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Renal failure
 

Renal failure

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renal failure

renal failure

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    Renal failure Renal failure Presentation Transcript

    • Renal Failure
      • Nico Caponi
    • Overview
      • Why I chose it?
      • What is it?
      • Causes
      • Diagnostic Approach
      • Treatment
    • Why I chose this?
      • 9 year old cousin
      • Battling since he was born
      • Has CKD
      • Will need a transplant in 2-4 years
      • Wanted to be more knowledgable
    • What is it?
      • Renal or Kidney Failure-
        • When kidneys fail to filter toxins/waste products from blood
      • Two Types:
        • Acute and Chronic
    • Acute Kidney Injury (AKI) (AKI)
      • Rapid loss of kidney function
        • Caused by numerous things
            • Prerenal - decrease blood flow to kidney
            • Intrinsic - damage to glomeruli, renal tubules, or interstitium
            • Postrenal - Urinary tract obstruction
    • Diagnosis of AKI
      • Based on clinical history and laboratory data
          • Rapid reduction in kidney function - Serum creatinine levels
          • Rapid reduction in urine output
      • Further testing
          • Urine sediment analysis, renal ultrasound, or kidney biopsy
    • AKI Treatment
      • Specific Therapies
        • AKI without fluid overload- Administer intravenous fluids
        • AKI with low BP- Inotropes may be administered
          • i.e.- norepinephrine or dobutamine
        • Intrinsic AKI- Each have specific therapies pending on what causes it
          • i.e. Wegener’s granulomatosis would require steroid medication
      • Renal replacement
    • Chronic Kidney Disease (CKD) (CKD)
      • Progressive loss in kidney function over a period of months or years
      • Range of symptoms
        • feeling generally unwell
        • reduced appetite
        • may not be found until you have a disease related to it
          • i.e. Cardiovascular disease, anemia, or pericarditis
    • Causes of CKD
      • 3 Most Common
        • Diabetes mellitus, hypertension, and glomerulonephritis
      • Others
        • Vascular: Large/small vessel diseases
        • Glomerular: Primary/Secondary glomerular disease
        • Tubulointerstitial: Polycystic kidney disease
        • Obstructive: Kidney stones and diseases of the prostate
    • Diagnosis of CKD
      • Many times previous renal disease or other disease are present
      • Glomerular filtration rate (GFR) <60mL/min/1.73m 2 for 3 months
      • CKD and AKI contrasts
        • CKD = smaller kidneys
        • CKD serum creatinine levels increase over months and years
      • Tests
        • Nuclear medicine MAG3 scan, DMSA
    • Stages of CKD
      • Stage 1: Slightly diminished function, normal/high GFR
      • Stage 2: Kidney Damage, mild reduction in GFR
      • Stage 3: Moderate reduction in GFR
      • Stage 4: Preparing for failure, severe reduction in GFR
      • Stage 5: Kidney failure
    • Treatment
      • Goal is to slow or halt CKD before Stage 5
      • Control BP
      • Treat original disease (when possible)
      • Angiotensin Converting Enzyme Inhibitors (ACEIs) or Angiotensin II Receptor Antagonists (ARBs)
      • If Stage 5 is reached either dialysis or a transplant is necessary
      • The most common cause of death in people with CKD is NOT renal failure
    • Bibliography
      • http://en.wikipedia.org/wiki/Renal_failure
      • http://en.wikipedia.org/wiki/Chronic_kidney_disease
      • http://en.wikipedia.org/wiki/Acute_kidney_injury