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6 Cards in this Set
- Front
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4 pathophysiological mechanisms of ARF |
Hypovolaemia/hypotension ischaemia > acute tubular necrosis Medication induced Pigment nephropathy Infectious |
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Which medications can cause ARF |
Aminoglycosides (gentamicin) > acute tubular necrosis NSAIDS > medullary crest/papillary necrosis >hyperexhoic on US Oxytetracycline >proximal tubule necrosis (flexor tendon contracture in foals) Amphotericin B (antifungal) >cell death of distal tubule epithelium Vitamin K IV/IM > ARF within 6-48hr >acute tubular necrosis, interstitial necrosis |
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Infectious causes of ARF? |
Leptospirosis-tubulointerstitial nephritis Actinobacillus equui- purulent glomerulonephritis foals |
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7 (3) principles of treatment of ARF |
1. Treat primary disease/exacerbating factors 2. Fluid tx- 80ml/kg/day 3. Nutritional support - dextrose IV + NGT and parenteral nutrition 4. Adjunct tx ie gastric protectant, calcium (amonoglycosides) 5. Increase urine production> furosemide, mannitol 6. Increase renal perfusion - dopamine- controversial 7. Peritoneal dialysis -rare |
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How do you monitor response to therapy ARF? |
Minimum data daily- BW Vol fluid administered PCV/TP creatinine Electrolytes |
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prognosis depends on duration ARF prior to Tx. Good prognostic indicator? |
Creatinine drops in first 24h Tx |
