Acute renal failure (ARF)

Acute renal failure (ARF) is a syndrome characterized by rapid decline in glomerular filtration rate (hours to days), retention of nitrogenous waste products, and perturbation of extracellular fluid volume and electrolyte and acid-base homeostasis.
ARF is usually asymptomatic and is diagnosed when biochemical screening of hospitalized patients reveals a recent increase in plasma urea and creatinine concentrations.
Classification:
It may complicate a wide range of diseases, which for purposes of diagnosis and management are conveniently divided into three categories:
(1) diseases that cause renal hypoperfusion without compromising the integrity of renal parenchyma (prerenal ARF, prerenal azotemia) (~55%);
(2) diseases that directly involve renal parenchyma (intrinsic renal ARF, renal azotemia) (~40%); and
(3) diseases associated with urinary tract obstruction (postrenal ARF, postrenal azotemia) (~5%)
In the clinical differential diagnostic, the traditional Chinese doctors differentiate it mostly based on re zheng (heat symptoms) and shi zheng (true symptoms) ; generally it is due to excessive accumulation of heat, stoppage of heat, accumulation of heat and moist affecting heart and liver and caused the disturbances in the internal regulation and external dehydration and injured to the Qi Yin . The main treatment is to eliminate xie (heat) , often used treatment which can discharge heat and bad substances, clear heatiness and nourish blood, improve blood circulation, strengthen Yin and normalized Yang , nourish Qi and Yin and so on.