is the root cause of the ailment.

Oliguria is a term used to describe briefly the decrease in the volume of urine. Normally, a person should allocate approximately the amount of liquid that he consumed, minus the part "spent" by the body on sweating and breathing. In oliguria, however, the volume of urine becomes less than half a liter, outside the direct connection with the amount of liquid drunk, which entails an increase in the body tissues of liquid and decay products.

The duration of the first stage depends on how quickly the adequate treatment was started.

Polyuria, on the contrary, means an increase in diuresis, in other words, the amount of urine can reach five liters, although 2 liters of urine per day is already an occasion for diagnosing polyuric syndrome. This stage lasts about 10 days, and its main danger is the loss of the body's necessary substances together with urine, as well as dehydration.

After the completion of the polyuric stage, a person, with a favorable development of the situation, recovers. However, it is important to know that this period can last for one year, during which deviations in the interpretation of the analyzes will be revealed.

Clinical picture

The initial stage of acute arthritis does not have specific symptoms, for which it was unmistakably possible to recognize the ailment, the main complaints during this period are:

• loss of strength;
• headache.

Symptomatic picture is complemented by the signs of pathology that caused arthrosis:

1. In the case of an oliguric syndrome in the background of acute arthritis, the symptoms become specific, easily recognizable and fit into the overall picture of the pathology:
   • decrease in diuresis;
   • dark frothy urine;
   • indigestion;
   • the retardation;
   • wheezing in the chest due to fluid in the lungs;
   • susceptibility to infections due to reduced immunity.
2. The polyuric( diuretic) stage is characterized by an increase in the amount of excreted urine, so all complaints of the patient result from this fact, and the fact that the urine body loses a large amount of potassium and sodium:
   • fixes irregularities in the work of the heart;
   • hypotension.
3. The recovery period, ranging from 6 months to one year, is characterized by fatigue, changes in the results of laboratory urine tests( specific gravity, red blood cells, protein), blood( total protein, hemoglobin, ESR, urea, creatinine).

Diagnostics

Diagnostics of the arrester is carried out with the help of:

• interrogation and examination of the patient, constitutes his anamnesis;
• a clinical blood test showing reduced hemoglobin;
• biochemical blood test, which reveals elevated creatinine, potassium, urea;
• monitoring diuresis, that is, control over how much fluid( including soups, fruits) for 24 hours is consumed by a person, and how much excretes;
• ultrasound method, with ARF more often showing the physiological size of the kidneys, a decrease in size is a bad sign, talking about tissue damage, which can be irreversible;
• nephrobiopsy - fetching a piece of organ with a long needle for microscopic examination;is infrequent because of the high degree of trauma.

Treatment of

Therapy of acute renal failure occurs in the intensive care unit of the hospital, less often in the nephrologic department of the hospital.

All medical manipulations performed by a doctor and medical staff can be divided into two stages:

1. Detection of the root cause of a pathological condition is carried out using diagnostic methods, studying symptoms, specific patient complaints.
2. Elimination of the cause of acute renal failure is the most important stage of treatment, because without treatment of the underlying cause of the disease, any measures of therapy will be ineffective:
   • , when revealing the negative effect of nephrotoxicity on the kidneys, extracorporeal hemocorrection is used;
   • , when an autoimmune factor is detected, glucocorticosteroids are prescribed( Prednisolone, Metipred, Prenizol) and plasmapheresis.
   • in case of urolithiasis, medical litholysis or surgical intervention is performed to remove concrements;
   • for infection, antibiotics are prescribed.

At each stage the doctor adjusts the prescriptions based on the symptomatic picture at the moment.

Hemodialysis is a procedure for purifying blood from decay products and removing excess fluid from the body, has an ambiguous attitude of nephrologists. Some doctors say that preventive hemodialysis with ARF is necessary in order to reduce the risk of complications. Other specialists warn of the tendency of complete loss of kidney function since the beginning of the application of artificial blood purification.

In the period of polyuria it is important to replenish the patient's missing blood volume, restore electrolyte balance in the body, continue the diet number 4, beware of any infection, especially when taking hormonal medications.

Forecasts and complications of

ARF on the background of proper treatment has a favorable prognosis: only 2% of patients after lifetime illness need lifelong hemodialysis.

Complications of acute kidney failure are associated with uremia, that is, with the process of poisoning the body with its own products of decay. As a result, the latter are not excreted by the kidneys in oliguria or at a low rate of blood filtration by glomeruli.

Pathology leads to:

• cardiovascular disruption;
• anemia;
• increased risk of infections;
• neurological disorders;
• dyspeptic disorders;
• uremic coma.

It is important to note that in acute nephrological insufficiency, unlike chronic, complications are rare.

Prevention of

Prevention of ARI is as follows:

1. Avoid taking nephrotoxic medicines.
2. Timely cure chronic ailments of the urinary and vascular system.
3. Monitor the blood pressure indicators, if you see signs of chronic hypertension, immediately consult a specialist.

On the video about the causes, symptoms and treatment of acute renal failure: