Chronic renal failure is the progressive loss of kidney function over months or years. It is defined as a decline in glomerular filtration rate below 70-75% and is generally irreversible. It progresses through stages and is caused by conditions like diabetes, hypertension, and glomerulonephritis. Symptoms result from kidney's inability to regulate fluids, electrolytes, and waste and include edema, shortness of breath, fatigue, and neurological changes. Treatment focuses on slowing progression through blood pressure control, cholesterol medications, treating anemia, and dialysis or transplant for end-stage disease.

1. CHRONIC RENAL FAILURE
NUR IZZATUL NAJWA BINTI
SHARUPUDDIN
082015100036

2. LEARNING OBJECTIVE
AT THE END OF THIS SEMINAR, STUDENTS SHOULD BE ABLE TO :
• DEFINE CHRONIC RENAL FAILURE
• EXPLAIN THE STAGES OF CHRONIC RENAL FAILURE
• EXPLAIN THE VICIOUS CYCLE AND ETIOLOGY OF
CHRONIC RENAL FAILURE
• DESCRIBE PATHOPHYSIOLOGY and CLINICAL
MANIFESTATION OF CHRONIC RENAL FAILURE
• LIST THE DIAGNOSIS and TREATMENT OF CHRONIC
RENAL FAILURE

3. DEFINITION
• Progressive and irreversible loss of large
numbers of functioning nephrons
• Decline of kidney function for 3 months or
more
• Serious clinical symptom < 70 – 75 %
• End- stage renal disease
– Chronic Kidney Disease stage 6 ( CKD 6 )
– A state where renal replacement is needed

4. HIGH RISK
FOR
DEATH!

5. DEFINITION

6. STAGES

7. VICIOUS CYCLE

8. ETIOLOGY
• Diabetes Mellitus
• Hypertension
• Glomerulonephritis
• Polycystic kidney disease
• Obstruction due to tumour
• Unknown

10. CLINICAL MANIFESTATION
May disrupt all the kidney functions:
• Alterations in fluids and electrolyte
• Metabolic acidosis
• Anaemia
• Complication of uremia

11. PATHOPHYSIOLOGY
SODIUM & WATER
RETENTION
SHORTNESS OF BREATH
GENRALIZED EDEMA
SWELLING
• PULMONARY EDEMA AND
LOSS OF AIR SPACE
• VENTILATION – PERFUSION
MISMATCH
FLUID ACCUMULATION
LOSS
OF
GFR

12. INABILITY TO SECRETE
POTASSIUM IN THE URINE
HYPERKALEMIA
PALPITATION, ARRYHTMIAS
ALTERATION OF FLUID AND ELECTROLYTE

13. LEAN OF BODY MASS
• IMPAIRED HYDROGEN
SECRETION FROM BODY
• PROTEIN – ENERGY
MALNUTRITION
LOSS WEIGHT FATIGUE, PALLOR
ANAEMIA
LOSS OF ERYTHROPIOETIN
RELEASE
METABOLIC ACIDOSIS ANAEMIA

14. COMPLICATIONS OF UREMIA
HIGH CONCENTRATION OF
NONPROTEIN NITROGENS
- UREA, CREATININE, URIC ACID
UREMIA- INDUCES
PLATELET
DYSFUNCTION
CHEST PAIN, MALAISE
INCREASE TENDENCY
GI BLEED AND
ECCHYMOSIS
UREMIC
ENCEPHALOPATHY
UREMIC PERICARDITIS
HEADACHES,
CONFUSION, COMA

15. DIAGNOSIS
• Blood test
– Creatinine, urea
• Urine test
– Dipstick, 24 hours urinary protein
– Microscopic examination, RBC/ Pus cell/ cast
– Microalbuminemia, morning sample, use strip
• Imaging test
– Structure and size of kidney
• Kidney biopsy

16. TREATMENT
• Treatment options vary, depending on the cause.
• High blood pressure medications.
– angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor
blockers
• Medications to lower cholesterol levels.
– Statins ; atrovastatin, lovastatin, rosuvastatin
• Medications to treat anemia.
– supplements of the hormone erythropoietin, sometimes with added iron.
• Lower protein diet
• Dialysis
• Kidney transplant

17. SUMMARY

18. REFERENCE
• GUYTON & HALL TEXTBOOK OF MEDICAL
PHYSIOLOGY, 12TH EDITION ; CHAPTER 84,
Applied Physiology Of The Renal System