In cases where (ARF) Acute Renal Failure is neither caused by problems in the circulation of the blood nor obstructions in the excretion, the cause is considered to be renal or intrinsic, which means damage or injury within both kidneys. Some 40% of ARF cases are intrinsic ARF.
Intrinsic Acute Renal Failure can be classified into three types depending on the underlying cause. First, it can be caused by vascular disease such as the inflammation of the blood vessel, obstruction to the arteries in the kidneys or in the veins, or low blood platelet and red blood cell counts. Second, it can also be caused by diseases in spaces between parts of tissues, such as the accumulation of proteins in kidney tissues or interstitial nephritis associated with an allergy or infection. Finally, it can be caused by an accumulation of toxins or by ischemia, which is the lack of blood flow to an organ.
Majority or nearly 90% of intrinsic ARF cases are brought about by ischemia or the accumulation of toxins. Ischemia or toxin buildup results to a reduction of blood flow to the kidneys. This, in turn, results to tissue death and irreversible kidney failure. This type of intrinsic ARF occurs usually when there is blood loss or hemorrhage, trauma or infection to the blood (sepsis), or when patients undergo major cardiovascular surgery.
Intrinsic ARF may also be caused by nephrotoxins. The effects of nephrotoxins usually depend on its dosage. Medications or drug treatment, which usually cause intrinsic ARF, include: antibiotics, chemotherapeutic drugs, cyclosporine and radiocontrast dyes.
The signs and symptoms of Intrinsic Acute Renal Failure vary for each patient, according to underlying causes. When the condition is caused by allergic interstitial nephritis manifests signs of fever, rash or pain in the joints. When it is caused by obstruction to the artery or vein in the kidneys, flank pain is experienced. If the cause is malignant hypertension, the symptoms are usually: headache, dizziness, confusion, and seizure. If it is due to glomerulonephritis and vasculitis, the patient may suffer reduced urination or oliguria, swelling or edema, and hypertension.
Treatment of intrinsic ARF usually includes resolving the underlying cause of the condition and its complications. In nephrotoxic ARF cases, the elimination of the toxins is the main course of action. In ischemic ARF cases, healthy blood flow to the kidneys must be restored. Medical drugs may also be administered in order to alleviate the condition, and to control blood pressure.
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