Indications in acute renal failure
Absolute:
1) Severe fluid overload with CCF
2) Severe hyperkalemia unresponsive to medical Rx or with ECG changes
3) Severe hyponeatrmia
4) Server metabloic acidosis requiring > 2 doses of NaHCO3 (2mEq/kg/dose)
5) Uraemia
6) Fluid restriction curtailling ample nutrition
Relative:
1) Anuria
2) High urea and creatinine values alone are not indications

METHOD
Materials:
1) Pertioneal dialysis tubing, trocar and cannula
2) Yellow intracath #14 gauge needle – …

Rapidly progressive is characterized by the histopathologic finding of crescents in the majority of glomeruli. The natural history in most forms is rapid progression to end-stage renal failure.
It is characterized by rapid deterioration of renal functions over days to weeks.
MANAGEMENT of RPGN-
We have elaborated “The regimen used by the Glomerular Disease Collaborative Network at the University of North Carolina at …

Primary Immunopathogenic mechanism:
Initiator of the disease process by:

Antibody mediated injury: immune complex deposition or cytotoxic antibodies
T-cell mediated immune injury: non-immune complex deposition mechanism

Secondary immunopathogenic mechanism:
Role of mediators of the disease:
A) Cells:

Neutrophils and monocytes
Macrophages, T lymphocytes and NK cells
Platelets
Resident glomerular cells (Mesagnial cells)

B) Soluble mediators:

Complement components
Eicosanoids, NO, angiotensin and endothelin
Cytokines: IL-1 and TNF
Chemokines: MCP-1, RANTES, TGF-B
Coagulation system

Antibody Mediated Injury
Include:

Membranous glomerulonephritis
IgA nephropathy
Membranoproliferative …

Patient with RA stenosis presents with:
A.Hypertension when it affects single kidney and as Renal failure when it affects bilateral kidneys. It is often a part of Atherosclerotic vascular disease.
B. Deterioration of Renal function on ACE inhibitors: A drop in GFR ie .20% rise in serum creatinine levels when patient is on ACEI , raises the possibility of RA stenosis …