Large changes in urine output, beware of acute tubular necrosis

  Acute tubular necrosis is the most common type of acute renal failure. Severe tubular necrosis often leads to severe renal failure, resulting in low or complete renal function, and sometimes life-threatening. Therefore, acute renal failure Tubular necrosis requires timely treatment. So what are the causes, clinical manifestations and treatments of acute tubular necrosis? This article will tell you the answer.
Renal ischemia is the most common cause

  The causes of acute tubular necrosis are mainly acute renal ischemia, intravascular hemolysis, acute nephrotoxic damage, etc. Sometimes certain infections can also cause renal tubular necrosis.
  Among many factors, acute renal ischemia is the most common and more serious cause than other causes. A large amount of bleeding during or after an important operation, cardiopulmonary bypass, various shocks, etc. can cause acute renal ischemia. The nephrotoxic damage is mainly related to medical history or working environment. For example, excessive exposure to heavy metals such as platinum and lead, or exposure to chemical poisons, biological poisons, etc., will cause nephrotoxic damage; in terms of drugs, gentamicin in antibiotics , Amphotericin, sulfa drugs, etc. have strong nephrotoxicity.
Clinical manifestations are divided into 3 stages

  The clinical manifestations of acute tubular necrosis can be divided into three stages: oliguria, polyuria, and recovery. It is also the three stages experienced by patients with acute tubular necrosis.
  Oliguria: All symptoms of renal failure caused by kidney disease, the main clinical manifestation is the decrease in urine output. If the filtration rate of the glomerulus drops, there will be nitrogen wastes in the body, which will cause the water balance in the body to be disturbed, and the corresponding urine output will be reduced. Generally speaking, less than 400 ml of urine per day is called oliguria, and less than 100 ml is anuria. The lower the urine output, the more serious the damage to the glomeruli. At this stage, patients will develop systemic edema, and in severe cases, pulmonary edema and heart failure; and some digestive symptoms, such as nausea, vomiting, and anorexia. Generally speaking, the duration of the oliguria period is within one month. If it exceeds this time, it means that acute tubular necrosis is more serious and it is more difficult to recover renal function.
  Polyuria: As the name implies, the urination volume exceeds the normal range. In clinical manifestations, when a day’s urine output exceeds 400 ml, it means the end of the oliguria period, and it also marks the beginning of a gradual return to normal kidney function. In the late stage of polyuria, the patient’s urination volume can reach more than 2000 ml a day, and even some patients can reach 4000 ml. At this time, as the urine output increases, the edema on the patient gradually disappears, but then there may be dehydration.
  Recovery period: At this stage, the glomerular filtration rate of the patient gradually becomes normal, and the urine output has returned to the normal level. But this process is extremely slow and requires long-term treatment to achieve. Generally speaking, it takes about half a year to a year for renal function to fully recover. In addition, some patients’ renal function will remain damaged at this stage and develop into chronic renal failure, laying hidden dangers for future health.
Diagnosis and treatment: hemodialysis
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  Acute tubular necrosis is an important disease that causes acute renal failure. Once discovered, it must be treated promptly.
  Currently, there are three main treatment methods, namely hemodialysis, peritoneal dialysis, and kidney transplantation. In my country, a considerable number of patients choose hemodialysis because it can flexibly choose the frequency of treatment according to economic conditions and renal function.
  Hemodialysis refers to the drainage of blood from the body to the outside of the body, through a dialyzer composed of countless hollow fibers, the blood and the electrolyte solution (dialysis solution) containing the body’s concentration similar to the inside and outside of the hollow fibers, through diffusion and ultrafiltration , The principle of adsorption and convection to carry out material exchange, remove metabolic waste in the body, maintain electrolyte and acid-base balance, remove excess water in the body, and return the purified blood to the body. In addition to effective treatment of acute kidney injury such as acute tubular necrosis, hemodialysis also has a therapeutic effect on chronic renal failure that may be left after acute tubular rehabilitation. The longest survival time of dialysis patients in my country has exceeded 25 years.
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  However, although the effect of hemodialysis is excellent, it is not suitable for any group. For example, patients with severe heart disease cannot use this method for treatment.