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renal failure
inability of the kidney to maintain its normal functions, so that waste products and metabolites accumulate in the blood; it eventually affects most
body systems because of lack of maintenance of fluid balance and regulation of the electrochemical composition of body fluids
(acid-base balance), as well as blood pressure. See acute renal failure and chronic renal failure. Called also kidney failure.
acute renal failure
renal failure that happens suddenly; it may be caused by trauma, infection, inflammation, exposure to nephrotoxic chemicals that damage the renal tubules, or less often circulatory collapse, severe dehydration, or hypotension. Acute renal failure may be classified as either prerenal (associated with poor systemic perfusion and decreased renal blood flow), intrarenal (associated with kidney ischemia or toxins), or postrenal (resulting from obstruction of urine flow out of the kidneys). Oliguria is the hallmark of tubular necrosis, but it is not always present.
chronic renal failure
progressive loss of kidney function that may eventually progress to end-stage renal disease. It starts slowly, with diminishing kidney function but no accumulation of waste products in the blood. Later the glomerular filtration rate begins going down and the blood chemistry begins to show abnormalities. Eventually the patient develops uremia with very low kidney function, high levels of protein end products in the blood, and impairment of all body systems. The
most common causes of renal failure are infection, inflammation, urinary tract obstruction, and systemic diseases and toxicities
such as hypercalcemia, hypertension, disseminated lupus erythematosus, atheroma, and diabetes mellitus.
Copyright 2007. An Elsevier publication. All rights reserved.
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