By Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)
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Extra info for Acute and Chronic Renal Failure
Although renal failure itself does not cause confusion, convulsions or abnormal neurological signs except terminally, it probably contributes to their appearance in patients who have widespread infection or inappropriate drug 32 Acute and Chronic Renal Failure therapy. However, an alternative explanation, such as a subdural haematoma, should always be excluded. 6. The development of haemorrhage, particularly from the gastrointestinal tract. 7. To ensure earlier and adequate calorie administration.
There are some more favourable features of renal failure due to polycystic renal disease. Anaemia is not as marked as in other forms; hypertension, although common, is generally mild and easily controlled; and a significant recovery of renal function can occur even at a late stage after correction of reversible factors. In fact, many patients remain remarkably well for months after just one short period of peritoneal dialysis. Polycystic kidneys are associated with berry aneurysms, and these patients suffer an increased incidence of subarachnoid haemorrhage.
The increased postoperative incidence of ATN following operations for the relief of biliary obstruction. Dawson (1968) showed that patients undergoing simple surgical procedures for the relief of obstruction were liable to develop renal failure and the severity of the jaundice was proportional to the risk of renal failure. He showed that all patients undergoing surgery had a fall in the creatinine clearance, which was most marked in jaundiced patients and was proportional to bilirubin levels. It could be ameliorated by infusing 500 ml of 10 per cent mannitol beginning two hours before surgery and sufficient five per cent mannitol postoperatively to maintain a urine flow of 1 ml/min over the next 40 Acute and Chronic Renal Failure 24 hours.