Hopp til innhold
NHI.no
Annonse
Informasjon

Akutt nyresvikt - symptomer og diagnose

Akutt nyresvikt eller nyreskade er en diagnose som først og fremst baserer seg på blodprøver som måler nyrefunksjonen.

Nyrene
Nyresvikt påvises forholdsvis enkelt ved hjelp av blod- og urinprøver.

Sist oppdatert:

30. des. 2019

Innhold i artikkelen

Hva er symptomene?

Symptomene ved akutt nyreskade eller nyresvikt varierer. Noen er uten symptomer, i hvert fall i de tidlige stadier. Symptomene kan også være meget vage:

  • Nedsatt urinproduksjon
  • Hevelse i kroppen
  • Konsentrasjonsvansker
  • Forvirring
  • Slitenhet
  • Slapphet
  • Kvalme, brekninger
  • Magesmerter
  • Diaré
  • Metallsmak i munnen
Annonse

Symptomer som kramper og koma kan forekomme i svært alvorlige tilfeller av akutt nyresvikt.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Nyreskade, akutt . Referanselisten for dette dokumentet vises nedenfor

  1. Schrier RW, Wang W, Poole B, Mitra A. Acute renal failure: definitions, diagnosis, pathogenesis, and therapy. J Clin Invest Jul 2004; 114(1): 5-14. PubMed
  2. Schrier RW, Wang W, Poole B, Mitra A. Acute renal failure: definitions, diagnosis, pathogenesis, and therapy. J Clin Invest 2004; 114: 5-14. PubMed
  3. Mercado MG, Smith DK, Guard EL. Acute kidney injury: diagnosis and management. Am Fam Physician. 2019 Dec 1;100(11):687-694. . www.aafp.org
  4. Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet 2005; 365: 417-30. PubMed
  5. Kellum JA, Unruh ML, Murugan R. Acute kidney injury. Clin Evid 2011; 11: 1094-1118.
  6. Kellum JA, Levin N, Bouman CSC, et al. The RIFLE Criteria of Acute Renal Failure. http://www.adqi.net (last accessed 16 January 2004).
  7. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(suppl 1):1–138. kdigo.org
  8. Schrier RW, Wang W, Poole B, Mitra A. Acute renal failure: definitions, diagnosis, pathogenesis, and therapy. J Clin Invest Jul 2004; 114: 5-14. PubMed
  9. UK Renal Association. Clinical practice guidelines: acute kidney injury. March 2011. (Accessed 11 May 2017). www.renal.org
  10. Metcalfe W, Simpson M, Khan IH, et al. Acute renal failure requiring renal replacement therapy: incidence and outcome. QJM 2002; 95: 579-83. PubMed
  11. Goldberg R, Dennen P. Long-term outcomes of acute kidney injury. Adv Chronic Kidney Dis Jul 2008; 15(3): 297-307. PubMed
  12. Hilton R. Acute renal failure. BMJ 2006; 333: 786-90. PubMed
  13. Hartmann A, Midtvedt K, Witczak B. Nyreskader og nyresvikt utløst av legemidler. Tidsskr Nor Lægeforen 2004; 124: 2765-6. PubMed
  14. Bellomo R, Kellum JA, Ronco C, et al. Acute kidney injury in sepsis. Intensive Care Med. 2017;43(6):816–828. PMID: 28364303 PubMed
  15. Brater DC. Anti-inflammatory agents and renal function. Semin Arthritis Rheum 2002; 32: (suppl 1) 33-42.
  16. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002; 39: 930-36. PubMed
  17. Carmichael P, Carmichael AR. Acute renal failure in the surgical setting. Aust NZ J Surg 2003; 73: 144-53. PubMed
  18. Gruber SJ, Shapiro CJ. Nephropathy induced by contrast medium. N Engl J Med 2003; 348: 2257-59. New England Journal of Medicine
  19. Lapi F, Azoulay L, Yin H, Nessim SJ, Suissa S. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ Jan 8 2013; 346: e8525.
  20. Pickering JW, Frampton CM, Walker RJ, et al. Four hour creatinine clearance is better than plasma creatinine for monitoring renal function in critically ill patients. Crit Care. 2012;16(3):R107. PubMed
  21. Perazella MA. The urine sediment as a biomarker of kidney disease. Am J Kidney Dis. 2015;66(5):748–755. PMID: 25943719. PubMed
  22. Podoll A, Walther C, Finkel K. Clinical utility of gray scale renal ultrasound in acute kidney injury. BMC Nephrol. 2013;14:188. PubMed
  23. Hewitt SM, Dear J, Star RA. Discovery of protein biomarkers for renal diseases. J Am Soc Nephrol 2004; 15: 1677-89. PubMed
  24. Mishraa J, Dentb C, Tarabishia R, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 2005; 365: 1231-8. PubMed
  25. Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis. 2018;72(1):136–148. PMID: 29478864. PubMed
  26. Ho KM, Sheridan DJ. Meta-analysis of furosemide to prevent or treat acute renal failure. BMJ 2006; 333: 420-3. British Medical Journal
  27. Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 2004; 350: 2247-56. New England Journal of Medicine
  28. Van den Berghe G, Wouters PJ, Bouillon R, et al. Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med 2003; 31: 359-66. PubMed
  29. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76(4):422–427. PMID: 19436332. PubMed
  30. Prowle JR, Kirwan CJ, Bellomo R. Fluid management for the prevention and attenuation of acute kidney injury. Nat Rev Nephrol. 2014;10(1):37–47. PMID: 24217464. PubMed
  31. D'Intini V, Ronco C, Bonello M, Bellomo R. Renal replacement therapy in acute renal failure. Best Pract Res Clin Anaesthesiol 2004; 18: 145-57. PubMed
  32. Tonelli M, Manns B, Feller-Kopman D. Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery. Am J Kidney Dis 2002; 40: 875-85. PubMed
  33. d'Avila DO, Cendoroglo NM, dos Santos OF, Schor N, de Figueiredo CE. Acute renal failure needing dialysis in the intensive care unit and prognostic scores. Ren Fail 2004; 26: 59-68. PubMed
  34. Van Biesen W, Vanholder R, Lameire N. Dialysis strategies in critically ill acute renal failure patients. Curr Opin Crit Care 2003; 9: 491-95. PubMed
  35. Birck R, Krzossok S, Markowetz F, et al. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362: 598-603. PubMed
  36. Nainggolan L. Two Antihypertensives Plus NSAID Ups Risk of Acute Kidney Injury. Two Antihypertensives Plus NSAID Ups Risk of Acute Kidney Injury. Heartwire. Jan 9 2013; Accessed Jan 14, 2013.
  37. Schrier RW, Wang W. Acute renal failure and sepsis. N Engl J Med 2004; 351: 159-69. New England Journal of Medicine
  38. Hoste EA, Lameire NH, Vanholder RC, Benoit DD, Decruyenaere JM, Colardyn FA. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. J Am Soc Nephrol 2003; 14: 1022-30. PubMed
  39. Chawla LS, Eggers PW, Star RA, et al. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med. 2014;371(1):58–66. PMID: 24988558. PubMed
  40. Metnitz PG, Krenn CG, Steltzer H, et al. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 2002; 30: 2051-8. PubMed
  41. Odutayo A, Wong CX, Farkouh M, et al. AKI and long-term risk for cardiovascular events and mortality. J Am Soc Nephrol. 2017;28(1):377–387. PMID: 27297949. PubMed
  42. Vanmassenhove J, Vanholder R, Lameire N. Points of concern in post acute kidney injury management. Nephron. 2018;138(2):92–103. PMID: 29131132. PubMed
Annonse
Annonse