Chronic Kidney Disease - SISON, JULIUS

8/2/2019 Chronic Kidney Disease - SISON, JULIUS

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3/19/12

ChronicRenal

Failure(CRF)Presented By: Julius Christian P. Sison, RN,MAN


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ANATOMY

ANDPHYSIOLOGY


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Renal System


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Kidney


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Major Functions

Removing waste and water from theblood

Regulation of fluids and electrolytes

Maintenance of acidbase balance

Regulation of blood pressure


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Other functions

erythropoietin, or EPO, whichstimulates the bone marrow to make

red blood cells

renin, which regulates blood

pressure

calcitriol, the active form of vitamin

D, which helps maintain calcium for


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Nephron


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Renal Corpuscle


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RAAS


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Chronic Renal Failure

also known as chronic kidneydisease

formerly called renal insufficiency

is a progressive loss inrenal function over a period ofmonths or years.
http://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Kidney


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PATHOPHYSIOLOGY(CKD)

PrecipitatingFactors:

Lifestyle-smoking-alcohol

drinking

Certain

Diseases(Hypertension

PredisposingFactors:

Ages 55 andabove

FamilyHistory(Diabetes

Mellitus,Hypertension)


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Thickening and/or anin the amount of

collagen in thebasement membranesof the small vessels

Impaired/sluggish blood

flow

Glomerulosclerosis

GFR(Glomerular

Filtration

Rate)


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proteinuria

Renal Blood

Stage IDIMINISHED

RENAL RESERVE

GFR 50%(90mL/min)

Normal BUN,creatinine

S & SX-Usuallyfew or nophysicalsymptoms

- slightlyelevatedserumcreatinine- positiveprotein in

Treatment-Low proteindiet-ACEinhibitors ifwithincrease BP


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More than75%damage

Stage IIRENAL

INSUFFICIENCYGFR 20-50%(6089

mL/min)

BUN, creatininelevels begin to

rise

Remainingnephrons undergo

changes to

compensatefor those damaged

S & SX-

Usuallyfew or nophysicalsymptoms- slightly

elevatedserumcreatinine-Increase

protein inthe urine

Treatment-Lowproteindiet-

ACEinhibitors ifwithincreaseBP


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Filtration of moreconcentrated bloodby the remaining

nephrons

Hypertrophyof nephrons

Intolerance andexhaustion of the

remaining nephrons

Further damageof the nephrons


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80-90%damage

Stage IIIRENAL FAILURE

GFR 10-20%(3059mL/min)

Impaired kidneyfunction

Continuous declinein renal functions

S & SX-Higherserumcreatinine-Fatigue-

Puffinessin theeyes-Edema-Back pain-Proteinuria-IncreaseBP

Treatment-Renal diet( lowprotein,lowpotassium,

lowphosphorus, lowsodiumhighcalorie)-Anti-hypertensive drugs-

Supplements


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> 90 % of kidneydamage

-Reduction in renalcapillaries

-Scarring of Glomeruli

- Atrophy & Fibrosisof Renal tubules

Stage IVEND-STAGE RENAL

DISEASE(ESRD)GFR


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> 90 %of kidneydamage

Continuousdecline in

renal

functions

Pulmonaryand

Peripheraledema

edemaDecreasedUrine

Output

Increased BP

Hypertension

HEART

Na &

H2Oretention

oliguria

Malfunction of RAAS


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renal

functions


IncreaseNitrogenou

s waste

Decreaseerythropoiet

in

productionImpairsplatelets

Bleedingtendenci

es

ANEMIA


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renal

functions


Increasetoxin

circulating inthe blood

Toxinsirritate

pericardialsac

Pericarditis

CARDIA C

TAMPONADE

ToxinsimpairsimmunesystemDecrease

immunesystemRisk forsuper

infectionsSEPSIS


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renal

functions


Increasenitrogen

waste andtoxins

Uremic

frost

Ureadeposits on

the skin

Uremia

Affects theCNS

UREMIC

ENCEPHALOPATHY


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DEATH


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THANK YOUAND

GOODAFTERNOON

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Chronic Kidney Disease - SISON, JULIUS