顾勇-急性肾衰

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Acute Renal Failure,2005-3-10,Huashan,Hospital,Fudan,University,1,Definitions,Rapid decline in GFR,2,Classification,Prerenal,ARF,Intrinsic renal ARF,Postrenal,ARF,3,Prerenal,ARF,Intravascular volume deletion,Decreased cardiac output,Systemic vasodilatation,Renal vasoconstriction,Pharmacologic agents,4,Intrinsic ARF,Diseases involving large renal vessels,Diseases involving renal microvasculature,Diseases of,glomeruli,Diseases characterized by injury to renal tubules,Diseases of the,tubulointerstitium,5,Postrenal,ARF,Ureteric,obstruction,Bladder neck obstruction,Urethral obstruction,6,Acute Tubule Necrosis,Etiology,Pathology,Pathophysiology,Clinical features,Differentiation,Management,7,Etiology,Ischemia,Exogenous toxins,Endogenous toxins,8,Pathology,Focal loss of tubular epithelium cells,Exposure of basement membrane,Loss of proximal tubular brush border,Necrosis in the outer medulla,9,Pathophysiology,Hemodynamic,abnormalities,Tubule obstruction,Back-leakage,10,Clinical Features,Oliguric,phase,Polyuric,phase,Recovery phase,11,Oliguric,Phase,Oliguria,progressively increased BUN and,SCr,Disorders of fluid and electrolyte,Hemodynamic,disorders,ARDS,MODS,Infection,12,Polyuric,Phase,Polyuria,Decreased BUN and,SCr,13,Recovery Phase,Rena function recover,14,Laboratory Assessment of ATN,Blood test,Urinary findings,Renal biopsy,15,Differentiation,Fractional excretion of Na,Urinary Na concentration,Urinary,creatinine,/plasma,creatinine,Urinary specific gravity,Urine,osmolality,Plasma BUN/Cr,Renal failure index,16,Management,Prevention,Maintenance of fluid and electrolyte balance,Provision of adequate nutrition,Treatment of infection,Treatment of uremia,17,