Predisposing Factors Acute Renal Failure Precipitating Factors

- Age - Diabetic nephropathy

- Sex - Glomerulonephritis
- Race - Renal Obstruction
- Cardiovascular
Disorders

Decreased blood flow to the renal arteries

Release of rennin by the juxtaglomerular apparatus

Renin enters the blood stream

Conversion of angiotensinogen in the liver to

angiotensin I

Angiotensinogen I passes through the lung

capillaries

ACE in the Lung capillaries converts Angiotensin I

to Angiotensin II (potent vasoconstrictor)

VASOCONSTRICTION Release of Aldosterone

in the adrenal glands

Sodium retention

Increase Plasma volume

Increase BLOOD PRESSURE

Signs and Symptoms:

Decrease Tissue Perfusion - Decrease Urine output
- Increase BUN
- Increase Serum
Unable to excrete metabolic waste Creatinine
- Edema
- Hypertension

If TREATED: If Not TREATED:

- Dialysis
- Antihypertensive Meds
- Diuretics
- etc.
Good Prognosis/ Poor Prognosis Recurrent ARF
(It depends on the patient’s
Coping abilities)
Further damage to the glomeruli

Hypertrophy of the remaining

healthy glomeruli

A number of the hyperthrophied

glomeruli dies
Signs and Symptoms:
- Nocturia
- fatigue
Renal Impairment (40-50%
- lassitude
remaining GFR)
- anorexia
- uremia

Further stimulation of RAAS

(rennin angiotensin aldosterone
system)

Further damage occurs

Signs and Symptoms:

- Muscle cramps
- hypereflexia Renal Insufficiency
- seizure (20-40% remaining GFR)
- nausea and vomiting
- uremic frost
- pruritus
Renal Failure
(10-20% remaining GFR)

ESRD

DEATH