Acute And Chronic Renal Failure

As a rule of general aging, the urinary apparatus will age in terms of its functional form with age. This aging is usually symptomatic, in urine without proteinuria and erythrocytes.
In the elderly there are differences in morphological changes, kidney size among individuals such as kidney size decreases by 0.5cm every 10 years after age 40.
Reducing the number of glomeruli, the function decreases by 10% after 70 years of age and by 30% after the age of 80, thickening the glomerular basement and renal tubular membranes, organizing glomerular artery enlargement, renal tubular cell atrophy should reduce renal lumen, interstitial fibrosis

. Gradually reduce glomerular filtration rate, reduce renal perfusion blood flow. Maintain relative glomerular filtration rate, increase filtration fractions and increase resistance in the kidney
Acute renal failure in the elderly includes functional renal failure, acute renal failure due to obstruction, and acute renal failure in the kidney.
Functional acute renal failure: also known as anterior renal failure, the causes are due to a decrease in circulating volume, hypotension, common hemodynamic disorders in: acute diarrhea, gastrointestinal bleeding, various types of shock and multiple organ failure; due to use of drugs such as strong diuretics such as furosemide, thiazide, hypotension group such as calcium inhibitors, sympathetic beta blockers
Manifestations of low blood pressure, rapid pulse, small, cold extremities, reduced skin elasticity, sunken eyes, emaciated face.



Oliguria or anuria. The test showed that urine sodium was low, urine potassium increased, osmotic and urine density was normal. The treatment depends on the cause. Rehydration and electrolyte, pay attention to enough sodium and treat potassium loss. Use caution diuretics.
Acute renal failure due to obstruction: called renal failure after kidney: met in urinary stones (ureteral stones, kidney stones), benign prostatic tumors, prostate cancer, bladder cancer, kidney cancer. A pinched tumor is a urinary tract obstruction Expression of oliguria or anuria, increased urea, increased creatinine, increased uric acid, increased blood potassium.




High blood pressure, accompanied by high urea syndrome. Treatment is solved according to the cause of the blockage, releasing the obstruction by opening the kidneys to the skin, opening the bladder to the skin.
Acute renal failure: including renal damage in acute glomerular disease, acute interstitial renal tubular disease causing renal tubular necrosis seen in intoxication such as bee stings, snake bites, antibiotics that cause kidney toxicity aminozid antibiotic group. Blood clotting scattered in the lumen, multiple injuries.
Symptoms characteristic pathological manifestations are accompanied by oliguria or anuria, renal function tests show marked renal failure such as increased urea, elevated creatinine, increased potassium.
The treatment should address well the cause, necessary dialysis (extra-renal dialysis, peritoneal dialysis). Maintain homeostasis, limit blood potassium, eliminate necrotic foci, fight infections.
Chronic renal failure: in the elderly, chronic renal failure increases with age, after 70 years, 5% of men and 1% of women have serum creatinine above 180 µmol / L (normal: 53 - 97 µmol / L).




Hypertension and other factors other than the kidneys may impair kidney function. The diagnosis is based on quantitative serum creatinine and evaluation of glomerular filtration function.
Characteristic of chronic kidney failure is a history of prolonged kidney disease, glomerular filtration rate decreases (glomerular filtration rate is the first amount of urine in 1 minute, this is an indicator to assess the degree of chronic kidney failure and they are measured by creatinine concentration, normal glomerular filtration rate 120 ml / minute, creatinine 53 - 97 olmol / L.
When the glomerular filtration rate drops below 50%, (<60 ml / min) and creatinine increases by 130 µmol / L or more, the kidneys become clear. Causes of chronic glomerulonephritis, chronic pyelonephritis, chronic interstitial nephritis. The treatment of chronic renal failure, adhering to the principle, slowing the progression of chronic kidney failure, applying standard conservative kidney conservation treatments, such as a diet with energy and ingredients suitable for each individual. possible, etiology, stage renal failure. Controlling hypertension, keeping blood pressure in patients at 140 / 80mmHg.


Anti-anemia, with adequate iron supply, preventing abnormalities of metabolism of calcium, phosphorus. Alternative kidney treatment. There is no age limit in principle for dialysis and dialysis procedures..

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