Acute renal failure is a syndrome. For a variety of reasons cause, glomerular filtration rate decreased rapidly below 50% of normal, blood urea nitrogen and serum creatinine increased rapidly and cause water substance disorders and disorders of acid-power balance base and symptoms of acute uremia. Acute renal failure is observed in disease subjects, acute renal failure and chronic renal failure are different, such as early diagnosis and timely rescue, renal function is fully restored, such as delayed treatment may be fatal . The prognosis of the primary disease, age, diagnosis and treatment sooner or later, if you want to combine multiple organ failure, and other factors.
Clinical manifestations
1. Oliguria: (1) Three low (sodium, calcium, reduced pH), three high (potassium, phosphorus, creatinine increased), edema (2) uremic symptoms may include nausea, vomiting, gastrointestinal bleeding, difficulty. breathing, coughing, chest pain, hypertension, heart failure, drowsiness, mental confusion, tremors and epileptic seizures, anemia and bleeding tendency etc. (3) Infection according to the site of infection to produce symptoms.
2. The time of much urine: The function of the kidneys failed to restore, blood urea and creatinine continues to rise, and prone to dehydration, infection, hypokalemia, gastrointestinal bleeding etc.
3. Convalescence: blood urea nitrogen and creatinine near normal, urine output gradually returned to normal, the role of glomerular filtration rate in 3-12 months more back to normal.
Differential Diagnosis
based diagnosis
1. There shock or hemolysis, drug toxicity or intravascular allergies.
2. By correcting or exclude acute hypovolemia, dehydration, urinary tract obstruction, urine remains ≤ 17 / ml / hu urine remains ≤ 400 / ml / 24h.
3. Specific gravity of urine in 1015 or less, and even set to 1,010.
4. Abrupt onset and increasing azotemia.
5. The urine osmolality <350mOsm / Kg.H2O, urinary sodium> 40 mmol / L.
6. Except prerenal and postrenal azotemia little or no urine.
Above mentioned are the clinical features and differential diagnosis of acute renal failure? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and fitness has all the information? If you have any problem, you can consult our experts online or leave message below!
2014年12月23日星期二
The differential diagnosis of lupus nephritis
Laboratory tests
① General inspection: The majority of patients (80%) had a moderate anemia (anemia pigmented cells are positive) rarely showed hemolytic anemia, thrombocytopenia, 1/4 patients with pancytopenia, 90% accelerate ESR. Globulin patients was significantly higher.
② Immunological tests:
(1) Antinuclear Antibody: Sensitivity of antinuclear antibodies in 90%, but lower specificity in mixed connective tissue disease, rheumatoid arthritis, Sjogren's syndrome etc can be positive. Therefore, this test is not the only indicator for diagnosis, can be used as indicators of disease activity reference, however, its titer and severity of renal disease or not has nothing to do.
(2) anti-dsDNA antibodies: an antibody that is diagnostic marker of SLE, the sensitivity of 72%, the change in titer and is closely related to the activity occasionally lupus.Sólo syndrome in sjogren, active rheumatoid arthritis and hepatitis are positive.
(3) antibodies and anti-anti-RNP Sm: Sm antibodies common in 25% -40% of patients illness, common anti-RNP antibodies in 26% -45% of patients. Anti-Sm antibody specificity in the diagnosis of systemic lupus erythematosus high.
(4) anti - histones: Common in 25% -60% of patients. Specificity are better, although common in rheumatoid arthritis and Sjogren's syndrome etc.
(5) antibodies and anti-anti -SSB SSA: The first is common in 30% -40% of patients, the latter is only 0-15% .Both antibodies were mainly observed in Sjogren's syndrome.
(6) Other antibodies: SLE and a variety of other autoantibodies, such as hemolytic anemia, anti-erythrocyte antibodies, necrotizing vasculitis and neutrophil cytoplasmic antibodies (ANCA) etc. in recent years special attention antiphospholipid antibodies, common in 34% of patients .
(7) Complement: C3, C4, CH50 can reduce, in particular, C3 decreased activity of lupus is a sensitive and reliable determine indicators.
(8) Band lupus Skin: Epidermis of non-lesional skin and dermis town link, using direct immunofluorescence, may have IgG and (o) C3 granulated calm band yellow-green fluorescence. The disease is common in patients with more than 70%.
(9) Other: Rheumatoid factor (RF) and cold globulin test can be positive activists pathological changes.
Above is the differential diagnosis of lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and Fitness has all the information? If you have any problem, you can consult our experts online or leave a message below!
① General inspection: The majority of patients (80%) had a moderate anemia (anemia pigmented cells are positive) rarely showed hemolytic anemia, thrombocytopenia, 1/4 patients with pancytopenia, 90% accelerate ESR. Globulin patients was significantly higher.
② Immunological tests:
(1) Antinuclear Antibody: Sensitivity of antinuclear antibodies in 90%, but lower specificity in mixed connective tissue disease, rheumatoid arthritis, Sjogren's syndrome etc can be positive. Therefore, this test is not the only indicator for diagnosis, can be used as indicators of disease activity reference, however, its titer and severity of renal disease or not has nothing to do.
(2) anti-dsDNA antibodies: an antibody that is diagnostic marker of SLE, the sensitivity of 72%, the change in titer and is closely related to the activity occasionally lupus.Sólo syndrome in sjogren, active rheumatoid arthritis and hepatitis are positive.
(3) antibodies and anti-anti-RNP Sm: Sm antibodies common in 25% -40% of patients illness, common anti-RNP antibodies in 26% -45% of patients. Anti-Sm antibody specificity in the diagnosis of systemic lupus erythematosus high.
(4) anti - histones: Common in 25% -60% of patients. Specificity are better, although common in rheumatoid arthritis and Sjogren's syndrome etc.
(5) antibodies and anti-anti -SSB SSA: The first is common in 30% -40% of patients, the latter is only 0-15% .Both antibodies were mainly observed in Sjogren's syndrome.
(6) Other antibodies: SLE and a variety of other autoantibodies, such as hemolytic anemia, anti-erythrocyte antibodies, necrotizing vasculitis and neutrophil cytoplasmic antibodies (ANCA) etc. in recent years special attention antiphospholipid antibodies, common in 34% of patients .
(7) Complement: C3, C4, CH50 can reduce, in particular, C3 decreased activity of lupus is a sensitive and reliable determine indicators.
(8) Band lupus Skin: Epidermis of non-lesional skin and dermis town link, using direct immunofluorescence, may have IgG and (o) C3 granulated calm band yellow-green fluorescence. The disease is common in patients with more than 70%.
(9) Other: Rheumatoid factor (RF) and cold globulin test can be positive activists pathological changes.
Above is the differential diagnosis of lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and Fitness has all the information? If you have any problem, you can consult our experts online or leave a message below!
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