Figure 122

Presenting features of acute renal failure (ARF). ARF usually comes to clinical attention by the finding of either elevated (or rising) blood urea nitrogen (BUN) or serum creatinine concentration. Less commonly, decreased urine output ( less than 20 mL per hour) heralds the presence of ARF. It is important to acknowledge, however, that at least half of all cases of ARF are nonoliguric [2-6]. Thus, healthy urine output does not ensure normal renal function. Rarely, ARF comes to the attention of the clinician because of symptoms of uremia (eg, anorexia, nausea, vomiting, confusion, pruritus) or laboratory findings compatible with renal failure (metabolic acido-sis, hyperkalemia, hyperphosphatemia, hypocalcemia, hyper-uricemia, hypermagnesemia, anemia).

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