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Renal failure

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renal failure

renal failure

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  • 1. Renal Failure
    • Nico Caponi
  • 2. Overview
    • Why I chose it?
    • What is it?
    • Causes
    • Diagnostic Approach
    • Treatment
  • 3. 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
  • 4. What is it?
    • Renal or Kidney Failure-
      • When kidneys fail to filter toxins/waste products from blood
    • Two Types:
      • Acute and Chronic
  • 5. 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
  • 6. 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
  • 7. 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
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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
  • 12. 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
  • 13. Bibliography
    • http://en.wikipedia.org/wiki/Renal_failure
    • http://en.wikipedia.org/wiki/Chronic_kidney_disease
    • http://en.wikipedia.org/wiki/Acute_kidney_injury

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