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Chronic renal failure (Chronic kidney disease) Lecture 1

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Published on

03.05.2016

Published in: Health & Medicine
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Chronic renal failure (Chronic kidney disease) Lecture 1

  1. 1. DR. ASMATULLAH SAPAND A H M A D S H A H A B D A L I I N S T U T U T E O F H I G H E R E D U C AT I O N D E PA R T M E N T O F I N T E R N A L M E D I C I N E K H O S T - A F G H A N I S TA N
  2. 2. DEFINITION OF CRF: Chronic renal Failure (CRF) now called Chronic Kidney Disease (CKD) is the irreversible deterioration of renal function OR when the GFR is reduced to <60ml/min/1.73m2 for at least 3 or more months it is called CKD or CRF.
  3. 3. CKD results from the loss of the following Kidney functions: • Excretory • Regulatory • Endocrine • Metabolic
  4. 4. STAGES OF CKD:
  5. 5. ETIOLOGY OF CKD:
  6. 6. ETIOLOGY OF CKD:
  7. 7. PATHOPHYSIOLOGY OF CKD: It circles on the following 2 conditions: 1. Hyperfiltration 2. Uremic syndrome
  8. 8. 1. Hyperfiltration • Hyperfunction of the glomerules and renal tubules. • Enlargement of the glomerules and renal tubules. • Overload and hypertrophy of the Nephrons • Finally fibrosis and sclerosis of the Nephrons. All due to DAMAGE OF THE RENAL TISSUE
  9. 9. Hyperfitration
  10. 10. 2. Uremic Syndrome • Accumulation of the Urea and Creatinine. • Accumulation of other Hundreds of toxins other than Urea and Creatinine. • Abnormal regulation of Acid-Base balance. • Decreased degradation, excretion and abnormal regulation of many hormones includind PTH, FGF-23, prolactin, steroid hormones, insulin and glucagon. • Progressive systemic inflammation.
  11. 11. Clinical Features of CKD and Uremia • In the early stages CKD is asymptomatic. • Symptoms and Signs of Uremia are manifested with GFR of less than 5-10ml/min/1.73m2. • At this point, the build-up of metabolic waste products or uremic toxins can result in uremic syndrome.
  12. 12. Clinical Features of CKD and Uremia

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