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By Carlos Rotellar

A short, transparent, functional, and funny method of acute renal insufficiency.

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Extra resources for Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition)

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Oral c alci um salts (calcium carbonate, c alcium citrate or calcium acetate) and aluminum salts can be given to co n tro l the hyperphosphat emia. Decrease of both oral phosphate and magnesium should be prescribed. In rhabdomyol ysis , both sev e re hyperphosphatemia and hyperkalemia can occur due to the releas e of phosphate and potassium from the damaged muscle. In the rhabdomyolysis recovery phase , hypercalcemia can occur as a result of calcium mobilization (previously deposited in the damaged muscle) , decrease of serum phosphate due to increase of urinary phosphate and increase of calcitriol.

Figure 45 More urine does not mean better urine. ) The kidney starts to excrete toxins and copious amounts of water with them (Fig. 46) . During this period, the kidney cannot concentrate the urine and loses a lot of water with electrolytes (polyuric phase) . Furthermore, the urea and toxins are acting as osmotic diuretics increasing even more the water and electrolyte excretion. The therapeutic measures at this point are directed toward adequate fluid and electrolyte replacement to compensate for the excessive losses.

S mg/dl). , cerebral hemorrhage), we can perform a CAT scan with contrast knowing that it may prolong the ARE First we have to save the patient and then the kidneys. , idiopathic rapid progressive glomerulonephritis, Wegener's granulomatosis, polyarteritis nodosa etc). Transplanted kidneys can suffer acute renal failure due to any of the etiologies discussed previously and the approach to diagnosis and treatment are the same as for native kidneys. However, in the differential diagnosis we have to add two major situations in which the acute renal failure is directly related to the fact that we are dealing with a transplanted kidney.

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