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Category: Medical

Topic: Genitoury and Renal Problems

Level: Paramedic

Next Unit: Urinary Retention

5 minute read

Renal Diseases

Acute kidney injury (AKI) affects approximately 0.02 percent of patients, with a morbidity rate of 33% requiring dialysis, and 13% mortality rate within 90 days. AKI's are a sudden decrease in filtration through the glomeruli, resulting in a buildup of toxins in the blood. 

AKI's are labeled according to where in the genitourinary tract they occur:

  • Prerenal acute kidney injury is a condition caused by hypoperfusion to the kidneys.
  • Intrarenal acute kidney injury describes damage to the kidney itself.
  • Postrenal acute kidney injury is caused by an obstrution of urine flow from the kidneys.


Chronic kidney disease (CKD) affects approximately 14% of the population, with a high morbidity rate and a high mortality rate. Chronic kidney disease is the gradual loss of kidney function, measured by blood urea nitrogen (BUN) and serum creatinine levels, over a period of months and years.

Chronic kidney disease can be caused by diabetes and hypertension.

Signs and symptoms of chronic renal failure may include:

  • headaches 
  • weakness
  • anorexia
  • vomiting
  • increased urination
  • rusty or brown-colored urine
  • increased thirst
  • hypertension
  • pruritus


End-stage renal disease (ESRD) affects approximately 363 million people per year, with a very high rate of dialysis or kidney transplant, and a very high mortality rate. End-stage renal disease is the last stage of chronic kidney disease, in which dialysis or a kidney transplant is necessary to live. ESRD is caused by a progressive decline in kidney function.

Signs and symptoms of end-stage renal failure may include:

  • confusion
  • altered levels of consciousness
  • shortness of breath
  • peripheral edema
  • chest pain
  • bone pain
  • pruritus
  • nausea
  • vomiting
  • diarrhea
  • bruising
  • muscle twitching
  • tremors
  • seizures
  • hallucinations.
IV sites and blood draws should never take place at the site of any dialysis port. Consider pharmacological interventions as indicated.
Use caution when giving fluids to these patients, they are often fluid overloaded on presentation due to their decreased ability to remove excess body fluids through normal means. 
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