MOHD KHAIRUL AMRAN HS221/5 MEDICAL LAB TECH UiTM 1 Azotemia Azotemia is a type of Nephrotoxicity. Azotemia is an excess of nitrogen compounds in the blood. Uremia, or uremic syndrome, occurs when the excess of nitrogen compounds becomes toxic to your system. Azotemia, if untreated, can lead to acute (sudden) renal failure. Renal failure is when each kidney shuts down. Signs and symptoms of Azotemia • High serum urea level • Reduced urination • Pallor • Confusion • Fatigue • Dry mouth • Thirst • Swelling • Orthostatic blood pressure • Rapid pulse • Reduced alertness Prevention: • Drink a lot of plain water to keep kidney function properly • Avoid taking substances or medications that can poison or damage kidney tissue • Do physical exams include blood test and urinalysis to monitor kidney and urinary tract health • Regular monitoring of blood pressure, urea, creatinine and glomerular flow rate • Eat a low-fat, low-salt diet • Exercise most days of the week
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MOHD KHAIRUL AMRAN
HS221/5 MEDICAL LAB TECH UiTM 1
Azotemia
Azotemia is a type of Nephrotoxicity.
Azotemia is an excess of nitrogen compounds in the blood. Uremia, or uremic syndrome, occurs when the excess of nitrogen compounds
becomes toxic to your system. Azotemia, if untreated, can lead to acute (sudden) renal failure. Renal failure is when each kidney shuts down.
Prevention: • Drink a lot of plain water to keep kidney function properly • Avoid taking substances or medications that can poison or damage kidney tissue • Do physical exams include blood test and urinalysis to monitor kidney and urinary tract health • Regular monitoring of blood pressure, urea, creatinine and glomerular flow rate • Eat a low-fat, low-salt diet • Exercise most days of the week
tone ACE inhibitors or angiotensin II receptor blockers 4. Low systemic vascular resistance Septic shock, liver failure, antihypertensive drugs 5. ECF volume depletion Excessive diuresis, hemorrhage, GI losses, loss of skin and mucus membranes, renal salt- and water-wasting states
Reddish brown urine indicate presence myoglobin or hemoglobin
RBC casts indicate glomerulonephritis
WBC casts suggest pyelonephritis or acute interstitial nephritis
Uric acid crystals associated with uric acid nephropathy
Calcium oxalate crystals present in cases glycol poisoning Dipstick assay may reveal significant proteinuria as result tubular injury
Prevention
• Drink a lot of plain water to keep kidney function properly • Avoid taking substances or medications that can poison or damage kidney tissue • Do physical exams include blood test and urinalysis to monitor kidney and urinary tract health
Treatments
• Immediate treatment of pulmonary edema and hyperkalemia • Dialysis as needed to control hyperkalemia, pulmonary edema, metabolic acidosis, and uremic symptoms • Adjustment of drug regimen • Usually restriction of water, Na, and K intake, but provision of adequate protein • Possibly phosphate binders and Na polystyrene sulfonate
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ARF Associated with ACE Inhibitors and Angiotensin Receptor Blockers
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Example of Urinary sediment found in acute renal failure
Type of sediment Pictures
Red blood cells
Monomophic dysmorphic
Renal Tubular Epithelial Cell Cast
White blood cell cast
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Uric acid crystal
Calcium Oxalate Crystals
White blood cells
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Chronic renal failure, CRF
Description
Chronic kidney disease is long-standing, progressive deterioration of renal function.
Signs and symptoms
Effects and symptoms of chronic kidney disease include;
need to urinate frequently, especially at night (nocturia)
swelling of the legs and puffiness around the eyes (fluid retention)
high blood pressure
fatigue and weakness (from anemia or accumulation of waste products in the body)
loss of appetite, nausea and vomiting
itching, easy bruising, and pale skin (from anemia)
shortness of breath from fluid accumulation in the lungs
headaches, numbness in the feet or hands (peripheral neuropathy)
chest pain due to pericarditis (inflammation around the heart);
bleeding (due to poor blood clotting)
bone pain and fractures
decreased sexual interest and erectile dysfunction.
Causes
The most common causes of chronic renal failure are related to:
poorly controlled diabetes
poorly controlled high blood pressure
chronic glomerulonephritis.
Less common causes of chronic renal failure include:
Drink a lot of plain water to keep kidney function properly Do not smoke.
Eat meals that are low in fat and cholesterol
Get regular exercise (talk to your doctor or nurse before starting).
Take drugs to lower your cholesterol, if necessary.
Keep your blood sugar under control.
Regular monitoring of blood pressure, urea, creatinine and glomerular flow rate
Treatments
Dietary restrictions of potassium and phosphate containing foods Fluid restrictions Treatment of underlying cause (hypertension,diabetes,autoimmune diseases) Renal dialysis (hemodialysis or peritoneal dialysis)
Urinalysis:
Proteinuria
Glycosuria
Hematuria
Erythrocytes
Leukocytes
RBC, WBC casts
Uric acid crystals
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End – stage kidney disease
Description
Renal failure is any acute or chronic loss of kidney function and is the term used when some kidney function remains
Signs and symptoms
Signs and symptoms mentioned in various sources for End-stage renal disease includes the 10 symptoms listed below:
Reduced urine
Total lack of urine
Nausea
Vomiting
Uremia - causing various symptoms of uremia:
Drowsiness
Confusion
Seizures
Coma
Causes
Causes of End-stage renal disease includes:
Kidney disease - obviously ESRD starts as early kidney disease.
Diabetic nephropathy -
Chronic kidney failure - ESRD is by definition the last state of chronic kidney failure