Acute renal failure how to prognosis

The prognosis of acute renal failure, and cause the primary disease of renal failure type, the occurrence and treatment of complications, the severity of kidney lesions are closely related. Many dialysis centers reported 34 to 65 percent mortality in patients with acute renal failure and 42 percent for a group of 1350 patients. Mortality rate was 58 percent for patients over 51 years and mortality in patients under 50 years of age 31%. The factors that affect prognosis and mortality are described below.

(A) the nature and severity of primary disease
Common causes of acute renal failure are the original disease: trauma, infection, other organ lesions and cytoplasmosis and so on.
1. trauma: wartime trauma caused by acute renal failure, and wound injury are closely related. In recent years due to the development of transport, so that the injured in a short period of time after the injury can reach the hospital, severe trauma such as crush injury, burns, traumatic shock, wound infection and so can be dealt with in a timely manner. As a result, the number of acute renal failure statistics has declined significantly.

2. infection: biliary or gastrointestinal surgery, some antibiotics resistant to bacteria often cause sepsis or bloody shock; severe acute pyelonephritis, renal papillary necrosis, can lead to acute renal failure, often difficult to effectively treat The

3. Other organs of the primary disease: such as acute myocardial infarction, acute pancreatitis, abdominal visceral perforation, can lead to renal failure. If the active and effective treatment of renal failure, the patient may not die of uremia, but can die of serious primary disease.

4. Cytoplasmosis: barbiturate acute poisoning can occur quickly shock, anuria, pulmonary edema and death. Carbon tetrachloride poisoning, and sometimes cause acute renal tubular necrosis at the same time a wide range of liver damage, and even acute yellow liver atrophy; acute renal failure if the rescue success, the patient can die of liver failure. Other lethal cytoplasmic poisoning such as arsenic vapor, anilin, mercuric chloride, biogas, etc., can be found in amino acid urinary and renal tubular damage.

(B) complications
The incidence of complications often affects prognosis. Acute renal failure to get rid of bleeding, anemia, the main complications seen in the nervous system, gastrointestinal system, cardiovascular system, and nutritional complications.

1. neurological complications: the current can not be separated from a neurotoxin, many biochemical changes (acidosis, alkalosis, potassium poisoning, waterosis, calcium deficiency, magnesium too much, etc.), contributed to neurological complications, Not a single factor. Symptoms are temporary limb paralysis, hemiplegia, aphasia, deafness, blindness, and attention can not be concentrated, confused, insanity, delirium, spasm, coma and so on. Sometimes there are barriers to autonomic nervous system, such as miosis, leakage, vagal nerve stimulation caused by heart rate, Chen Shi's breathing and nausea, vomiting, diarrhea and so on. Even the presence of varying degrees of central nervous system involvement symptoms, olfactory nerve, optic nerve, auditory nerve, vestibular nerve more easily involved, it is difficult to react with drugs (streptomycin, etc.) identification. Chronic uremic patients sometimes appear suddenly blind, occasionally seen in patients with acute uremia.

The pathogenesis of three: (1) malignant hypertension caused by direct damage to the retina, nipple edema, retinal hemorrhage. (2) omental cortical embolism phlebitis. (3) optic neuritis, if the ophthalmoscope can not see the exception, and sometimes pay attention to correct biochemical changes. Temporary facial paralysis, is also a more common complication

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