Carlos Rotellar's Acute Renal Insufficiency Made Ridiculously Simple PDF

By Carlos Rotellar

ISBN-10: 0940780097

ISBN-13: 9780940780095

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

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Additional info for Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition)

Sample text

Therefore, to avoid Na " and Cl- imbalance we have to maintain some salt intake. Excessive salt restriction should not be 40 Figure 41 Avoid excessive salt restriction. prescribed. (Fig. 41). Furthermore, we should avoid an excessive intake of free water (water without salt). Potassium Balance Plasma potassium increases quite rapidly in patients with ATN. Hyperkalemia can cause cardiac arrest, therefore , it must be closely followed . Potassium intake should be lower than 40-60 mEq/24 hr; cation exchange resins (Kayexalate) (1) (Fig .

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. Aggressive calcium replacement in the hypocalcemic phase in this setting can lead to severe hypercalcemia in the recovery phase . Indications for Acute Dialysis BUN > 100 mg/dl and/or severe uremic symptoms K + > 7 mEq/1 Fluid overload (pulmonary edema) Severe acidosis (Fig.

Infusion of 500 ml of half normal or normal saline in one hour and watch the patient closely for an increase in urine output . The fluid challenge can be repeated but there is the risk of developing acute pulmonary edema. 33 Suspicion of renal artery obstruction should lead to a radioisotope renal scan. If renal artery stenosis is suspected because a patient develops acute renal failure after the use of either an ACE inhibitor or an angiotensin II receptor blocker, a renal scan with and without captopril may help in the diagnosis.

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Acute Renal Insufficiency Made Ridiculously Simple (MedMaster Series, 2005 Edition) by Carlos Rotellar


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