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Contents
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Acute renal failure
Acute renal failure
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Prognosis measured in weeks prior to the onset of this problem (in addition to symptom control) Prognosis measured in weeks prior to the onset of this problem (in addition to symptom control)
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Prognosis measured in months to years prior to the onset of this problem (in addition to the above) Prognosis measured in months to years prior to the onset of this problem (in addition to the above)
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Further reading Further reading
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Hyperkalaemia
Hyperkalaemia
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Prognosis measured in weeks prior to the onset of this problem (in addition to ‘prognosis measured in hours’) Prognosis measured in weeks prior to the onset of this problem (in addition to ‘prognosis measured in hours’)
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Establish the underlying cause. Establish the underlying cause.
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Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’) Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’)
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Further reading Further reading
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Hypokalaemia
Hypokalaemia
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem Prognosis measured in hours to days prior to the onset of this problem
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Prognosis measured in weeks or more prior to the onset of this problem (in addition to ‘prognosis measured in hours’) Prognosis measured in weeks or more prior to the onset of this problem (in addition to ‘prognosis measured in hours’)
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Further reading Further reading
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Hyponatraemia
Hyponatraemia
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’ Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’
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Establish the likely causes of hyponatraemia. Establish the likely causes of hyponatraemia.
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Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’) Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’)
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Further reading Further reading
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Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Hyponatraemia in this setting should not be acted on. Hyponatraemia in this setting should not be acted on.
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Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’ Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’
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Establish the diagnosis Establish the diagnosis
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Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’) Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’)
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Further reading Further reading
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Hypernatraemia Hypernatraemia
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Prognosis measured in weeks prior to the onset of this problem (in addition to ‘prognosis measured in hours’) Prognosis measured in weeks prior to the onset of this problem (in addition to ‘prognosis measured in hours’)
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Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’) Prognosis measured in months to years prior to the onset of this problem (in addition to ‘prognosis measured in weeks’)
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Further reading Further reading
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Acute gout Acute gout
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History History
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Physical examination Physical examination
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Investigations and management Investigations and management
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Prognosis measured in hours to days prior to the onset of this problem (symptom control) Prognosis measured in hours to days prior to the onset of this problem (symptom control)
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Pain relief Pain relief
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Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’ Prognosis measured in weeks prior to the onset of this problem in addition to ‘prognosis measured in hours’
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Prognosis measured in months to years prior to the onset of this problem (in addition to the above) Prognosis measured in months to years prior to the onset of this problem (in addition to the above)
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Further reading Further reading
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Tumour lysis syndrome Tumour lysis syndrome
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Further reading Further reading
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Cite
Extract
Acute renal failure
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Causes of acute renal failure
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History
Pre-renal failure may present with symptoms associated with diminished fluid reserve. These people may have thirst, symptoms of postural hypotension, dry mouth, and sensation of anxiousness and unease, which is often associated with bleeding.
A recent change in medications (ACE inhibitors, angiotensin II inhibitors, NSAIDs), recent radiology studies, or recent chemotherapy should be sought.
A history of acute deterioration and rapid changes in blood pressure should be sought from staff who have previously been caring for this person (ischaemic acute tubular necrosis, pre-renal failure).
Difficulties passing urine, nocturia, haematuria, and flank pain radiating to the groin suggest an obstructive cause.
A past history of chronic renal failure and recent changes that may account for this acute deterioration should be sought. In this group, check for any recent changes to medications (NSAIDs, ACE inhibitors, angiotensin II inhibitors, diuretics, lithium, cyclosporin). Check also for symptoms to suggest obstruction (difficulty voiding, haematuria), infection (fever, sweats, dysuria), hypercalcaemia, and hyperglycaemia.
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