Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.
| EMS etiologies | Setting: ER |
Renal failure results from the kidneys’ inability to filter waste, due to chronic conditions like diabetes, hypertension, or acute injury.
Acute Kidney Injury (AKI), is a sudden decline in kidney function that is often reversible. It is characterized by a reduction in the glomerular filtration rate (GFR), leading to the accumulation of waste products, water, and electrolytes in the body. AKI is common, particularly among hospitalized and intensive care unit (ICU) patients, where it can be seen in up to 30% of admissions. Diagnosis is typically based on criteria such as a rise in serum creatinine or decreased urine output.
Management of renal failure focuses on treating underlying causes, avoiding nephrotoxic drugs, managing electrolyte imbalances (such as hyperkalemia), and addressing volume overload with diuretics. In severe cases, renal replacement therapy (RRT) such as dialysis may be necessary. AKI can lead to significant complications like metabolic acidosis and fluid overload, and it requires close monitoring to prevent further kidney damage.
Chronic kidney disease (CKD) is defined by kidney damage or a reduction in estimated glomerular filtration rate for at least three months. CKD is a progressive condition that may lead to end-stage renal disease (ESRD), requiring renal replacement therapy such as dialysis or kidney transplantation.
Common CKD causes include:
Other risk factors include cardiovascular disease, obesity, smoking, and certain genetic factors. Managing CKD involves addressing these underlying conditions to slow disease progression and minimize complications.