RENAL CALCULI &

RENAL FAILURE
Prepared by
The boyz 5A
Renal calculi
 are solid concretions (crystal
aggregations) formed in the kidneys
from dissolved urinary minerals.
Etiology of renal calculi
1. Composed of calcium oxalate crystals
- When the amount of calcium intake
decreases, the amount of oxalate easy
to absorption into the bloodstream
increases and then excreted into the
urine by the kidney
2. Composed of uric acid

- a persistent undue urine acidity


Sign & Symptoms
 Colicky pain - the worst pain
 Hematuria - blood in the urine
 Pyuria - pus (white blood cells) in the
urine.
 Dysuria - burning on urination when
passing stones.
 Oliguria - reduced urinary volume
caused by obstruction of the bladder or
urethra by stone



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 Abdominal distension.
 Nausea/vomiting
 Fever and chills.
 Loss of appetite
 Loss of weight

Diagnostic test
 X-ray
 CT scans
 Ultrasound
 Urine C & S
 Blood FBC
 24 hours urine collection
Treatment
qMedication such as
- Analgesia such as morphine sulfate ( to
relieve pain and reduce uteral spasm )
- NSAID such as suppository ( may reduce
the amount of narcotic analgesia
required for acute renal colic)
qSurgery
- Lithotrispy– using sound or shock waves
to crush stone.

Prevention
 Drinking enough water
 A diet low in protein, nitrogen and sodium
intake.
 Restriction of oxalate rich foods, such as
chocolate plus maintenance of an
adequate intake of dietary calcium.
 Taking drugs such as thiazides, potassium
citrate, magnesium citrate and
allopurinol, depending on the cause of
stone formation.
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 Some fruit juices, such as orange,
blackcurrant, and cranberry, may be
useful for lowering the risk factors for
specific types of stones.
 Avoidance of cola beverages.
 Avoiding large doses of vitamin C.
Renal failure
 the kidneys fail to function adequately.
 It is divided in acute and chronic forms
due to a large number of other medical
problems.

Acute Renal Failure
 a rapidly progressive loss of renal
function, generally characterized by
oliguria , body water and body fluids
disturbances; and electrolyte
derangement.
Chronic renal failure
 develop slowly and show few initial
symptoms, be the long term result of
irreversible acute disease or be part of a
disease progression.

symptoms
 High levels of urea in the blood, can result
in
 Vomiting and/or diarrhea (dehydration)
 Nausea
 Weight loss
 Foamy or bubbly urine
 Blood in urine
 Dysuria (difficult to urine)



Symptoms
 Failure of kidneys to remove excess fluid
may cause
 Swelling of the legs, ankles, feet, face
and/or hands
 Shortness of breath due to extra fluid
on the lungs (may also be caused by
anemia)




Pathophysiology

 The causes and pathophysiology of acute

renal failure (ARF) are commonly
categorized as prerenal , intrinsic , and
postrenal ARF.
 In prerenal ARF, hypoperfusion leads to
acute renal failure without directly
affecting the intergrity of kidney tissues.
 Intrinsic (or intrarenal) ARF , due to direct
damage to functional kidney tissues.
 Urinary tract obstruction with resulting
kidney damage is the precipating factor
for postrenal ARF.
Causes of acute renal failure
cause exam ples

-Hypovolemia -Hemorrhage, dehydration, excess fluid

prerenal -Low cardiac loss from GIT
output -Heart failure, cardiogenic shock
-Altered -sepsis, anaphylaxis, vasoactive drugs
glomerular/micr
vascular -glomerulonephritis, DIC,
intrarena ovascular injury hypertension,hemolytic uremic
l resistance
- Acute tubular syndrome.
necrosis -ischemia due to conditions associated
-Intersitial -acute
with pyelonephritis,toxins,metabolic
prerenal failure;toxins such as
postrenal nephritis imbalance
drugs
-ureteral Calculi, cancer, external compression

obstruction Prostatic enlargement, calculi, cancer ,

-uretheral blood clot.

obstruction
Treatment
qMedication such as loop diuretics
ü Example : bumetanide ( bumex ),
ethacrynic acid (edecrin ), Furosemide
(lasix)
qRenal replacement therapy : dialysis