Question

A 55 year old male was admitted for sepsis due to Staph aureus. On assessment, he was found to be experiencing septic shock. After monitoring his urine output, the nurse discovered he had a significant decreased amount of urine. He was found to have edema and weight gain the next morning.

1. Is this most likely acute or chronic renal failure?

2. Is this reversible?

3. What is the difference between acute and chronic renal failure? (referring to onset and prognosis)

4. What is causing the patient's weight gain?

5. What is azotemia?

Answer 1

1.The condition seems to be an acute renal failure because the symptoms has developed over night and has lead to edema and oliguria by morning.

2.When acute renal failure are diagnosed as earlier that is in less than 24 hours can be treated effectively and reversed.At this time the cause will be ruled out by blood test and urine measurement of the patient along with the symptoms.

3.

Acute Renal Failure	ChronicRenal Failure
The onset is suddenly in hours	The onset is a long term months to years
Caused due to insult to kidney (injury,accident,infection )	caused due to long term illness (diabetes,severe hypertension,recurrent kidney infection or diseases)
reversible	non reversible
The treatment are generally correcting the underlying symptom	The treatment lies in preventing the symptoms (Dialysis,medication, lifestyle changes,fluid restriction, surgery)
has a good prognosis	has a poor prognosis until a kidney transplant

4.The main reason for the patients weight gain is the inability of the kidney to excrete the toxic wastes ,resulting in accumulation of the fluid in the body.This is because of the sepsis the kidney looses its function.

5Azotemia refers to presence of excess blood urea nitrogen in the body causing raise on serum creatinine and decreasing the urine output.It can be pre renal,post renal or intra renal.If not treated can lead to irreversible kidney injury.