ENFERMEDAD

RENAL
AGUDA y
LESIÓN
RENAL
AGUDA
Profesor: Eliazar García Kantún.
 E.R.A. CONTENIDO

INTRODUCCIÓN ETIOLOGÍA
1 2 Pre-Renal, Renal y Pos-Renal
Incidencia y
definición.

TRATAMIENTO FISIOPATOLOGÍA
TSR: ¿Lenta continua o
4 3 Clasificación: KDIGO,
intermitente? AKIN, RIFLE
 INTRODUCCIÓN
Definición
● KDIGO. Kidney Disease Improvive Global Outcomes
● AKIN. Acute Kidney Injury Network
● RIFLE. Risk, Injury, Faliure, Lost y End.

● IRA: Es un síndrome clínico que de forma brusca altera la homeostasis del

organismo. Una multitud de causas provocan disminución en la capacidad que
poseen los riñones para eliminar productos nitrogenados de desecho y alteran
además el equilibrio hidroelectrolítico. Con frecuencia se manifiesta con una
diuresis insuficiente. Su presentación es en horas o en días y la elevación por
encima de las cifras basales de la concentración sérica de creatinina y de urea (o
nitrógeno ureico) sirve para el diagnóstico, hasta la consolidación de nuevos
marcadores de daño renal. Los límites para definir el fracaso renal agudo son muy
variables entre autores y marcar una barrera es totalmente artificial y arbitrario
pero necesario.
● ERA: Deterioro de la función renal mayor a siete días y menor de tres meses)
referida, por consenso, a la transición tras un episodio agudo hacia los criterios ya
establecidos de ERC.
 INCIDENCIA
● La IRA ocurre aprox. El 10-15% de los ptes que son hospitalizados. En la
comunidad 61%, el 29% recibió TRR y la mortalidad fue del 26.5%.
Posteriormente a los 90 días de seguimiento el 81% recuperó función
renal.
● Otros estudios internacionales reportaron que de 1,800 ptes de 97 UCIs. El
57% desarrolló IRA (KGIGO). 39% en grado 1 y 2. 13.5% requirió TRR.

● La IRA asociada a sepsis es la etiología más común en la UCI: 10-20% de

los casos. Y hasta el 50-70% en auellos con choque séptico, con una taza
de mortalidad del 50% y mayor taza cuando presentan IRA.
potencialmente presentan L.R.A.
● Pacientes con alto riesgo de presentar L.R.A.

● Shock séptico.
● Cirugías mayores.
● Sx cardiorenal.
● Insuficiencia hepática.
●
Complicaciones
 ETIOLOGÍA

Renal
Tubular: Necrosis Pre-Renal
Tubular Hipovolemia.
Vascular: Hipotensión.
Vasculitis. I.C.C. Cirrosis Hep.

Pre-Renal
Intoxicación por
AINES, Antibióticos
y Drogas.

Renal Post-Renal
Intersticial: Nefritis.
Glomerular: Sx. Litiasis.
Nefrótico-Nefrítico. Problemas de la
próstata y vejiga.
ETIOLOGÍ
A
EL SÍNDROME CARDIO-
RENAL
Críticamente
enfermo
 CLASIFICACIÓN

Terminología aceptada

LRA ERA Recup. Renal ERC

Tiempo de < 7 días ≥ 7 días Recup. Temprana <7 días ≥ 3 meses
evolución.
Recup. Tardía ≥7 días
Gravedad G-1 G-1 G-1 G-1
G-2 G-2 G-2 G-2
G-3 G-3 G-3 G-3a y 3b
G-4
G-5

Terminología aceptada de la cronología y gravedad del continuo lesión renal aguda (LRA),
enfermedad renal crónica (ERC). El término «insuficiencia renal aguda» sería un término que,
aunque antiguo, permitiría englobar tanto el concepto también propuesto de «alteración» de la
función renal como los distintos estadios de gravedad. La gradación de la gravedad también podría
denominarse «estadio» ya que la RAE lo describe como el «periodo o fase de un proceso»
CLASIFICACIÓN
CLASIFICACIÓN
FISIOPATOLOGÍA
 El papel de Enfermería

PREVENIR
UCI Todas las posibles
complicaciones que
Concer los datos del pte crítico estén a cargo de
para dar una mejor atención.
enfermería
Cuidados especiales de acuerdo
a la patología base.
Cuidados especializados de
acuerdo a patologías relacionas.

REHABILITACIÓN
Darle continuidad al
tratamiento.
LLEGAMOS AL FINAL

DUDAS

PREGUNTAS

GRACIAS
 KIDNEYS: NEPHROLOGY CENTER
It’s the farthest
1 2 3 planet from the
Sun

SATURN VENUS JUPITER

Saturn was Venus is the Jupiter is the
named after a second planet biggest planet
Roman god from the Sun of them all
KIDNEYS: NEPHROLOGY CENTER

MERCURY
It’s the smallest
planet in the Solar
System

VENUS
Venus is the second
planet from the Sun
 KIDNEYS: NEPHROLOGY CENTER
25% 41%
MARS VENUS
Despite being red, Venus is the second
Mars is a cold place planet from the Sun

4% 30%
MERCURY SATURN
It’s the smallest It’s composed of
planet in the Solar hydrogen and helium
System
Follow the link in the graph to modify its data and then paste the new one here. For more info,
click here
KIDNEYS: NEPHROLOGY CENTER
SATURN
It’s composed of
MERCURY
It’s the closest
hydrogen and
planet to the Sun
helium

1 2 3 4 5

JUPITER
Jupiter is the
VENUS
Venus is the
NEPTUNE
It’s the farthest
biggest planet of second planet from planet from the
them all the Sun Sun
KIDNEYS: NEPHROLOGY CENTER

VENUS
Venus is the
NEPTUNE
It’s the farthest
second planet from planet from the
the Sun Sun

SATURN
It’s composed of
hydrogen and
helium
KIDNEYS: NEPHROLOGY CENTER
MARS
Mars is a cold
place

SATURN
Saturn is a gas
giant

JUPITER
Jupiter is a big
planet

VENUS
Venus is very hot
KIDNEYS: NEPHROLOGY CENTER
VENUS
21% Venus is the second
planet from the Sun

SATURN
47% Saturn is composed
mostly of hydrogen and
helium
MERCURY
85% It’s the smallest planet
in the Solar System

Follow the link in the graph to modify its data and then paste the new one here. For more info,
click here
KIDNEYS: NEPHROLOGY CENTER
Venus has a
beautiful name
1 and is the second
planet from the
3
Sun
MARS VENUS MERCURY
Mercury is the
Despite being red,
closest planet to
Mars is actually a
cold place. It’s full 2 the Sun and the
smallest of them
of iron oxide dust
all
 KIDNEYS: NEPHROLOGY CENTER
VENUS
Venus is the 30
second planet from
the Sun %
MARS
Mars is actually a 50
very cold place %
JUPITER
Jupiter is the 80
biggest planet of
them all %
 KIDNEYS: NEPHROLOGY CENTER

SATURN
VENUS Saturn is
MARS Venus is the
composed mostly
of hydrogen and
SUN Despite being
second planet
from the Sun and
helium
red, Mars is is terribly hot
The Sun is the actually a very
star at the center cold place
of the Solar
System
KIDNEYS: NEPHROLOGY CENTER
JUPITER
2 Jupiter doesn’t
have a solid
surface
VENUS
Venus is the
second planet
from the Sun

MARS
Mars is actually a
very cold place
3

1
 KIDNEYS: NEPHROLOGY CENTER
MARS

JUPITER
Jupiter is the
NEPTUNE
It’s the farthest
biggest planet of planet from the
them all Sun

VENUS
Venus is the
MERCURY
It’s the closest
second planet from
planet to the Sun
the Sun
KIDNEYS: NEPHROLOGY CENTER
STEP 1 VENUS Venus is the second
planet from the Sun Yes
STEP 2 JUPITER Jupiter is the biggest
planet of them all No
STEP 3 MARS Despite being red, Mars
is a very cold place Yes
STEP 4 SATURN Saturn is composed of
hydrogen and helium Yes
STEP 5 NEPTUNE Neptune is the farthest
planet from the Sun No
KIDNEYS: NEPHROLOGY CENTER
20 MARS 60 SATURN
Mars is a cold Saturn is a gas
% place % giant

VENUS 42 JUPITER 87
Jupiter is a big
Venus is very hot % planet %
 KIDNEYS: NEPHROLOGY CENTER

VENUS
Venus is the
JUPITER
Jupiter is the
NEPTUNE
It’s the farthest
second planet from biggest planet of planet from the
the Sun them all Sun

SATURN
KIDNEYS: NEPHROLOGY CENTER
MARS JUPITER
1 Mars is actually a 4 Jupiter is the
biggest planet of
very cold place
them all

SATURN MERCURY
2 It’s composed of
hydrogen and
5 It’s the closest
planet to the Sun
helium

VENUS NEPTUNE
3 Venus is the
second planet from
6 It’s the farthest
planet from the
the Sun Sun
KIDNEYS: NEPHROLOGY CENTER
Jupiter is the
biggest planet of
them all
SATURN
2 It’s composed of
hydrogen and
The Sun is the
closest star to
helium Earth

1
Neptune is far
away from the Sun
VENUS MERCURY
3 It’s the closest Mars was named
planet to the Sun after a Roman god
KIDNEYS: NEPHROLOGY CENTER
8%
VENUS Venus is very hot

90%
Mars is a cold
MARS place

45%
Saturn is a gas
SATURN giant

Follow the link in the graph to modify its data and then paste the new one here. For more info,
click here
KIDNEYS: NEPHROLOGY CENTER
MON TUE WED THU FRI SAT
Saturn is
Venus is Mars is a
8:00 very hot
a gas
cold place
giant
Jupiter is Mercury
11:00 a big is very
planet small
Neptune
We all live
13:00 on Earth
is an ice
giant
The Sun
15:00 is the star
Pluto is a dwarf planet

Venus is the second

18:00 planet from the Sun
KIDNEYS: NEPHROLOGY CENTER
70
VENUS Venus is very hot
%
40 Mars is a cold
MARS
% place

90 Saturn is a gas
SATURN
% giant

20 Jupiter is a big
JUPITER
% planet
KIDNEYS: NEPHROLOGY CENTER
Venus has a beautiful name
25 and is the second planet
VENUS from the Sun. It’s terribly
% hot

75 Mercury is the closest planet

MERCURY to the Sun and the smallest
% one in the Solar System
KIDNEYS: NEPHROLOGY CENTER
7/10 Neptune is the
farthest planet
NEPTUNE from the Sun

4/10 Saturn has around

eighty moons,
SATURN more than Jupiter

2/10 Mars is actually a

cold place. It's full
MARS of iron oxide dust

8/10 Venus is the

second planet
from the Sun and
VENUS is terribly hot
KIDNEYS: NEPHROLOGY CENTER
NEPTUNE

MARS SATURN MERCURY

● Jupiter is the ● Saturn is a gas ● Neptune is the
biggest planet of giant and has farthest planet
them all several rings from the Sun
● Mercury is the ● Venus is the ● Despite being
closest planet to second planet red, Mars is
the Sun from the Sun actually a very
cold place
 KIDNEYS: NEPHROLOGY CENTER
INVESTIGATION DONE IN PROCESS TO DO

Pluto is now considered a dwarf planet X

Neptune is the farthest planet from the Sun X

Saturn has around eighty moons, more than

X
Jupiter

Venus is the second planet from the Sun X

Mars is actually a very cold place X

Jupiter is the biggest planet of them all X

KIDNEYS: NEPHROLOGY CENTER
JUPITER MERCURY NEPTUNE
Jupiter is the biggest It’s the closest planet It’s the farthest planet
planet of them all to the Sun from the Sun

MARS VENUS SATURN

Mars is actually a very Venus is the second It’s composed of
cold place planet from the Sun hydrogen and helium