Chronic Renal Failure (CRF)

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Presented By: Julius Christian P. Sison, RN,MAN

ANATOMY AND PHYSIOLOGY

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Renal System

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Kidney

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Major Functions

Removing waste and water from the blood of fluids andelectrolytes ofacidbase balance

Regulation

Maintenance

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Regulation

ofblood pressure

Other functions
erythropoietin,

or EPO, which stimulates the bone marrow to make red blood cells which regulates blood pressure

renin,

the active form of vitamin D, 3/19/12 which helps maintain calcium for

calcitriol,

Nephron

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Renal Corpuscle

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RAAS

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Chronic Renal Failure

also

known aschronic kidney disease called renal insufficiency

formerly

is

a progressive loss in renal functionover a period of months or years.

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PATHOPHYSIOLOGY (CKD)
Predisposing Factors: Ages 55 and above Family History (Diabetes Mellitus, Hypertension) Precipitating Factors: Lifestylesmokingalcohol drinking Certain Diseases (Hypertension

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Thickening and/or an in the amount of collagen in the basement membranes of the small vessels Impaired/slug gish blood flow Glomeruloscle rosis GFR(Glomer ular Filtration Rate)

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proteinuri a Renal Blood S & SX -Usually few or no physical symptoms - slightly elevated serum creatinine - positive protein in 3/19/12

Stage I DIMINISHED RENAL RESERVE GFR 50%(90 mL/min) Normal BUN, creatinine

Treatment -Low protein diet -ACE inhibitors if with increase BP

S & SX -Usually few or no physical symptoms - slightly elevated serum creatinine -Increase protein in the urine

More than 75%damage Stage II RENAL INSUFFICIENCY GFR 20-50%(6089 mL/min) BUN, creatinine levels begin to rise Remaining nephrons undergo changes to compensate forthose damaged Treatment -Low protein diet -ACE inhibitors if with increase BP

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Filtration of more concentrated blood by the remaining nephrons Hypertrophy ofnephrons Intolerance and exhaustion of the remaining nephrons Further damage ofthe nephrons
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S & SX -Higher serum creatinine -Fatigue -Puffiness in the eyes -Edema -Back pain -Proteinuri a -Increase BP
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80-90% damage

Stage III RENAL FAILURE GFR 10-20%(3059 mL/min) Impaired kidney function Continuous decline in renal functions

Treatment -Renal diet ( low protein, low potassium, low phosphoru s, low sodium high calorie) -Antihypertensi ve drugs -Suppleme nts

> 90 % ofkidney damage Reduction in renal capillaries -Scarring of Glomeruli - Atrophy & Fibrosis ofRenal tubules
-

S & Sx -anemia -Easy bleeding and bruising -Headache -Dec. LOC -Drowsy feeling -Weakness 3/19/12

Stage IV END-STAGE RENAL DISEASE(ESRD) GFR <15% (GFR <15 mL/min) DEATH

Treatment -Dialysis -Kidney Transplant

Continuous decline in renal functions

Malfunctio n of RAAS Na & H2O retention

> 90 % ofkidney damage

Decreased Urine Output oliguria

Increase d BP Hypertens ion HEART

edema

Pulmonary and Peripheral edema

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Continuous decline in renal functions Increase Nitrogenou s waste Impairs platelets Bleeding tendenci es ANEMIA
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> 90 % ofkidney damage Decrease erythropoiet in production

Continuous decline in renal functions

Increase toxin circulating in the blood

> 90 % ofkidney damage

Toxins irritate pericardial sac Pericarditi s CARDIA C TAMPONADE

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Toxins impairs immune system Decrease immune system Risk for super infections SEPSIS

Continuous decline in renal functions

> 90 % ofkidney damage Increase nitrogen waste and toxins Uremia

Urea deposits on the skin Uremic frost

Affects the CNS UREMIC ENCEPHALOP ATHY

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DEATH

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THANK YOU
AND

GOOD AFTERNOON

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