Typical clinical course of renal failure can be divided into three phases:
1, the start of this period patients often suffer some of the known causes of ATN, such as hypotension, ischemia, sepsis and renal toxins. But significant renal parenchymal damage has not yet occurred. At this stage of acute renal failure is preventable. But with the apparent renal tubular epithelial damage, GFR sudden drop in the performance of the clinical syndrome of acute renal failure becomes obvious, then enter the maintenance phase.
2, the maintenance phase, also known as oliguria. Typically, 7-14 days, but it may be as short as a few days to 4-6 weeks long. Glomerular rate remained at a low level. Many patients may be oliguria (<40Oml / d). However, some patients may not have oliguria, urine output 400ml / d or more, known as non-oliguric acute renal failure, which mostly mild disease, the prognosis is good. However, regardless of whether or not to reduce the amount of urine, with renal dysfunction, may appear a series of clinical manifestations of uremia.
Another common infection is acute renal failure and serious complications. In acute renal failure at the same time or in the process of development of the disease can also merge multiple organ failure, mortality can be as high as 70%.
3, recovery of renal tubular cell regeneration, repair, tubular integrity restored. Glomerular filtration rate gradually returns to normal or near-normal range. Oliguric patients began diuretic, it can show how the urine, daily urine output up 3000-5000ml, or more. Usually lasts 1-3 weeks, and then again back to normal. Compared with the glomerular filtration rate, glomerular epithelial cell function (solute and water reabsorption) relative delay of recovery, often take several months before recovery. A minority of patients may ultimately left with varying degrees of renal structural and functional defects.
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