Postrenal Acute Renal Failure

by Sharon Hopkins


The Postrenal Acute Renal Failure, or Postrenal ARF, is a result of an acute blockage that distresses the normal flow of the urine out of the kidneys. The obstruction causes a legitimate amount of pressure to build up in the renal nephrons, the tubular filtering components that produce urine. The extreme fluid pressure eventually causes these nephrons to fail. The amount of renal failure corresponds precisely with the degree of blockage. Postrenal ARF occurs to most elderly men that have enlarged prostrate glands that hinder the normal flow of urine.

Causes

Some of the most notable causes of Postrenal Acute Renal Failure are:

  • The kidney stones found in both ureters (which are the tubes that transport urine from each kidney right to the bladder) or those patients with one kidney
  • Bladder outlet blockage that results from the enlargement of prostate gland or bladder stone
  • Tubule obstruction
  • Renal injury, which is usually acquired from car accidents or playing sports
  • Neurogenic bladder, which is caused by the failure of the bladder to clean out
  • Retroperitoneal fibrosis, which is the development of fibrous tissue located behind the peritoneum (the membrane that positions the abdominal cavity)

Diagnosis

Diagnosis of Postrenal ARF often requires a comprehensive physical examination and medical history. Oftentimes the catheterization of a bladder which holds about two to three liters of urine can help make the diagnosis. In this way, the volume of urine is measured and the swelling of the bladder is resolved. An ultrasound of the kidneys, ureters and the bladder is usually conducted in order to determine the cause and location of obstruction. If the test results show signs that the kidneys are stretched or dilated beyond its normal size because of fluid buildup, then an obstructive Postrenal ARF is established. In some cases, a computed tomography or a CT or CAT scan of the kidneys can help provide additional information on the diagnosis of the patient.

Treatment

Treatment of Postrenal ARF general focuses on the removal of the obstruction in the ureter or in the bladder. If the obstruction is found at the bladder outlet and caused by an enlarged prostate, the obstruction is relieved by placing a catheter into the bladder. Then the prostate undergoes examination and proper treatment. However, if obstruction is caused by kidney stones and occurs in the kidneys, the stones must be removed. If the stones cannot be removed, tubes that drain urine from the kidneys through an opening in the skin or percutaneous nephrostomy tubes maybe fitted into the patient.

Recovery

Recovery from Postrenal ARF is indicated by the duration and severity of the obstruction. Usually it can be known within seven to 14 days after the obstruction has been removed. At times, short-term treatment and dialysis may be required until the doctor is able to determine the renal function.


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