) Neuromuscular - Drowsiness, confusion and agitation occur in advanced uremia and may Indicate water or drug intoxication Convulsions, coma or focal neurological signs may also be observed Muscular twitching or cramps are uncommon in absence of plasma electrolyte disorders. (f) Infection
- Secondary sepsis is a major risk in patients with ARF. BIOCHEMICAL DISTURNABCES - 1. Nitrogen retention - Blood urea rises rapidty during the first few days but the increase is not closely related with the clinical severity of uremia 2 Sodium - Hyponatremia is common usually with hypochloremia. 3. Potassium -Hyperkalemia. Rarely hypokalemia due to loss of potassium by Gl tract, alkalosis or dextrose-rich hyperalimentation. 4 Bicarbonate - Metabolic acidosis results from reduced secretion of hydrogen ions and accumulation of acid from Increased protein break down 5. Calcium - Moderate hypocalcemia is conrnon but tetany is uncommon because of concomitant hypomagneserria and acidosis which increase fonised calcium 6 Hematological disorders - Anaemia appears after several days of oliguria Anaemia at onset is due to haemorrhage or haemolysis Bleeding tendency and platelet function abnormalities appear in patients with uncontrolled uremia DIURETIC STAGE -This phase of the disease is ushered in by increase in urinary output to about out 1000 ml. in 24 hours.s this may progress to polyuria Febrile reaction is common and uremic symptoms may be aggravated and lead to coma. With profound duresis dehydration may set In Differential Diagnosis: 1. Acute exacerbation of CRF - Features which suggest underlying CRF - (I) Severe normochrorric normocytic anemia. (II) Pigmentation (iii) LV hypertrophy (iv) Radiologcal evidence of renal osteodystrophy (v) Evidence of bilateral small kidneys (<>
- Secondary sepsis is a major risk in patients with ARF. BIOCHEMICAL DISTURNABCES - 1. Nitrogen retention - Blood urea rises rapidty during the first few days but the increase is not closely related with the clinical severity of uremia 2 Sodium - Hyponatremia is common usually with hypochloremia. 3. Potassium -Hyperkalemia. Rarely hypokalemia due to loss of potassium by Gl tract, alkalosis or dextrose-rich hyperalimentation. 4 Bicarbonate - Metabolic acidosis results from reduced secretion of hydrogen ions and accumulation of acid from Increased protein break down 5. Calcium - Moderate hypocalcemia is conrnon but tetany is uncommon because of concomitant hypomagneserria and acidosis which increase fonised calcium 6 Hematological disorders - Anaemia appears after several days of oliguria Anaemia at onset is due to haemorrhage or haemolysis Bleeding tendency and platelet function abnormalities appear in patients with uncontrolled uremia DIURETIC STAGE -This phase of the disease is ushered in by increase in urinary output to about out 1000 ml. in 24 hours.s this may progress to polyuria Febrile reaction is common and uremic symptoms may be aggravated and lead to coma. With profound duresis dehydration may set In Differential Diagnosis: 1. Acute exacerbation of CRF - Features which suggest underlying CRF - (I) Severe normochrorric normocytic anemia. (II) Pigmentation (iii) LV hypertrophy (iv) Radiologcal evidence of renal osteodystrophy (v) Evidence of bilateral small kidneys (<>
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