Talk:Renal failure

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[edit] Article Mistakes

This article refers to "African-American" as a "race" which it is not.


—The preceding unsigned comment was added by 63.240.201.51 (talk) 19:49, 11 January 2007 (UTC).

[edit] Wikipedia 'Renal Failure' Article Discussion

Given some of the discussion that has occurred below (see 'split'), it would be interesting to create a 'renal failure' article that covers the following issues (that have been suggested as being worthy of consideration below) :

i)Symptoms of the 2 given forms of renal failure.

ii)(Dialysis) treatments

iii)Prognosis.

iv)Etiology (the causes of diseases and pathologies – in this case, the cause of renal failure).

There are, I am sure, several other headlines that it is worth making a note of on the article, but the above would suffice as a first try. An interesting point that I have been thinking about concerns metal poisoning and how this may result in renal failure, though I can imagine that renal failure (of both types) has many varied causes. Does anyone know about any 'flow charts' or 'flow diagrams' that show how it is that symptoms can be used to determine if someone suffers from renal failure (and, possibly, an etiology flow chart that could show how various causes of renal failure actually induce renal failure). This would be much effort, but I can imagine that such information is online somewhere (I will post it here if possible).

Renalsfailure 20:07, 19 December 2006 (UTC)

I think most of the things you've listed are already in the sub-articles chronic renal failure (CRF) and acute renal failure (ARF).
Speaking broadly, the symptoms, treatment, prognosis and etiology of renal failure can be divided into two: ARF and CRF. Individuals with ARF, frequently, are sick acutely (suddenly), get rehydrated and observed and/or dialysis, and then get better. The etiology is often pre-renal (cardiac-related, trauma, severe dehydration... anything that drops the blood pressure). Individuals with CRF generally have a long and protracted course-- they often have a chronic disease/condition of some sort (e.g. diabetes mellitus, systemic lupus erythematous, benign prostatic hypertrophy, congestive heart failure) or congenital conditions (e.g. polycystic kidney disease). I think that the way the articles are arranged currently is ideal-- it is hard to integrate the differences between CRF and ARF into one article. That isn't to say I don't think things can be improved.
On the question of "by symptoms" -- the American Academy of Family Physicians has a nice set of "Search by Symptom" charts. They aren't specific to kidney disease. That said, diagnosing the etiology of kidney failure is not a trivial matter and cannot be done by symptoms alone, i.e. symptomatically many kidney diseases have the similar symptoms. Most often, the diagnosis cannot be made without some sort of lab testing, which can be frustrating for the individual undergoing the tests 'cause they can sometimes take weeks. In some cases, lab tests are not enough and doctors have to do what is known as a kidney biopsy. In a kidney biopsy a small part of the kidney is removed from the body so that it can be examined under the microscope and stained with special dyes to make apparent subtle structural changes. Sometimes (minimal change disease), an electron microscope is need to make the diagnosis. If you're looking for the search by symptom charts in the hope of diagnosing yourself-- I strong advise against this and suggest you talk with your doctor.
Based on your comments... I'll see if can create a few little flow charts. I have a few sample flow charts on my Notes page. Based on your user name-- it sounds like you're interested in kidneys-- we have a little project where people with interest in kidney hang-out. It is called WikiProject Nephrology. Nephron  T|C 22:20, 19 December 2006 (UTC)

[edit] Urine Production Figures

I just spent 20 minutes on google trying to find urine productions figures that match "0.5 mL" for children, but the few numbers I came across weren't specific to children and were approximate to eachother. I don't remember peeing that much more when I was a kid than now, perhaps it was a typo and meant "500 mL" or "0.5 dL", however I do not feel qualified to do anything but bring this to people's attention, hoping someone with some real knowledge (or at least the knowledge of where to find the answer) will chime in. Half a cubic centimeter of urine just seems, well, low. Hope I did this talk page thing right. - Jay Straw (thisiswherejunkgoes@gmail.com) @ 12:22 AM US-EST 9 Sept 2006 Over and out

It's a unit problem. I'm fixing it now. - Nunh-huh 04:26, 9 September 2006 (UTC)

[edit] Split?

This page deserves to become a disambig with seperate pages dealing with acute renal failure and chronic renal failure. They are so different that they can't possibly be dealt with in one article! JFW | T@lk 10:51, 12 May 2004 (UTC)

This page can't be a disambig stub if the two disambiguators are barely a full typed page each. Our current cap for FA's are at around 50k, so this should not be viewed as a particularly extensive article. Try to look at this from the perspective of someone who isn't a major fan of medicine if anything. They are certainly similar enough to keep in the same article. Splitting the article shouldn't be an issue until we start getting over 30k.
Peter Isotalo 11:54, 13 July 2005 (UTC)

Peter, perhaps you are under the impression that all forms of renal failure should be lumped on one page because both are due to dysfunctioning of the kidneys. This is completely untrue. The causes are completely different, the symptoms are different, the treatment is different and the underlying mechanism is different. ARF is usually due to low blood pressure or sudden damage, it presents with cessation of urine output, is rarely treated with dialysis and is usually due to acute tubular necrosis. CRF, in contrast, is usually due to progressive damage to the glomeruli, is rarely oliguric, and is the main indication for dialysis.

Please do not make such sweeping changes without discussing them. It's like putting Ford and Mitsubishi on the same page because they both manufacture cars. The size of the respective articles is utterly irrelevant. JFW | T@lk 14:27, 13 July 2005 (UTC)

This can be said about virtually anything that one has a major interest in. Both are about kidney failure and as long as the actual information in the individual articles is so close to stub-level, it makes the split completely superfluous, so please expand or merge. The need to have separate article needs to be more self-evident. And that this would be as big a disambig as between Ford and Mitsubishi is as easily dismissed as counting the amount of similar letters. We're a general encyclopedia, not academic literature for med students.
And why are you saying I need to discuss it first? You don't have consensus for your move anymore...
Peter Isotalo 04:00, 15 July 2005 (UTC)
CRF (chronic renal failure) and ARF (acute renal failure) are a different breed of animal and the medical management is very differnt. ARF Pts are almost always unstable-- e.g. hyperkalemic (high risk of cardiac death) or hypotensive (risk of multi-organ failure)... whilst CRF Pts are usually quite stable in this respect. The dialysis treatments are much different CVVHD & SLED vs. CCPD, CAPD, HHD, IHD... as is the prognosis and etiology.
Pts that have CRF, generally aren't interested in ARF and ESRD (end-stage renal disease) Pts don't give a hoot about ARF... 'cause they basically can't get it. I think for that reason alone-- the ARF and CRF should be separate.
>We're a general encyclopedia, not academic literature for med students.
I think the line btw "general" and "academic" is very fuzzy if you talk to ESRD patients-- they know a lot about their condition. Also, I think wikipedia isn't like a 'general encyclopedia.' There isn't a hard space limit... and no reason there cannot be a detailed article on ARF and a detailed article on CRF. Nephron 07:32, 15 July 2005 (UTC)

Peter, I find your approach offensive. You say We're a general encyclopedia, not academic literature for med students. Will you please go ahead and merge all those esoteric LGBT articles that have proliferated into the thousands? Will you also go and VFD all those academic mathematics pages, because they fall outside of what you consider the scope for a general encyclopedia?

Wikipedia is not academic literature for med students, but it is supposed to reflect the state of the art in medicine. Ask any doctor (e.g. on WikiProject Clinical medicine) - all will inform you that ARF and CRF are completely disparate and that it would be wrong to cast the impression that they are very similar.

Then about the size. Wikipedia is rife with stubs that are easily merged, yet are kept on seperate pages because they are different subjects.

I hope you understand. Please accept that there are some things you don't know much about[1], and trust people with a bit of expertise to make the relevant distinctions. My approach now has consensus, with Nephron kindly weighing in. JFW | T@lk 11:35, 15 July 2005 (UTC)

This page on renal failure should only summarize ARF and CRF which deserve their own pages. I concur with Jfdwolff and Nephron. Alex.tan 11:45, July 15, 2005 (UTC)
No, I don't understand why you would need minimal sub-articles (they barely have more info than the disambig) for something that easily fits in one article; but fine. You're obviously not eager to compromise. It's a matter of article length and disambiguation, not making a point about how similar or different the ailments are. Getting all worked up by winding up rants about how I'm insulting to the medical profession is... well... disproportionate and dishonest. Is it really that hard to keep civil and to the point...?
Peter Isotalo 10:14, 16 July 2005 (UTC)

OK, here we go again. I did not accuse you of being insulting to the medical profession. You downplayed two important topics as "academic literature for med students". That is insulting to your readers, who may just have learnt they have a GFR 10 ml/min and will need dialysis very soon, and are not served by having to wade through stuff about acute renal failure.

You seem to confuse article length with notability. Just because these two subjects have pages that are admittedly too short, that does not mean they should be artificially lumped together. When it comes to the decision to merge mathematics articles, you ask a mathematician whether these articles are conceptually similar. The same applies over here. You are perpetuating an argument that really has no base at all, and you seem to have difficulty conceding. It is not "a matter of article length and disambiguation", and I think it is your pushiness that is disproportionate. We'll talk about the dishonesty sometime later. JFW | T@lk 08:02, 17 July 2005 (UTC)

I think we have differing views of what exactly merits something being encyclopedic. Disagree all you like, but I will be pushy enough to define my own argumentation. Try to concentrate on defining your own. I mean, c'mon; "I find your approach offensive"? That's pretty obvious incivility...
Peter Isotalo 15:52, 25 July 2005 (UTC)

I'm allowed to say what I think of your approach. I am not calling you offensive (that would be incivil).

  • You are acting against consensus (Nephron, Alex.tan and myself against you).
  • You have not addressed my point that ARF and CRF are different medical situations that bear little resemblance.
  • There is no indication you have even entertained my points.
  • You reverted without discussion. JFW | T@lk 16:05, 25 July 2005 (UTC)
Humbug! Now you're literally lying and trying to get away with a very cheap "I only insulted your actions"-excuse, which is insulting both our intelligences. I haven't entertained your points or addressed the vast differences between the conditions because I don't really feel them to be relevant. It's a practical layout issue to me and that's it.
And "reverted without discussion"? "Acting against consensus"? The revert was only after you alone had posted a very brief and very exaggerated post. Try cleaning up your own act if you feel like screaming bloody murder again. As a pointer for next time: try raising your credibility a smidgen by expanding any of the articles beyond near-stubs. At least that would make it seem as if you're making a fuss about something substantial.
Good look in your future editing.
Peter Isotalo 16:29, 26 July 2005 (UTC)
Peter:
>It's a practical layout issue to me and that's it.
IMHO, layout isn't a good argument to merge. There are lots of stubby articles out there.
>And "reverted without discussion"? "Acting against consensus"?
I think you may want to carefully re-read what was above.
>Try cleaning up your own act if you feel like screaming bloody
>murder again.
You could expand the article just as well. Read up on it and perhaps you'll understand why JFW, Alex.tan and I have voiced disagreement with your idea. Nephron 22:02, 26 July 2005 (UTC)
Peter, with all due respect, according to the edit history, you reverted to your preferred version of combining the two articles on July 15th before without consensus on this talk page. At that point, Nephron had already chimed in on JFW's side. The bottom line is that your reasoning for why ARF and CRF should be merged (because their individual content is still at stub level) is less important than that they should be separate articles because of the large physiological and pathological differences between them. Entire chapters could be written either condition - just because this has not yet been done does not mean that it will not be oneday. Alex.tan 23:10, July 26, 2005 (UTC)


== This article refers to "African-American" as a "race" which it is not.

[edit] Symptoms

what are some symptoms and when do they occur?

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