we're going to look at acute renal failure which is defined as a decrease in glomerular filtration rate and I put reversible because in quotations because it may be reversible but essentially it's you know it's it's damage to the kidneys which will cause a few problems and many problems actually and so we'll look at these these problems and some causes of acute renal failure . so here I'm just during the anatomy here we have the kidneys the inferior vena cava where the renal veins drain into and then we have the ribs here and here is the diaphragm and here we have the aorta which will supply the kidneys through the renal artery and here we have the pelvis and now the kidneys as we know produce urine which will travel through the ureter and go to the bladder and your EIN is stored in the bladder and when needed the bladder will contract and expel your run through the urethra.
now above the kidneys we have glands known as adrenal glands which are important because they produce some important hormones okay now I want to talk about the the main causes of acute renal failure and there's three main. ones it can either be pre Reno before the kidneys in torino within the kidneys or post renal after the kidneys so these are the main causes but now we will focus on each one and look at these in a bit more detail so pre renal cause of acute renal failure can be due to a sudden or severe decrease in blood pressure or it can be due to a flow on a flow obstruction to the kidneys and this can be due to atherosclerosis or some form of ischemia so stenosis and then you have intravenous cause now intra renal causes include direct damage to the kidneys.
itself inflammation within the kidneys a
form of infection drugs as well as autoimmune diseases such as systemic lupus erythematosus I hope I pronouncednthat right and then the third one the post renal cause of acute renal failure include mainly an obstruction of urine flow so this can be due to a benign prostatic hyperplasia kidney stones as well as some form of bladder injury or juma now we will mainly focus on intra renal which is the most common form of acute renal failure so it's the most common cause now before we look into that we should just quickly brush over the anatomy so here I'm drawing the right kidney the ureter the renal pelvis the renal pyramids within the which are within the renal medulla and around this area are are the functional units of the kidneys which are called nephrons
let's.
just zoom into one of these nephrons so here you're under in one nephron it has a the head which is the Bowman's capsule and then we have this convoluted pot called the proximal convoluted tubules. which then forms a loop of Henle and then we have the distal convoluted tubules and then the collecting duct so let us briefly look at the function of the kidneys of the nephron so in summary an afferent arteriole will carry blood from the renal artery this afferent arteriole will come down and it will be filtered in the glomerulus and this occurs in the Bowman's capsule the head of the nephron a term to note is the glamour filtration rate and this is literally the rate at which the glomerulus filters the blood when the blood is being filtered filtrate is produced and this is what will go through the nephron the remaining blood will leave the glomerulus and exit out through the efferent arteriole and this efferent arteriole will essentially make its way around the nephron as the Vasa recta the Vasa recta the Vasa directors role is to reabsorb things from the filtrate that is within the nephron as well the Vasa recta will secrete things that it doesn't need it will secrete things from the blood back into the nephron as filtrate the Vasa recta will then leave and head towards and join with other veins and form essentially the renal vein the filtrate.
which is inside the nephron is what we pee out it's it's our urine output okay now let's just recap the three main causes of acute renal failure we have pre renal intra renal and post renal we will mainly focus on in Torino now in Torino in in Torino causes there's actually four main types we can have acute glomerular nephritis and this is literally inflammation of the glomerulus one of the main one one one of the main causes of acute glomerulonephritis is an autoimmune condition known as systemic lupus erythematosus the second type of in Torino cause of acute renal failure is acute tubular necrosis and this is actually the main sort of sign we see in acute renal failure which is death of cells within the nephron and 50% of acute renal failure cases have this feature and then we have acute interstitial nephritis which is literally sort of inflammation of the interstitial space in the kidneys and we see this mostly in our allergic reactions as well as infection now before we look at the fourth sort of type of intra renal cause of acute renal failure . we have to understand that pre rino intra renal and post renal causes are all connected for example a pre renal and post renal can cause an intra renal problem and so this leads to the fourth main type of intra rino cause of acute renal failure which is vascular okay so we know that acute renal failure is characterized mainly by a decrease in the glomerular filtration rate or GFR so why do we have this characteristic of a decrease in GFR well it can be basically caused by two main changes the first is vascular change where we see endothelial dysfunction where we see very constricting in the afferent arteriole the arteriole coming into the nephron as well as we see we can see an increase in adhesion of inflammatory cells such as neutrophils and this will cause and aggravate the problem. it will cause inflammation the second change we see is our tubular changes so in tribute of change for example here is within the Toob of the nephron the filtrate normally goes this way and we now see cell loss we see damaged cell and this can be due to necrosis or you know it can later cause apoptosis so now if these can form necrotic bodies which will literally cause an obstruction in the tube and as a result the filtrate will back lick the urine will back lick and two other complications so these are the two main changes that cause a decrease in GFR in intra renal failure. okay so now just quickly going over the characteristics of acute renal failure functionally we have remember a decrease in GFR the filtration this will lead to a decrease in urine and we will have as a result of some problems in the tube increase in nitrogenous wastes in the blood such as urea and creatinine and this is what we can use to measure acute renal failure sort of the severity structurally in a Quirino failure we have cell death due to apoptosis or necrosis as well as loss of adhesion to intrinsic renal cells I hope you enjoyed THANK YOU FOR READING my blog.
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