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Chronic kidney disease. Alternative Names Kidney failure - chronic Renal failure - chronic Chronic renal insufficiency Chronic kidney failure Chronic kidney disease. KIDNEY FAILURE AND KIDNEY DISEASE. KIDNEY FAILURE

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Chronic kidney disease
Chronic kidney disease

Alternative Names

Kidney failure - chronic

Renal failure - chronic

Chronic renal insufficiency

Chronic kidney failure

Chronic kidney disease


Kidney failure and kidney disease
KIDNEY FAILURE AND KIDNEY DISEASE

KIDNEY FAILURE

  • Kidney failure occurs when the kidneys partly or completely lose their ability to carry out normal functions.

  • This is dangerous because water, waste, and toxic substances build up that normally are removed from the body by the kidneys.

  • It also causes other problems such as anemia, high blood pressure, acidosis (excessive acidity of body fluids), disorders of cholesterol and fatty acids, and bone disease in the body by impairing hormone production by the kidneys.


Chronic kidney disease1

Chronic kidney disease is when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually over time, usually months to years. Chronic kidney disease is divided into five stages of increasing severity . For the total or near–total loss of kidney function, the patients need dialysis or transplantation to stay alive.

CHRONIC KIDNEY DISEASE


Stages of chronic kidney disease
STAGES OF CHRONIC KIDNEY DISEASE usually permanent loss of kidney function over time. This happens gradually over time, usually months to years. Chronic kidney disease is divided into five stages of increasing severity . For the total or near–total loss of kidney function, the patients need dialysis or transplantation to stay alive.

  • Stage 1 with normal or high GFR (GFR > 90 ml/min)

  • Stage 2 Mild CKD (GFR = 60-89 ml/min)

  • Stage 3 Moderate CKD (GFR = 30-59 ml/min)

  • Stage 4 Severe CKD (GFR = 15-29 ml/min)

  • Stage 5 End Stage CKD (GFR <15 ml/min)


Stages of chronic kidney disease1

Stages of Chronic Kidney Disease usually permanent loss of kidney function over time. This happens gradually over time, usually months to years. Chronic kidney disease is divided into five stages of increasing severity . For the total or near–total loss of kidney function, the patients need dialysis or transplantation to stay alive.

Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman's capsule per unit time. Clinically, this is often measured to determine renal function. Compare to filtration fraction.


Normal ranges

NORMAL RANGES usually permanent loss of kidney function over time. This happens gradually over time, usually months to years. Chronic kidney disease is divided into five stages of increasing severity . For the total or near–total loss of kidney function, the patients need dialysis or transplantation to stay alive.

The normal ranges of GFR, adjusted for body surface area, are:

Males: 70 ± 14 mL/min/m2

Females: 60 ± 10 mL/min/m2

(125ml/mt)

GFR can increase due to hypoproteinemia because of the reduction in plasma oncotic pressure. GFR can also increase due to constriction of the efferent arteriole but decreases due to constriction of the afferent arteriole.


Stage 1 ckd

Slightly diminished function; Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2). Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 1 CKD


Stage 2 ckd

Mild reduction in GFR (60-89 mL/min/1.73 m2) with kidney damage. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies

Stage 2 CKD


Stage 3 CKD damage. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies

Moderate reduction in GFR (30-59 mL/min/1.73 m2)

Stage 4 CKD

Severe reduction in GFR (15-29 mL/min/1.73 m2)

Stage 5 CKD

Established kidney failure (GFR <15 mL/min/1.73 m2, or permanent renal replacement therapy (RRT)


Causes

Causes damage. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies

Diabetic nephropathy

Hypertension

Glomerulonephritis

Renal artery stenosis

Hemolytic-uremic syndrome

Vasculitis

Focal segmental glomerulosclerosis


Diabetic nephropathy

Chronically elevated blood sugars damage blood vessels and filtering units in the kidneys, the condition is known as diabetic nephropathy.

Diabetic nephropathy.


Pyelonephritis
Pyelonephritis filtering units in the kidneys, the condition is known as


Causes1
Causes filtering units in the kidneys, the condition is known as

IgG nephritis

Lupus nephritis

Polycystic kidney disease

Reflux nephropathy

Kidney stones and

Prostate

HIV infection


Pathophysiology of uremia
Pathophysiology of uremia filtering units in the kidneys, the condition is known as

  • Diminished excretion of electrolytes and water,

  • Reduced excretion of organic solutes,

  • Decreased hormone production


Ckd developing atherosclerosis
CKD developing atherosclerosis filtering units in the kidneys, the condition is known as


Clinical manifestations of kidney failure

Clinical manifestations of kidney failure filtering units in the kidneys, the condition is known as

Electrolytes

Edema,

Hyponatremia,

Hyperkalemia,

Metabolic acidosis,

Hyperuricemia,

Hyperphosphatemia,

Hypocalcemia


Gastrointestinal
Gastrointestinal filtering units in the kidneys, the condition is known as

  • Anorexia,

  • nausea,

  • vomiting,

  • malnutrition


Cardiovascular
Cardiovascular filtering units in the kidneys, the condition is known as

  • Accelerated atherosclerosis,

  • systemic hypertension,

  • pericarditis


Calcification of the left coronary artery in a patient with chronic kidney disease receiving dialysis as seen on a computerized tomography (CT) scan. The extensive deposition of mineral (arrowed) results in a radio-opaque vessel with a density similar to that of bone


Hematologic
Hematologic chronic kidney disease receiving dialysis as seen on a computerized tomography (CT) scan. The extensive deposition of mineral (arrowed) results in a radio-opaque vessel with a density similar to that of bone

  • Anemia,

  • immune dysfunction,

  • platelet dysfunction


Musculoskeletal
Musculoskeletal chronic kidney disease receiving dialysis as seen on a computerized tomography (CT) scan. The extensive deposition of mineral (arrowed) results in a radio-opaque vessel with a density similar to that of bone

  • Renal osteodystrophy,

  • muscle weakness,

  • growth retardation in children,

  • amyloid arthropathy caused by beta2-microglobulin deposition



Neurologic
Neurologic renal osteodystrophy

  • Encephalopathy,

  • seizures,

  • peripheral neuropathy


Endocrine
Endocrine renal osteodystrophy

  • Hyperlipidemia,

  • glucose intolerance caused by insulin resistance,

  • amenorrhea

  • infertility in women,

  • impotence


Skin renal osteodystrophy

  • Pruritus


Decreased hormone production

The kidneys normally produce several hormones, including erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.

Decreased hormone production


Exams and tests
Exams and Tests   erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.

  • Urinalysis

  • Creatinine levels progressively increase.

  • BUN is progressively increased.

  • Creatinine clearance progressively decreases.


  • Potassium test erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.

  • Arterial blood gas

  • blood chemistry

  • Abdominal CT scan

  • Abdominal MRI


Systemic complications and their treatment
Systemic complications and their treatment erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.

Uremic syndrome consists of an array of complex symptoms and signs that occur when advanced kidney failure prompts the malfunction of virtually every organ system. However, the onset of uremia is slow and insidious, beginning with rather nonspecific symptoms such as malaise, weakness, insomnia, and a general feeling of being unwell. Patients may lose their appetite and complain of morning nausea and vomiting. Eventually, signs and symptoms of multisystem failure are evident.


Management
MANAGEMENT erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.

  • Potassium balance:

  • Sodium balance:

  • Water balance:

  • Metabolic acidosis:

  • Gastrointestinal complications

  • Cardiovascular complications

  • Hematologic complications

  • Bone disease

  • Hyperphosphatemia

  • PTH suppression

  • Neurologic complications


Hemodialysis
HEMODIALYSIS erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.


Home dialysis
HOME DIALYSIS erythropoietin and calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D. The decreased production of these two hormones plays an important role in the development of anemia and bone disease, respectively.


A gene that protects from kidney disease

Scientists from the European Molecular Biology Laboratory (EMBL) and the University of Michigan have discovered a gene that protects us against a serious kidney disease. In the current online issue of Nature Genetics they report that mutations in the gene cause nephronopthisis (NPHP) in humans and mice. NPHP is a disease marked by kidney degeneration during childhood that leads to kidney failure requiring organ transplantation. The insights might help develop effective, noninvasive therapies

A gene that protects from kidney disease


Enzyme for treatment of diabetic kidney disease

Northwestern University Feinberg School of Medicine scientists have observed that an enzyme called ACE2 may hold the potential to treat diabetic kidney disease, the most common form of kidney disease.

Enzyme For Treatment Of Diabetic Kidney Disease


THANK YOU scientists have observed that an enzyme called ACE2 may hold the potential to treat diabetic kidney disease, the most common form of kidney disease.


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