04 Differential Diagnosis Of Acute Renal Failure
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04 Differential Diagnosis Of Acute Renal Failure
- 1. Differential Diagnosis of Acute Renal Failure 臺灣大學附設醫院外科 4B 加護病房實習報告 報告者 : 李浩遠 (Intern, 學號 : B8601076) 臺北醫學大學醫學系七年級
- 31. Urinalysis Acute interstitial nephritis, pyelonephritis WBC casts Glomerulonephritis, malignant HTN RBC casts ATN, glomerulonephritis, interstitial nephritis Granular casts
- 32. Urinalysis prerenal and postrenal failure, HUS/thrombotic thrombocytopenic purpura (TTP), preglomerular vasculitis, or atheroembolism Normal Acyclovir, sulfonamides, methotrexate, ethylene glycol toxicity, radiocontrast agents Crystall-uria Acute allergic interstitial nephritis, atheroembolism Eosino-philuria
- 33. Complete blood count multiple myeloma Anemia and rouleaux formation SLE or TTP Leukopenia and thrombocytopenia common in ARF Leukocytosis
- 34. Complete blood count liver disease or hepatorenal syndrome. Coagulation disturbances allergic interstitial nephritis, polyarteritis nodosa, or atheroemboli Eosinophilia TTP or atheroemboli Microangiopathic anemia
- 35. Blood chemistry common complication of ARF Hypocalcemia (moderate) Hyperkalemia rapidly progressive liver failure and hepatorenal syndrome Elevations in liver transaminases rhabdomyolysis and myocardial infarction Creatine phosphokinase (CPK) elevations
- 36. Urine indices <20 >40 Urine/plasma creatinine ratio <10-15 >20 Plasma BUN/creatinine ratio >40 <15-20 Urine sodium (mEq/L) <500 >500 Urine osmolality (mOsm/kg H 2 O) <1.012 >1.018 Urine specific gravity ATN prerenal ARF
- 37. Laboratory Findings in the Differential Diagnosis of Acute Renal Failure:
- 38. Laboratory Findings in the Differential Diagnosis of Acute Renal Failure:
- 39. References Akposso K, Hertig A, Couprie R, et al: Acute renal failure in patients over 80 years old: 25-years' experience [In Process Citation]. Intensive Care Med 2000 Apr; 26(4): 400-6 3 Druml W: Prognosis of Acute Renal Failure. Nephron 1996; 53: 8-15 4 Klahr S, Miller SB: Acute oliguria. N Engl J Med 1998 Mar 5; 338(10): 671-5 2 Liano F, Pascual J: Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996 Sep; 50(3): 811-8 1
- 40. References Ragaller MJ, Theilen H, Koch T: Volume replacement in critically ill patients with acute renal failure. J Am Soc Nephrol 2001 Feb; 12 Suppl 17: S33-9 6 Moghal NE, Brocklebank JT, Meadow SR: A review of acute renal failure in children: incidence, etiology and outcome. Clin Nephrol 1998 Feb; 49(2): 91-5 5
- 41. References Renal Failure, Acute September 17, 2002 eMedicine.com, Inc. 8 San A, Selcuk Y, Tonbul Z, Soypacaci Z: Etiology and prognosis in 438 patients with acute renal failure. Ren Fail 1996 Jul; 18(4): 593-9 7
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