Chronic Kidney Disease

Modifiable Factors
A. PATHOPHYSIOLOGY Non-Modifiable Factors
a. Schematic Diagram -Hereditary
-Age greater than 60 years
old
-Gender
-Race
-Diabetic Mellitus
-Hypertension
-Increase Protein and
Cholesterol Intake
-Smoking
-Use of analgesics

Decreased renal blood flow

Primary kidney disease
Damage from other diseases
Urine outflow obstruction
BUN Serum
Decreased Creatinine
glomerular filtration

Hypertrophy of
Dilute remaining nephrons Loss of Sodium Hyponatremia
Polyuria in Urine

Inability to
concentrate urine
Dehydration

Further loss of
nephron function

Loss of nonexcretory 2
a
renal function

Failure to convert Failure to produce Impaired insulin Production of Immune Disturbances in

inactive forms of eryhtropoietin action lipids disturbances reproduction
calcium

Anemia Erratic blood Advanced

Calcium Pallor glucose levels atherosclerosis Delayed wound Infection Libido Infertility
absorption healing

1
 2
1 a
Hypocalcemia Osteodystrophy
Loss of excretory
renal function

Excretion of Decreased Decreased Decreased Decreased

nitrogenous sodium potassium phosphate hydrogen
waste reabsorption in excretion excretion excretion
tubule
Uremia Hyperkalemia Hyperphosphatemia Metabolic acidosis
Water Retention
BUN,
Creatinine Hypertension
Heart Failure Decreased
Uric Acid
Edema calcium
absorption

Proteniuria
Hypocalcemia

Peripheral nerve Hyperparathyroidism

changes
Decreased
potassium excretion

Pericarditis
Increased potassium

CNS changes

Pruritus

Altered Taste

Bleeding
Tendencies