Depending on their location within the kidney system, healthcare providers differentiate the three types of acute renal failure (ARF): prerenal, postrenal, and intrarenal. Each of the mentioned subgroups is characterized by the presence of risk factors that contribute to the disease aggravation and lead to further hospitalization. To prevent the development of any prerenal, postrenal, or intrarenal failures, clinicians should address specific strategies that help minimize the effect of the mentioned risks.
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Examples, Risk Factors, and Preventive Strategies
Inadequate blood perfusion to kidneys is the major sign of prerenal ARF. Patients diagnosed with this type of disease usually have low blood pressure. The examples of accompanying illnesses include heart failure, sepsis, dehydration, and blood loss (Westhoff et al., 2016). Risk factors enumerate chronic liver disease, old age, atherosclerosis, heart failure, and other ailments. Prevention measures involve consuming a required minimum of fluids, maintaining adequate arterial pressure, and treating electrolyte disorders (correcting potassium level).
Postrenal ARF is not associated with insufficient blood circulation since it is caused by the blockage of urine flow forcing pressure to accumulate in renal nephrons. The cause examples include such formations as kidney stones, renal injuries, retroperitoneal fibrosis, neurogenic bladder, and more (Nsengiyumva, Igiraneza, & Lameire, 2018). The following diseases put patients at risk of developing postrenal ARF: prostate disease, malignancy, bladder-outlet obstruction. Preventive measures require preliminary hemodialysis, peritoneal dialysis, and correction of electrolyte abnormalities.
Intrarenal ARF is usually characterized by a sudden loss in a kidney’s function. Typical examples of this condition include glomerular, tubular, interstitial, and vascular diseases (Westhoff et al., 2016). Risk factors are usually associated with old age, diabetes, chronic kidney disease, liver or cardiac failure. As referred to the preventive strategies, the emphasis should be made on a prompt correction of blood/plasma, eliminating the fluid deficit, and stabilizing digoxin dosage.
Prerenal, postrenal, and intrarenal ARFs are characterized by different origins and, therefore, require different preventive strategies to be addressed when managing the disease. Some of the risk factors, such as old age and heart/liver failure, appear to be common for all of the three types. Nevertheless, preventive measures must be planned with the consideration of each factor in particular for the intervention to demonstrate maximum effectiveness and lead to a faster recovery.
Nsengiyumva, V., Igiraneza, G., & Lameire, N. (2018). Definition and epidemiology of acute kidney injury. Rwanda Medical Journal, 75(2), 17-23.
Westhoff, J. H., Fichtner, A., Waldherr, S., Pagonas, N., Seibert, F. S., Babel, N., & Westhoff, T. H. (2016). Urinary biomarkers for the differentiation of prerenal and intrinsic pediatric acute kidney injury. Pediatric Nephrology, 31(12), 2353-2363.