Unit 10 - Renal Failure (Elie)

What happens in a malfunctioning kidney?

Excretory & regulatory functions of kidneys are decreased in both

What are the 2 classifications of a malfunctioning kidney?

• Acute Renal Failure (ARF)

• Chronic Renal Failure (CRF)

  • BUN and Creatinine increase

What are the 3 classifications of Renal failure causes?

• Prerenal

• Renal

• Postrenal

What is prerenal failure caused by?

Decreased perfusion of kidneys

What is renal failure caused by?

Intrinsic renal disease

What is postrenal failure (5%) caused by?

• Obstructive process (may be reversible)

  • Malignant diseases – bladder, prostate, uterus, ovaries, rectum

  • Retroperitoneal fibrosis

  • Renal calculi

  • Pregnancy

Patients with lab results indicating compromised renal function should receive what kind of studies?

“R/O obstruction” studies

Ultrasound is extremely sensitive in diagnosing ___________ & is the procedure of choice for these patients with known or suspected renal failure

Hydronephrosis

What is Acute Renal Failure?

• Abrupt, transient decrease in renal function

  • Oliguria – Azotemia (^nitrogenous waste in blood)

What are the renal causes of Acute Renal Failure?

• Parenchymal disease

  • Glomerulonephritis

  • Acute interstitial nephritis

  • Acute tubular necrosis

• Hydronephrosis

• Vascular

  • Renal vein thrombosis

  • Renal artery occlusion* (rare)

What is this image showing?

Acute Renal Failure (ARF)

What is the most common medical renal disease to produce acute renal failure?

Acute Tubular Necrosis (ATN)

Acute Tubular Necrosis can be:

Reversible

What is the differential diagnosis for Acute Tubular Necrosis (ATN)

Nephrocalcinosis

What are the US findings for Acute Tubular Necrosis?

• Enlarged kidneys

• Hyperechoic pyramids (can revert to normal appearance with medical treatment)

What are these images showing?

Acute Tubular Necrosis

What is Chronic Renal Failure (CRF)?

Progressive destruction of nephrons

What are the causes of Chronic Renal Failure?

• Obstructive nephropathies

• Parenchymal diseases

• Renovascular disorders

• Any process that destroys nephrons

What is Chronic Renal Disease?

Loss of renal function because of disease (most commonly parenchymal diseases)

What are the 3 types of chronic renal failure?

• Nephron

• Vascular

• Interstitial

What are the US findings for Chronic Renal Disease:

• Diffusely echogenic kidney

• Loss of normal anatomy

• Small

• May be bilateral

What may Chronic renal disease be a result from?

Hypertension

Chronic inflammation

Chronic ischemia

What is this image showing?

Chronic Renal Disease