Chronic kidney failure is the progressive loss of kidney function over months or years. It is characterized by a buildup of waste products due to decreased filtration by the kidneys. The National Kidney Foundation stages chronic kidney disease based on glomerular filtration rate. Stage 1 involves normal kidney function while stage 5 is end-stage renal disease requiring dialysis or transplantation. Treatment options depend on the stage and may include lifestyle changes, medication, dialysis, and transplantation.

1. Chronic Kidney
Failure
Group Members
Md. Azamu Shahiullah Prottoy
Hamzah Naquib
Tasnuva Nowrin

2. Chronic Kidney/Renal Failure
Progressive loss of kidney functions.
Over a period of months or years.
• Characterized by
1. Uremia: Creatinine, Urea; BUN test
2. Anaemia: RBCs
3. Metabolic Acidosis: Metabolic Acid muscle loss
4. Osteodystrophy: Bone development
5. Neuropathy: Nerve functions
6. General weakness (Hypertension, Edema)

3. Causes of Chronic Kidney Failure
• Damage to the infrastructure of the kidney.
• Progressive loss of nephron-units occur.
• Remaining units give backup to maintain normal GFR.
• As a consequence, GFR gradually declines.
• Symptoms free until 15-20 ml/min – GFR rate.

4. Typical Signs and Symptoms of CKD

5. Renal and Hepatic Involvement in Vitamin D Metabolism
Cholecalciferol
(From diet and sunlight - Inactive)
1α hydroxycholecalciferol
(Alfacalciferol - Inactive)
LIVER
KIDNEY
25- Hydroxycholecalciferol
(Inactive)
1, 25- Dihydroxycholecalciferol
(Active)

6. Disturbance of Calcium and Phosphate Balance

7. Stages of Chronic Kidney Failure
• National Kidney Foundation (NKF) has identified 5 stages of CKD.
• Glomerular Filtration Rate (GFR) for each step.
Stage 1: Normal or high GFR > 90 mL/min
Stage 2: Mild CKD (GFR = 60-89 mL/min)
Stage 3A: Moderate CKD (GFR = 45-59 mL/min)
Stage 3B: Moderate CKD (GFR = 30-44 mL/min)
Stage 4: Severe CKD (GFR = 15-29 mL/min)
Stage 5: End stage CKD (GFR < 15 mL/min)

8. Symptoms of Different Stages
Stage 1
• Higher creatinine & urea.
• Blood/protein in urine.
• Kidney damage evidence in MRI, CT scan also
ultrasound and contrast X-ray.
Stage 2
• Family history of PKD (polycystic kidney disease)
• Higher than normal levels of GFR.
• MRI, CT scan and X-ray shows signs.
Stage 3
• Fatigue, fluid retention, edema.
• Shortness in breathing.
• Back pain, urination changes.
• Sleeping problems.

9. Treatment Options
Stage 1
• Healthy diet.
• Regulation of BP, Sugar level.
• Regular checkups and GFR measurement.
• Stage 2
• Regular exercise, Proper medication.
• Stopping smoking.
• Healthy diet.
• Regulation of BP, Sugar level.
• Regular checkups and GFR measurement.
Stage 3
• Controlling blood glucose level to
maintain Diabetes under control.
• Taking blood pressure
medications, like
1. Angiotensin Receptor Blockers
(ARBs).
2. Angiotensin Converting
Enzyme (ACE) Inhibitors.

10. Stage 4 : Chronic Kidney Failure
Advanced kidney damage with a severe decrease of GFR – 15/30 ml/min.
Symptoms:
• Fatigue
• Fluid retention, swelling (edema) of extremities and shortness of breath
• Urination changes (foamy; dark orange, brown, tea-colored or red if it contains
blood; and urinating more or less than normal)
• Kidney pain felt in their back
• Sleep problems due to muscle cramps or restless legs.
• Nausea and/or vomiting
• Taste changes a metallic taste in the mouth
• Bad breath due to urea buildup in the blood
• Nerve problems: Numbness or tingling in the toes.

11. Stage 5 : Chronic Kidney Failure
End stage renal disorder (ESRD) with a GFR of 15 ml/min or less.
Symptoms:
• Loss of appetite
• Nausea or vomiting
• Headaches
• Being tired
• Being unable to concentrate
• Itching
• Making little or no urine
• Swelling around the eyes.
• Muscle cramps
• Tingling in hands or feet
• Changes in skin color
• Increased skin pigmentation

12. Management
• Diet
• Medication
• Exercise
• Change in lifestyle
• Treatment

13. Treatment

14. Hemodialysis

15. Peritoneal dialysis

16. Thank You