Acute Renal Failure : definition and types

Hi everyone, my name is Shawn Chen I’m from college of pharmacy Taipei Medical University. Today, our topic is acute renal failure. And I believe that you have already review all the lectures provided by Charles Lee, and professor Lee already review a lot of basic pharmacokinetics and renal dosing for you. And in the following two weeks lectures, I’m going to review with you for those very clinical evaluation about acute renal failure and the chronic renal failure and their treatments. And today’s outline, I will start with the definition of ARF and epidemiology, risk factor, pathophysiology and there are three kind of a different ARF and we will go through the classifications.

And also I will mention about a few drugs that we as a very strong nephrotoxicity may induce ARF. And also we review about a goal of ARF treatment. And those treatment strategies and also complications that we will simply review those list. And finally we summarized those ARF treatments. Definition of ARF. ARF was define as a rapid decline in renal function, and there are a lot of a different ARF definitions And a basic clinical definition is actually look at those serum creatinine level. If the creatinine level is increased dramatically in short time, we actually define a patient with ARF. Snd so you can do care those creatinine level.

And they’re shorten increment if increase about 0.5 or 1.0 mg/dL depends on their baseline creatinine level, and we can define a patient with ARF. And border definition in critically ill patients is actually, defining us those patient with kidney unable to control a balance of a body fluid and acid-base, the nitrogen wastes that could actually define as ARF And there are a lot of good definition. Well, such as a RIFLE or AKIN definition and with more details and could actually use for study those ARF. Epidemiology is actually has higher incidence in ICU or in hospital. And about one percent of a patient at admission actually with ARF already. And the mortality rate is pretty high.

And so those patient with multiple organ failure they even have higher mortality rates. And prognosis Actually, if the patient can survive with those ARF most patient can actually completely recover. So ARF can actually define as a hospital-based in a critical ill patient’s disease. And risk factors to develop ARF includes sepsis, bleeding, volume depletion, chronic liver disease, mechanical ventilation surgery and a contrast media patient And type of ARF there are three major kinds. The first way is anuria and oliguria and non-oliguria. So that’s actually differentiated by the urine output. So for those who almost has no urine output can define as anuria. and for those patient with less urine output less than 500 ml/day that could not define as oliguria.

And non-oliguria patient has no more urine output.