Acute renal failure

There are many common types of diseases. When treating some diseases, the choice of methods is critical. Renal failure is a disease that causes great harm to human health. The occurrence of this type of disease not only affects the patient's life and work, but also has a significant impact on the patient's family. If renal failure is not treated in time, it will threaten the patient's life, and the same is true for acute renal failure.

Kidney failure is also divided into different categories, and acute renal failure is one of them. The treatment of this type of kidney disease is mainly based on drugs and surgery, which can effectively control the patient's disease, but many people do not know much about this disease.

Acute renal failure:

Western medicine treatment of acute renal failure

The general treatment principle of acute renal failure is to eliminate the cause, maintain water, electrolyte and acid-base balance, alleviate symptoms, improve renal function and prevent complications. The main treatment for prerenal ARF is to supplement fluid, correct abnormalities in extracellular fluid volume and solute composition, improve renal blood flow, and prevent it from evolving into acute tubular necrosis. For post-renal ARF, the cause should be eliminated actively and the obstruction should be relieved. Regardless of prerenal or postrenal type, water, electrolyte and acid-base balance should be maintained while rehydrating or eliminating obstruction. For renal parenchymal ARF, the treatment principles are as follows:

1. Treatment of oliguria The oliguria period often leads to death due to acute pulmonary edema, hyperkalemia, upper gastrointestinal bleeding and concurrent infection. Therefore, the focus of treatment is to regulate water, electrolyte and acid-base balance, control nitrogen retention, provide appropriate nutrition, prevent and treat complications and treat the primary disease.

(1) Bed rest: All patients with a clear diagnosis should strictly rest in bed.

(2) Diet: Those who can eat should use the gastrointestinal tract to supplement nutrition as much as possible, and should be given light liquid or semi-liquid food as the main food. Limit water, sodium, and potassium as appropriate. Protein should be restricted in the early stage (0.5 g/kg of high biological value protein). Severe patients often have obvious gastrointestinal symptoms. Supplementing some nutrition from the gastrointestinal tract allows the patient's gastrointestinal tract to adapt first, with the principle of avoiding abdominal distension and diarrhea. Then gradually supplement some calories, with a degree of 2.2~4.4kJ/d (500~1000Kcal). If you supplement food too quickly or in excess, it will not be absorbed and may lead to diarrhea.

(3) Maintain water balance: Patients in the oliguric phase should strictly calculate the amount of water they drink and lose over 24 hours. The 24-hour fluid replacement volume is the sum of apparent and inapparent fluid losses minus the endogenous water. Apparent fluid loss refers to the sum of fluid losses from urine, feces, vomiting, sweating, drainage fluid and wound exudate within the previous 24 hours; inapparent fluid loss refers to the daily loss of water from exhaled breath (400-500 ml) and loss of water from skin evaporation (300-400 ml). However, it is often difficult to estimate the amount of insensible fluid loss, so it can also be calculated at 12 ml/kg per day, taking into account body temperature, air temperature, humidity, etc. It is generally believed that for every 1°C increase in body temperature, the amount of water lost per hour is 0.1 ml/kg; when the room temperature exceeds 30°C, the insensible fluid loss increases by 13% for every 1°C increase; dyspnea or tracheotomy both increase respiratory tract water loss. Endogenous water refers to the total amount of water generated by body tissue metabolism, food oxidation and glucose oxidation during fluid replacement within 24 hours. The calculation of water produced by food oxidation is 0.43 ml of water for 1 gram of protein, 1.07 ml of water for 1 gram of fat and 0.55 ml of water for 1 gram of glucose. Since the calculation of endogenous water is often ignored, the calculation of insensible water loss is often an estimate, which affects the accuracy of fluid replacement during the oliguria period. For this reason, in the past, the fluid replacement principle of "outflow equals input, less is better than more" was mostly adopted to prevent excessive body fluids. However, attention must be paid to the presence of hypovolemia factors to avoid excessive restriction of fluid replacement, which may aggravate ischemic renal damage and prolong the oliguria period.

Through the above introduction, we have a good understanding of acute renal failure. Therefore, when treating such a disease, we can choose the above methods. However, it should be noted that when treating such a disease, the method must be selected properly and cannot be selected randomly. This will not help the treatment of the disease at all.