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Akutt nyreskade, årsaker: Postrenal svikt

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Nyrer og urinveier

Denne tilstanden kalles på fagspråket ofte for urinretensjon, fordi den skyldes at noe blokkerer urinstrømmen fra nyrene. Postrenal svikt er skyld i 10 prosent av alle tilfeller med akutt nyreskade. Denne tilstanden kan oppheves og normaliseres, med mindre avstengningen har stått på så lenge at det har gitt varig nyreskade. Avstegning av en eller begge urinlederne kan forårsakes av:

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  • Nyrestein
  • Kreft i urinveiene eller omgivende organer (som vokser inne i urinlederen og blokkerer den)
  • Medisiner

Avstengning av urinblæren kan forårsakes av:

  • Blærestein
  • Forstørret prostata (den vanligste årsaken hos menn)
  • Blodansamling som levrer seg
  • Blærekreft
  • Nevrologisk sykdom som hindrer blæren i å trekke seg sammen for tømning

Behandlingen består i å fjerne det som forårsaker blokkeringen. Når blokkeringen er fjernet, vil nyrene vanligvis gjenvinne sin funksjon i løpet av 1-2 uker, hvis det ikke foreligger infeksjon eller andre problemer.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Nyreskade, akutt . Referanselisten for dette dokumentet vises nedenfor

  1. Mercado MG, Smith DK, Guard EL. Acute kidney injury: diagnosis and management. Am Fam Physician. 2019 Dec 1;100(11):687-694. . www.aafp.org
  2. Levey AS, James MT. Acute Kidney Injury. Ann Intern Med. 2017;167(9):ITC66-ITC80. PMID: 29114754 PubMed
  3. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(suppl 1):1–138. kdigo.org
  4. Lewington A. Acute kidney injury. BMJ Best Practice. Last reviewed: 20 Jan 2023. bestpractice.bmj.com
  5. UK Renal Association. Clinical practice guidelines: acute kidney injury. March 2011. (Accessed 11 May 2017). www.renal.org
  6. Bellomo R, Kellum JA, Ronco C, et al. Acute kidney injury in sepsis. Intensive Care Med. 2017;43(6):816–828. PMID: 28364303 PubMed
  7. Selby NM, Kolhe NV, McIntyre CW, et al. Defining the cause of death in hospitalised patients with acute kidney injury. PLoS One. 2012 Nov 2;7(11):e48580. PubMed
  8. Subramaniam RM, Suarez-Cuervo C, Wilson RF, et al. Effectiveness of Prevention Strategies for Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis. Ann Intern Med. 2016;164(6):406-416. PubMed
  9. Lapi F, Azoulay L, Yin H, Nessim SJ, Suissa S. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ Jan 8 2013; 346: e8525.
  10. Hertzberg D, Rydén L, Sartipy U, Holzmann M. Viktigt utreda orsaken till akut njurskada - Behandlingen ska sikta på att begränsa skadan och förhindra progress Important to investigate the cause of acute kidney injury. Treatment should aim to limit the damage and prevent progression. Lakartidningen. 2016;113:DWDH. Published 2016 May 3. PMID: 27138121 PubMed
  11. Pickering JW, Frampton CM, Walker RJ, et al. Four hour creatinine clearance is better than plasma creatinine for monitoring renal function in critically ill patients. Crit Care. 2012;16(3):R107. PubMed
  12. Podoll A, Walther C, Finkel K. Clinical utility of gray scale renal ultrasound in acute kidney injury. BMC Nephrol. 2013;14:188. PubMed
  13. Perazella MA. The urine sediment as a biomarker of kidney disease. Am J Kidney Dis. 2015;66(5):748–755. PMID: 25943719. PubMed
  14. Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis. 2018;72(1):136–148. PMID: 29478864. PubMed
  15. Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis. 2018;72(1):136-148. PubMed
  16. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76(4):422–427. PMID: 19436332. PubMed
  17. Prowle JR, Kirwan CJ, Bellomo R. Fluid management for the prevention and attenuation of acute kidney injury. Nat Rev Nephrol. 2014;10(1):37–47. PMID: 24217464. PubMed
  18. Nainggolan L. Two Antihypertensives Plus NSAID Ups Risk of Acute Kidney Injury. Two Antihypertensives Plus NSAID Ups Risk of Acute Kidney Injury. Heartwire. Jan 9 2013; Accessed Jan 14, 2013.
  19. Chawla LS, Eggers PW, Star RA, et al. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med. 2014;371(1):58–66. PMID: 24988558. PubMed
  20. Odutayo A, Wong CX, Farkouh M, et al. AKI and long-term risk for cardiovascular events and mortality. J Am Soc Nephrol. 2017;28(1):377–387. PMID: 27297949. PubMed
  21. Vanmassenhove J, Vanholder R, Lameire N. Points of concern in post acute kidney injury management. Nephron. 2018;138(2):92–103. PMID: 29131132. PubMed
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