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Exams And Diagnostic Test For Renal Failure

In the diagnosis of Renal failure, There are various sources tests as used That can be relevant to renal failure, includes:

1. Kidney function tests.

These are the diseases or medical conditions in which the medical test 'Kidney tests' may be involved: Diabetes, Hyperparathyroidis, Kidney stones, Renal osteodystrophy, Type 1 diabetes Wegener's granulomatosis.

2. Urine tests.

The urine may contain various substances for different types of disease. For example, sugar in urine may mean diabetes and blood in urine may mean various kidney conditions. Thus, a variety of diseases have urine tests.

There are several types of different urine tests;Fasting urine test, Random urine test, Mid-stream urine test, 24-hour urine test.

3. Blood tests.

The blood laboratory tests used in the diagnosis of Renal failure, Such tests may include: BUN, Serum potasium, Creatinine clearance, Serum creatinine, Serum potassium, phosphorus, Urinalysis.

Blood tests may help reveal the underlying cause of kidney failure. Arterial blood gas and blood chemistries may show metabolic acidosis.

In a normal animal, the BUN is 25 or so. A good goal for BUN in renal failure is 60-80. Often at the time of diagnosis, BUN is well over 150, 200, or even 300.

A normal creatinine is less than 2.0. A good goal in renal failure is a creatinine of 4.5 or less. BUN and creatinine will be tracked (as will several other parameters) over time and in response to different treatments.

The calcium/phosphorus balance becomes deranged in renal failure due to hormone changes that ensue as well as the inability of the failing kidney to excrete phosphorus. If calcium and phosphorus levels become too high, the soft tissues of the animal's body will develop mineralized deposits which are inflammatory and uncomfortable. The bones will weaken as well.

If phosphorus can be maintained in the normal range (less than 7.5), a special medication called "calcitriol" can be used to help prevent or slow the progression of kidney failure. Medications and special diets can be used to help keep phosphorus levels down.

The failing kidney is unable to conserve potassium efficiently and supplementation may be needed. Signs of "hypokalemia" (the scientific name for low blood potassium) include weakness, especially drooping of the head and neck.

PACKED CELL VOLUME/HEMATOCRIT - This is a measure of red blood cell amount. More literally it represents the percentage of the blood made up by red blood cells. The hormone that stimulates the production of red blood cells is made by the kidney. The failing kidney does not make this hormone in normal amounts and anemia can result.

Anemia is often worsened by the extra fluid administrations needed to manage the kidney toxins. Sometimes a blood transfusion is needed or, more commonly, the owner of the pet must learn how to give hormone injections to boost the red blood cell count.

Blood pressure is not something measured off a laboratory result sheet but it is important to monitor in kidney patients as there is a tendency for hypertension to develop in kidney failure. Special medications may be needed to manage this problem should it arise.

4. Radiology Tests.

A kidney or abdominal ultrasound is the preferred test for diagnosing kidney failure, but abdominal x-ray, abdominal CT scan, or abdominal MRI can tell if there is a blockage in the urinary tract.

5. Home Diagnostic Tests

Bladder & Urinary Health: Home Bladder Tests, Home Urinary Tract Infection (UTI) Test, Home Cystitis Tests, Home Kidney Tests, Home Urine Protein Tests (Kidney Function), Home Prostate Cancer Tests.

Renal Health: Home Microalbumin Tests (Kidney/renal), Home Urine Protein Tests (Kidney/renal), Home Urinary Tract Infection (UTI) Tests.
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Treatment Of Chronic Renal Failure (CRF),

The goal of medical treatment for the patients with Chronic Renal Failure (CRF) is to control symptoms, reduce complications, and slow the progression of the disease and should focus on the following:

a. Delaying or halting the progression of chronic Renal Failure (CRF).

Once CRF has been diagnosed, the physician attempts to determine the cause of Chronic Renal failure (CRF) and, if possible, plan a specific treatment.

Nonspecific treatments are implemented to delay or possibly arrest the progressive loss of kidney function.

b. Aggressive Control of blood pressure to target values per current guidelines : hypertension (high blood pressure)—Target systolic blood pressure (BP) is 120 to 135 mm Hg; target diastolic BP is 70 to 80 mm Hg.

Antihypertensive medication from the ACE class is preferable because of protective effects on the kidneys. Systolic blood pressure control is considered more important and is also considered difficult to control in elderly patients with chronic Renal Failure (CRF).
Use of ACE inhibitors or angiotensin receptor blockers as tolerated, with close monitoring for renal deterioration and for hyperkalemia (avoid in advanced renal failure, bilateral renal artery stenosis [RAS], RAS in a solitary kidney).

Data support the use of ACE inhibitors/angiotensin receptor blockers in diabetic kidney disease with or without proteinuria. However, in nondiabetic renal failure, ACE inhibitors/angiotensin receptor blockers are effective in retarding the progression of disease among patients with proteinuria of less of than 500 mg/d.

Aggressive glycemic control per the American Diabetes Association (ADA) recommendations (target HbA1C <7%). Treating the pathologic manifestations of chronic Renal Failure (CRF), including the following:

Anemia with erythropoietin, with the goal being 11-12 g/dL, as normalization of hemoglobin in patients with chronic Renal Failure (CRF) stages 4-5 has been associated with an increased risk of combined outcome. Before starting Epogen, iron stores should be checked, and the aim is to keep iron saturation at 30-50% and ferritin at 200-500.

Hyperphosphatemia with dietary phosphate binders and dietary phosphate restriction for CRF.

Hypocalcemia with calcium supplements with or without calcitriol and Hyperparathyroidism with calcitriol or vitamin D analogs and Cardiovascular complications.

Volume overload with loop diuretics or ultrafiltrationMetabolic acidosis with oral alkali supplementationUremic manifestations with chronic renal replacement therapy (hemodialysis, peritoneal dialysis, or renal transplantation): Indications include severe metabolic acidosis, hyperkalemia, pericarditis, encephalopathy, intractable volume overload, failure to thrive and malnutrition, peripheral neuropathy, intractable gastrointestinal symptoms, and the GFR less than 10 mL/min.

c.Timely planning for chronic renal Failure (CRF) replacement therapy.

Early education regarding natural renal failure progression, different dialytic modalities, renal transplantation, patient option to refuse or discontinue chronic dialysis.

Timely placement of permanent vascular access (arrange for surgical creation of primary arteriovenous fistula, if possible, and preferably at least 6 months in advance of anticipated date of renal dialysis).

Timely elective peritoneal dialysis catheter insertion and Timely referral for renal transplantation.
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Treatment of Acute Renal Failure (ARF)

Once the cause of acute renal failure (ARF) is found and has developed, A variety of therapeutic approaches have been used. The goal of Acute Renal Filure (ARF) treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal.

And also to prevent acute ischemic and nephrotoxic renal injury and to improve renal function and reduce mortality. Usually, the Acute Renal Failure(ARF) patient has to stay overnight in the hospital for treatment.

Unfortunately, there have been few rigorous assessments of the efficacy of the Acute Renal Failure (ARF) treatment interventions. The reasons for the lack of abundant critical data regarding treatment effects in ARF are several.

First, ARF is a functional disorder. It has a spectrum of etiologies, occurs in a variety of clinical settings and varies in severity.

Second, selected endpoints of treatment success vary and co-morbid factors frequently determine outcome.

Third, it had been difficult to carry out prospective controlled studies in a disorder in which the mortality rate approaches 50%.
In this review, an effort was made to analyze the available literature with a primary focus on controlled studies to determine significant prophylactic and treatment effects of various interventions in ARF.

The amount of liquid Acute Renal Filure(ARF) patient eats (such as soup) or drink will be limited to the amount of urine the patient can produce. Patient will be advised what patient may and may not eat to reduce the build-up of toxins normally handled by the kidneys.

High in carbohydrates and low in protein, salt, and potassium will be the diet of Acute Renal Failure (ARF)

Three endpoints of Acute Renal Failure(ARF) therapy (change in renal function, change in course of azotemia, and change in mortality) were examined for pharmacologic agents. Changes in course of azotemia and mortality were assessed in evaluating different dialysis modes.

Effect on nitrogen balance, change in course of azotemia, and change in mortality were used as endpoints to determine treatment effects of different nutritional regimens. When weight was given to prospective controlled studies, some insights emerged as to treatment interventions that are most likely to have beneficial effects in specific settings of ARF.

Among pharmacologic agents, antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help the kidneys lose fluid. Calcium, glucose/insulin, or potassium will be given through a vein to help avoid dangerous increases in blood potassium levels. mannitol appears to have a positive prophylactic effect in kidney transplantation. There are no other significant beneficial effects of diuretics for prophylaxis or as treatment in early or established Acute Renal Failure (ARF).

Of vasoactive agents, there is a relatively small amount of data suggesting that diltiazem may have a positive prophylactic effect in kidney transplantation, and dopamine possibly is beneficial early in the evolutionary phase of Acute Renal Failure(ARF). Atrial natriuretic peptide and calcium channel blockers may have beneficial effects in established disease.

No other pharmacologic interventions are supported by substantial data. At best, the results are equivocal regarding the use of early and vigorous dialysis in ARF. Dialysis can make Acute Renal Failure(ARF) patient feel better. It is not always necessary, but it can save patient life if the potassium levels are dangerously high. Dialysis will also be used if patient mental status changes, stop urinating, develop pericarditis, retain too much fluid, or cannot eliminate nitrogen waste products from the body.
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Prevention of Renal Failure

Thirty percent of chronic renal failure is due to diabetic nephropathy, and 10% each to hypertensive nephropathy and chronic pyelonephritis. The patients who diagnosed as Diabetic and hypertension should be monitoring and always controling their condition to the physicient to help prevent or delay development of chronic renal failure.

Diabetics should control blood sugar and blood pressure closely and should refrain from smoking. Hyperglycemia should be treated; the goal is an A1C concentration below 7 percent. In patients with dyslipidemia, statin therapy is appropriate to reduce the risk of cardiovascular disease. Anemia should be treated, with a target hemoglobin concentration of 11 to 12 g per dL (110 to 120 g per L). All of these disease can be causes of renal failure.

For the women, who are pregnant must consult their doctors for a pre pregnancy consultation. especially for the women with twin pregnancy, because it can be one of high risk to develop renal failure.
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