My previously healthy 82yo grandfather was admitted to the emergency dept 3 days ago with acute renal failure. Prior to this he had been unwell for approx 5 weeks with what his GP said was a virus. With wkly checkups by his GP he has not improved. GP prescribed fluid tabs to relieve fluid build up. A few times last week he had lost total control of bowels and urine. By Saturday just gone he was a mess so we called ambulance. O/E he had a tender mass in abdo. An ultrasound showed enlarged bladder which was full and a lesion on kidney pole. At this stage we have not spoken to anyone form the renal team.
I would like to know what exactly we should be asking of the renal team once we speak to them. I would appreciate any suggestions of questions.Of course i have my own questions but from a medical point of view what should i be asking?
Acute renal failure can be renal, pre-renal or post renal. What is the nature of this mass in the kidney. Is it solid, is it a neoplasm, cyst etc. was there any dilatation of the kidney system. what is his creatinine, his urine output, his electrolytes. Is he on or going to require dialysis.
In my opinion there are two problems- 1. the renal failure and 2. the kidney lesion.
Renal failure may be due to reversible/ irreversible causes. If any reversible causes are identified they need to be corrected. Many factors are to be taken into account while treating the renal lesion: eg the nature (cyst tumor etc), patients general condition etc.
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