PATHOPHYSIOLOGY (Chronic Renal Failure)

Predisposing Factors:

■ Ages 55 and above

■ Family History (Diabetes Mellitus, Hypertension)

Precipitating Factors:

■ Lifestyle - smoking - alcohol drinking

■ Certain Diseases (Hypertension, Diabetes Mellitus, Recurrent infections

Thickening and/or an in the amount of collagen in the basement membranes

of the small vessels

Impaired/sluggish blood flow

GFR(Glomerular Filtration Rate)

Glomerulosclerosis

proteinuria

Renal blood

Stage IDIMINISHED RENAL

RESERVEGFR 50%

Normal BUN, creatinine

More than 75% damage

BUN, creatinine levels begin to rise

Stage IIRENAL INSUFFICIENCY

GFR 20-50%

Remaining nephrons undergo changes to compensate for those damaged nephrons

Filtration of more concentrated blood by the remaining

nephrons

Hypertrophy of nephrons

Intolerance and exhaustion of the

remaining nephrons

Further damage of the nephrons

80-90% damage

Stage IIIRENAL FAILURE

GFR 10-20%

Impaired kidney function and

Uremia

Malfunction of RAAS

Na & H2O retention

Decreased Urine

Output

Increased blood

pressure

OliguriaHypertension

Edema

Heart Failure

Pulmonary Edema,

Peripheral Edema

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Nitrogenous wastes impairs

platelets

Bleeding tendencies

ANEMIA

Decreased Erythropoietin

Production

-fatigue- weakness

Continuous decline in renal

function

> 90 % of kidney

damage

- Reduction in renal capillaries

-Scarring of Glomeruli- Atrophy & Fibrosis of

Renal tubules

Stage IVEND-STAGE RENAL

DISEASE(ESRD)

GFR <10%

Continuous Multisystem Affectation

Multiple Organ Failure

DEATH┼

Toxins irritate pericardial sac

Pericarditis

Cardiac Tamponade

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Toxins impair immune system

Decreased Immune system

Risk for superinfection

Sepsis

Urea deposits

on the skin

Uremic frost

Toxins affect CNS

Uremic Encephalopathy

-changes in mentation/ psychiatric symptoms-irritability-fatigue

-insomnia

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