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Abstract: The patient in this case was a 65-year-old grandfather who presented with symptoms such as decreased diet, generalized edema, decreased urine volume and occasional nausea in the past 1 week. He was given renal preservation medication in an outside hospital without significant relief of symptoms, so he was seen in our hospital. He was diagnosed with renal insufficiency and acute renal failure in the emergency department. Ultrasound examination in hospital revealed a large amount of urinary retention, and indwelling catheterization and bedside hemofiltration were performed. After treatment, urine output increased, renal function returned to normal, and the treatment effect was good.
Basic information】Male, 65 years old
Disease Type】Acute renal failure
Hospital】Jiangsu Provincial Hospital of Traditional Chinese Medicine
Date of consultation】March 2022
Treatment plan】Urinary catheterization + bedside hemofiltration
Treatment Period】Inpatient treatment for 9 days, followed up by outpatient after 1 month
Results】Increased urine output, normalized renal function, good treatment effect
I. Initial consultation
The grandfather lives in a nursing home and suffers from Alzheimer’s disease, unable to communicate with others except for his family. The family members reported: moncler outlet online in the past 1 week, the amount of food and drink decreased, general edema, urine volume decreased, occasional nausea symptoms, outside the hospital to give kidney preservation drugs without significant relief, 4 days ago, a transient loss of consciousness, 15 minutes after drinking water to recover, but still no urine, edema severe. There was no previous history of kidney disease. The cause of the sudden decrease in urine output and the sharp increase in blood creatinine was unknown. Emergency examination revealed: elevated blood creatinine up to 1217.8μmoI/L, urea nitrogen 44.22umol/L, hemoglobin 124/L. Preliminary diagnosis of renal insufficiency with high possibility of acute renal failure. It is recommended to be hospitalized as soon as possible for blood purification to maintain the stability of the internal environment, and to search for the cause of acute renal failure.
(Urine routine)
II. Treatment history
After admission, the family was again informed of the condition, advanced age, many comorbid diseases, long-term bed rest, unknown cause of renal failure, and unclear prognosis. As the blood creatinine and urea nitrogen were significantly elevated with anuria, and the internal environment was disturbed, he was treated with continuous bedside blood purification therapy by internal jugular vein placement to remove toxins and adjust the internal environment. The doctor also actively improved the examination to find the cause of renal insufficiency. moncler outlet online There are no obvious prerenal factors such as nausea and vomiting, diarrhea, gastrointestinal bleeding, hypotension; no recent history of special medication, no consideration of acute interstitial nephritis; no manifestations of other systemic diseases such as fever and arthralgia. The physical examination showed soft abdomen, no pressure pain, but the lower abdomen was obviously bulging, with turbid percussion sounds, and combined with his previous history of prostatitis, acute renal failure due to urinary retention was not excluded. The blood creatinine gradually decreased to normal, and only one bedside blood filtration treatment was performed, and then the patient was released from dialysis.
III. Treatment effect
moncler outlet online There was a significant increase in urine volume, bright red urine, which did not exclude bleeding caused by collateral damage during catheterization and sudden pressure changes in the bladder, and the blood creatinine decreased significantly. Because of entering the polyuric phase, attention should be paid to monitoring electrolytes to prevent electrolyte disorders as well as to prevent bladder infection and aggravation of bleeding. The renal function returned to normal and the urine color turned clear, and the catheter was removed. The renal ultrasound was repeated without bladder residual urine. 1 month later, moncler outlet online the follow-up renal function and electrolytes were normal, and the renal ultrasound did not show any abnormality. In conclusion, the grandfather was hospitalized for 9 days and followed up in outpatient clinic after 1 month. After treatment, the urine volume increased, renal function returned to normal, and the treatment effect was good.
IV. Notes
I am very happy for the recovery of the condition of the grandfather through treatment. It is still necessary to continue to monitor renal function and electrolytes after discharge. Some of the acute kidney injury can return to normal renal function after removing factors, but renal damage, such as proteinuria and hematuria, may still occur and transform into chronic kidney disease, so it is necessary to come to the hospital for regular review. In daily life, moncler outlet, you should pay attention to rest, avoid strain, normal diet, but pay attention to nutritional balance, etc., prostatitis aspects of regular review, urology consultation surgery if necessary.
V. Personal Insights
In this case moncler outlet, the sudden onset of oliguria, renal insufficiency, no previous history of kidney disease, highly considered acute renal failure, need to be examined as soon as possible to find the cause, and to remove the triggering factors, kidney function may be reversed, reduce the duration of the disease, reduce the possibility of turning into chronic kidney disease. Although it is impossible to communicate effectively with the moncler personal, but timely and accurate examination and as soon as possible to improve the examination, timely diagnosis and treatment, the amount of urine moncler outlet gradually increased, renal function returned to normal, the treatment effect is good.