Differential diagnosis of acute renal failure and chronic renal failure

Anyone is at risk for acute renal failure or chronic kidney failure, where acute kidney failure can be cured, kidney function restored, and chronic kidney failure is kidney failure damage, fibrosis, loss of function. At this time, the patient was prescribed dialysis to replace the kidney.

1.1 Acute kidney failure
Acute kidney failure, also known as acute kidney failure, is a condition in which the kidneys are damaged, the main functions of the kidneys including filtering and eliminating excess water, salt and other toxins are lost sudden and rapidly progressive over a period of hours to days. At that time, the body will face disturbances in the balance of water - electrolytes, alkaline - acidosis.
1.2 Chronic kidney failure
Chronic kidney failure, also known as chronic kidney failure, is a condition in which the kidneys are damaged, fibrosis, kidney function declines and cannot be reversed, this is the result of diseases of the kidney. urinary and chronic kidney disease. Chronic kidney failure progresses in stages and lasts from months to years.

Differential diagnosis of acute renal failure and chronic renal failure will be based on factors including: history, medical condition, etiology and symptoms of renal failure progressing through each stage of the disease.
2.1 Causes
2.1.1 Causes of AKI renal (kidney damage, sudden decline in filtering function) and post-renal, specifically:
Pre-renal causes: Decreased blood flow volume due to blood loss, dehydration, diuretic use; decreased cardiac output due to heart failure , arrhythmia , low blood pressure , cardiac tamponade ; peripheral vasodilation due to infection, bacterial infection, anesthetic use, anaphylactic shock; The amount of fluid in the body is redistributed due to severe burns, nephrotic syndrome, acute pancreatitis, ... Kidney causes: Some diseases damage and lead to acute kidney failure such as nephritis, interstitial nephritis, and interstitial nephritis. , glomerulonephritis , fatty kidneys, renal vascular diseases such as blood clots that block blood vessels in and out of the kidney; infection; Poisoning with drugs and other substances...

Post-renal causes: Diseases including bladder cancer, colon cancer, cervical cancer, kidney stones, prostate enlargement that obstruct the flow of urine out of the body and lead to kidney failure grant. 2.1.2 Causes of chronic kidney failure
Most of the chronic kidney diseases that cause chronic kidney failure are diseases: glomerulonephritis, tubulointerstitial inflammation, renal vessels.
Chronic glomerulonephritis: This is the main cause of chronic kidney failure. Tubulointerstitial nephritis: The disease is caused by some drugs for a long time such as the pain reliever Phenylbutazone, or by increased levels of calcium and uric acid in the blood. Chronic pyelonephritis: The disease occurs in patients with urinary stones, which is the cause leading to chronic pyelonephritis, causing chronic kidney failure. Renal Vascular Disease: Renal vascular fibrosis (malignant or benign), renal microvascular thrombosis, renal vein occlusion, inflammation around the nodular artery. Congenital kidney disease: Genetic or non-hereditary kidney diseases such as renal dysplasia, polycystic kidney, metabolic kidney cause chronic kidney failure. Other diseases: diabetes, Lupus.

2.2 Symptoms
2.2.1 Symptoms of acute kidney failure
Acute kidney failure has no symptoms, usually detected through a number of tests. However, clinically, the disease has the following symptoms:
Oliguria, decreased urine output. Swelling in the face, feet, ankles, legs. Pain in the back, hips, pelvis.

Fatigue, shortness of breath, chest pain, nausea, drowsiness,... Convulsions, coma (severe cases). 2.2.2 Symptoms of chronic kidney failure
Depending on the cause of chronic kidney failure, there will be different symptoms:
Edema: This is a typical symptom of kidney diseases, however, depending on the cause, The degree and duration of edema are different. Most of the end-stage renal diseases have symptoms of edema. High blood pressure: This is a symptom that occurs in most patients with chronic kidney failure. This symptom can lead to death when renal function is rapidly impaired by episodes of malignant hypertension.

Anemia: Anemia is considered an important symptom in the differential diagnosis between acute renal failure and chronic renal failure. Depending on the stage, the degree of anemia will vary. Digestive disorders: Loss of appetite, anorexia, nausea, vomiting, and diarrhea are common digestive disorders symptoms in patients with chronic kidney failure. Depending on the stage, the patient will experience different symptoms. When a patient has gastrointestinal bleeding, the concentration of urea and potassium in the blood increases rapidly. Bleeding: Common sites of bleeding are in the nose, teeth, and skin. Itching: Because calcium is deposited in subcutaneous tissues during the secondary hyperparathyroidism stage and causes itching. Cramps: Due to low levels of calcium, sodium in the blood causes cramps, especially at night. Heart failure: This is a symptom when the patient has late stage chronic renal failure, due to anemia, high blood pressure, and fluid retention for a long time. Pericarditis: End-stage chronic kidney failure leads to pericarditis. If the patient is not treated with dialysis in time, it can lead to death. Coma: Convulsions, coma are manifestations of hyperuricemia syndrome in end-stage chronic renal failure.

2.3 Criteria for differential diagnosis of acute renal failure and chronic renal failure
In addition to the above clinical symptoms, to differentiate acute renal failure and chronic renal failure, it is necessary to rely on laboratory tests including:
Anemia condition. Blood urea and creatinine levels. Red blood cells, white blood cells. Urine analysis. Kidney size.

Acute kidney failure if not detected and treated promptly can become chronic kidney failure, in which kidney function cannot be restored.
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