Renal failure is a common disease in clinic. It is pided into acute renal failure and chronic renal failure. Acute renal failure can be relieved if accurate diagnosis and reasonable treatment can be achieved. The distinction between acute and chronic renal failure, one is clinical diagnosis, mainly based on the duration of the disease and other indicators. Two is pathological diagnosis, and the pathological diagnosis of renal biopsy is the standard of identification of acute renal failure.
1. the length of the disease is the basis for distinguishing between acute and chronic renal failure. In 50 cases of chronic renal failure, half of the disease is less than 1 years, three of them are more acute, and the disease is less than 3 months. Therefore, the length of disease is the basis of judgment, especially chronic renal failure is not reliable.
2. it has been widely used to measure kidney size by B ultrasound in china. It is generally believed that the increase in renal volume is seen in acute renal failure, and the smaller size of the kidneys is seen in chronic renal failure. Our data suggest that both acute or chronic renal failure, kidney really increase or decrease only accounted for 1/3, the majority of cases of normal renal size, this part of the people using the ultrasonic kidney size no help in acute and chronic renal failure identification. Recently, we found that measuring renal parenchyma thickness under B-mode ultrasound is more meaningful than measuring renal volume.
3. nail creatinine measurement is a non-invasive and simple method, and the measured value reflects the level of serum creatinine three months ago. For patients with occult onset or an unknown history and normal size of the kidney, nail creatinine measurement can be used to understand renal function 3 months ago, with a specificity of 84%, which can be used as a complement to the above two data.
4. anemia. Chronic renal failure is one of the clinical manifestations, as one of the differential diagnosis of acute renal failure and chronic renal failure, sampling analysis showed no significant difference in the detection rate of acute renal failure and anemia in patients with chronic renal failure and severity.
In addition, acute renal failure caused by hemolytic uremic syndrome may present with severe anemia. Acute renal failure can lead to mild and moderate anemia. In acute nephritis with acute interstitial nephritis, the decrease of EPO results in anemia. Therefore, we believe that anemia is an unreliable indicator of acute renal failure and chronic renal failure.
5.The increase of nocturia and the decrease of urine specific gravity is the clinical manifestation of chronic renal failure. In patients with acute renal failure, half of the urinary gravity is below 1.015, and the renal biopsy tissue has tubular interstitial disease. This phenomenon can explain the decrease of urinary gravity in patients with acute renal failure.
6. when acute renal failure, especially acute tubular necrosis, increases the levels of urinary enzymes, brush border antigen and urinary adenosine binding protein, which is beneficial for differential diagnosis.
Above is the relevant introduction about how to distinguish between acute and chronic renal failure, if you have a kidney disease knowledge requires a detailed understanding, you can consult our online expert, our experts will reply as soon as possible.