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By Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)

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Extra resources for Acute and Chronic Renal Failure

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Acute renal failure. There are many associations between jaundice and acute renal failure . This patient had taken an overdose of paracelamol. Plate 4. Chronic renal failure. Typical skin colouring. Plate 5. Itching is common in chronic renal failure and scratching never quite relieves it although it may cause extensive damage to the skin. Plate 6. Chronic renal failure. This patient had to give up football because of the deformity. He had played for a Celtic Junior Team until eight weeks before the photograph was taken.

G. , Prescribing for patients with renal failure, Br. Med. , 1977, 2, 36. 3. Cortical Necrosis The term cortical necrosis describes bilateral massive necrosis of both glomeruli and tubules, causing permanent loss of renal function. It is probably caused by the same mechanisms as those causing ATN; therefore the degree of recovery depends on how much of the cortex has been affected. Presumably a degree of cortical necrosis is common, and this explains the permanent reduction in GFR found in many patients after an episode of A TN.

30 Acute and Chronic Renal Failure Disseminated Intravascular Coagulation (DIC) The diagnosis of disseminated intravascular coagulation is made by the finding of prolongation of the prothrombin time, PTI'K, or the thrombin time associated with thrombocytopenia, increased bilirubin concentration and elevated levels of fibrin degradation products; fragments of red cells are frequently seen on blood film. Not all these features may be present in each patient, but some evidence of DIC is found in about 20 per cent of patients with A TN, many of whom also have septicaemia or some other form of infection.

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