General introduction of Acute and Chronic Renal Failure.

1. ACUTE AND CHRONIC
RENAL FAILURE
M.MALARVANNAN & M.ELAVARASAN
2ND B.PHARM
THANTHAI ROEVER COLLEGE OF PHARMACY

2. ACUTE RENAL FAILURE.
DEFINITION:
 Acute renal failure is a decline in renal function by the inability of the
kidney to excrete metabolic waste products (nitrogenous waste and
water) and maintain acid-base balance.
 The waste substances build up to dangerous levels in the body and the
chemical balance of the blood is upset. The condition is life-threatening
and requires immediate hospital treatment.

3. AZOTEMIA:
Elevation in nitrogenous waste products.
e.g. (creatinine and urea nitrogen).
UREMIA:
clinical syndrome resulting from azotemia characterized by anorexia,
nausea, vomiting and mental status changes.

4. CAUSES.
 Hypotension, due to fall in blood pressure of reduced blood supply.
 Glomerulonephrosis, inflammation of glomeruli, the tiny filtering unit.
 Hydronephrosis, blockage in the urinary tract causes both kidneys to
swell with urine.

5. HYDRONEPHROSIS & INFLAMMATION OF THE
GLOMERULI.

6. PATHOPHYSIOLOGY.
 Acute renal failure result in alterations to any of the four basic
components they are
 VASCULATURE.
 GLOMERULI.
 TUBULES.
 INTERSTITIUM.

7.  AZOTEMIA (decreased renal perfusion).
 Azotemia is a elevation of blood urea nitrogen (BNU) and serum creatinine
levels. The reference range for BUN is 8-20 mg/dL and normal range for
serum creatinine 0.7-1.4 mg/dL.
 INTRINSIC RENAL FAILURE (structural damage to kidney).
 Vascular disease, renal artery obstruction (atherosclerosis, thrombosis).
 I schema (lack of blood flow to an organ), toxins.
 POST RENAL OBSTRUCTION (obstruction of urine flow from the kidney
out of the body).

8. SYMPTOMS.
o Greatly reduced urine volume.
o Nausea.
o Vomiting.
o Drowsiness.
o Headache.
o Back pain.

9. DROWSINESS AND BACK PAIN.

10. DIAGNOSIS.
KIDNEY BIOPSY.
 Ultra sound scanning or
computed tomography scanning.
 Kidney biopsy to examine
kidney tissue.

11. TREATMENT.
 CRITICAL CARE UNIT: To care people in a critical or unstable
condition, who requires continuous monitoring.
 DIALYSIS: Replacing the function of kidney, excess fluid and waste
products can be from blood stream.
 Blood transfusion.

12. CHRONIC RENAL FAILUR.
 Chronic renal failure is defined as chronic renal insufficiency (CRI)
denotes a creatinine clearance Crcl 50-80 ml/min; moderate CRI 30-
50 ml/min; severe 15-30 ml/min. gradual and progress loss of function
in kidneys.
 Patients requiring chronic dialysis or renal transplantation for relief of
uremic symptom are said to be end-stage renal disease (ESRD).

13. PATHOPHYSIOLOGY:
 Multiple risk factors identified for renal disease includes the following
 Diabetes.
 High blood pressure.
 Proteinuria.
 Increasing age.
 Hyperlipidaemia.
 Family history of renal disease.

14. HYPERLIPIDEMIA.
 Hyperlipidemia is
abnormally elevated
levels of any or all lipid
and / or lipoproteins in
the blood.

15. Abnormal amount of protein
is present in the urine. Due to
the disease in the glomerulus.
PROTINURIA:

16. SYMPTOMS:
 Frequent urination, during night.
 Pale, itchy, easily brushed skin.
 Shortness of breath.
 Persistent hiccups.
 Nausea and vomiting.
 Muscular twitching.
 Cramps in the legs.

17. HICCUPS AND MUSCULAR TWITCHING.

18. DIAGNOSIS:
 Ultra sound scanning or CT scanning to assess the size of
the kidney.
 KIDNEY BIOPSY: Small piece of kidney tissue is removed
and examined under microscope to determine the nature
of kidney damage.

19. TREATMENT USE DRUGS.
 Corticosteroids
Beclomethazone.
Dexamethazone.
Prednisolone.
Triamcinolone.

20. PREDNISOLONE.
 Prednisolone is a corticosteroid
it works by modifying the
body's immune response to
various conditions and
deceasing inflammation.