Renal Failure

Kumud P Mehta
Renal Failure - Prognosis
Prognosis of ARF depends on (a) underlying cause e.g. Acute poststreptococcal glomerulonephritis and ATN (Acute tubular necrosis)can recover fully if early diagnosis and treatment are offered. (b) Severe crescentic glomerulonephritis and HUS are associated with mortality (c) Anuria lasting for more than 3 weeks, young age, multiorgan failure, cortical necrosis, late referral are associated with high mortality (d) pre-existing renal disease like lupus, MPGN etc. are likely to progress to end stage renal disease years after the initial presentation as ARF.

Prognosis in a case with CRF depends on the cause e.g.congenital obstructive anomalies, congenital nephrotic syndrome, polycystic kidney disease, oxalosis, cystinosis progress to ESRD requiring RRT by 5-6 years of age, whilst chronic glomerulonephritis, chronic pyelonephritis, Alport's disease go into ESRD during adolescence and young adulthood.

There are some cases of CRF who remain with stable renal function with proteinuria and hypertension for years. They usually suffer from short stature. Growth Hormone therapy is additional treatment for short stature due to CRF. It is very expensive.

Prognosis of a patient with ESRD is poor unless there is a possibility of getting renal transplant.

Complications of ARF : hypertension, pulmonary edema or CCF, hyperkalemia, uremic or hypertensive encephalopathy gastrointestinal bleeding, nutritional deficiency.

Complications of CRF: growth failure, renal osteodystrophy anemia, cardiac dysfunction, hypertension, neurological and developmental defects in young children.

Renal Failure Renal Failure 01/10/2001
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