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- W2072007928 abstract "The subject of renal is an important one. It is important because this condition may be one of the most critical with which the physi cian must deal and yet it is also compatible with complete and lasting recov ery. It i s unfortunate, therefore; that the term acute renal has led to so much semantic confusion. Acute renal failure, in the functional sense, has been confused with urinary suppression and renal insuffi ciency. From an anatomical standpoint it has been variously classified as shock kidney, crush syndrome, tubular necrosis and first, but least ac curately, as lower nephron nephrosis ( 1) . The word failure is defined by Webster's Collegiate Dictionary, fourth edition, as omission to perform, and as wanting in strength, power, capacity; incompetent. These definitions certainly imply functional parameters. The functional as pect seems important. For instance, one recent excellent review (2) states that glomerular nephritis cannot be included in the category of acute renal insufficiency. However, in functional terms which is the ultimate concern of the patient, if not the semanticist, glomerular nephritis may certainly produce any and all degrees of incompetence of the kidney. Acute urinary suppression, on the other hand, would seem to imply the sup pression of urinary function by influences from without the kidney. Whether or not this is semantically justified, it is convenient from a diagnostic stand point to divide the general subject of renal into (a) pre renal, (b) renal, and (c) postrenal. This division, in turn, implies that only in cate gory (b) is there renal parenchymal damage and, by the same token, prerenal or postrenal defects may mask a kidney whose functioning parenchyma is intact. This has important connotations for immediate diagnosis and treat ment. A further division that has seemed useful in the past (3) has been a division of renal insufficiency and renal failure. Acute renal in sufficiency is defined as inability to perform standard tests of function, whereas renal failur.e implies inability to excrete at normal plasma levels the load of metabolite presented. As will be pointed out, in sufficiency may appear to be when the metabolic load becomes so great that even the normal functioning kidney cannot eliminate it at normal plasma levels. This fact was pointed out by Addis (4) in citing the fact that the blood urea nitrogen may rise dramatically in normal young men whose" @default.
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- W2072007928 date "1960-02-01" @default.
- W2072007928 modified "2023-10-02" @default.
- W2072007928 title "Kidney Disease: Acute Renal Failure" @default.
- W2072007928 cites W2009110424 @default.
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- W2072007928 doi "https://doi.org/10.1146/annurev.me.11.020160.001015" @default.
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