c. Treatment of Chronic Renal Failure. There are three basic elements in the
goal of medical management of a patient with chronic renal failure. First, maintain the
patient's normal body fluid volume and electrolyte balance. Second, reduce the
breakdown of tissue in the patient's body. And, third, try to prevent infection until
healing occurs. To accomplish all this, a variety of measures are used, including
restricting the patient's fluids to 400 ml per day for the average adult. Also included in
the management plan are the following:
(1) Adjustment of the patient's diet to limit the sources of nitrogen,
potassium, phosphate, and sulfate.
(2)
Vigorous treatment of infection with antibiotics.
(3) Treatment of anemia with a transfusion of a small volume of packed,
fresh red blood cells.
3-11. RENAL TUMORS
Tumors of the kidneys usually grow rather slowly. Occasionally, rapidly invading
types of tumors are found. Signs of a renal tumor include blood in the urine and dull
pain in the kidney region. Immediate surgery may be necessary to save the patient's
life.
3-12. POLYCYSTIC KIDNEY
Polycystic kidney disease is an inherited disorder. The disease runs in families.
As the name suggests, multiple, bilateral, grapelike clusters of cysts filled with fluid grow
in the kidneys. These cysts cause the kidneys to enlarge, compress the kidney tissue,
and finally squeeze functioning kidney tissue so that it cannot function any longer. The
disease may progress slowly in adults. While polycystic kidney disease cannot be
cured, life may be prolonged if associated urinary tract infections and secondary
hypertension are controlled.
3-13. RENAL CALCULI (KIDNEY STONES)
Renal calculi, more commonly known as kidney stones, are another disorder of
the genitourinary system. Substances such as calcium oxalate, calcium phosphate,
magnesium ammonium phosphate sometimes separate from the rest of the urine
solution and form a solid deposit. These formations can occur anywhere in the urinary
tract, but they usually develop in the renal pelvis or the calyces of the kidneys. There
may be one kidney stone or several. The size of the stones vary. Kidney stones
develop in Americans in the ration of 1 to 1,000 people. More common in men than
women, and rare in children and Blacks, renal calculi occur more frequently in people
who live in certain geographic areas: for instance, the Southeastern part of the United
States. The reason may be that the hot climate causes the people to become
dehydrated, or perhaps the cause is the diet of people in that part of the United States.
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