The document discusses chronic renal failure, which is the gradual loss of kidney function over time. The kidneys play several important roles like removing waste and excess water from the blood. Chronic renal failure occurs when the glomerular filtration rate is below 25 ml/min for an extended period. Some common causes are diabetes, high blood pressure, and glomerulonephritis. Symptoms include edema, fatigue, nausea, and loss of appetite. Without treatment, complications can arise like anemia, high blood pressure, and bone disease. Diagnosis involves medical tests of blood and urine. Treatment options include medications, dietary changes, dialysis, and kidney transplantation.

1. CHRONIC RENAL FAILURE
PATHOPHYSIOLOGY

2. FUNCTIONS OF KIDNEY:
 Remove toxic waste products
 Remove excess water and salts
 Play a part in controlling blood pressure
 Produce erythropoetin (epo) which
stimulates red cell production
 Helps to keep calcium and phosphate in
balance for healthy bones
 Maintains proper pH for the blood

3. CHRONIC RENAL FAILURE
INTRODUCTION
 Longstanding disease of the kidneys leading
to renal failure.
 The kidneys filter waste and excess fluid
from the blood. As kidneys fail, waste
builds up.
 Chronic kidney disease, also called chronic
kidney failure, describes the gradual loss of
kidney function.

4. CHRONIC RENAL FAILURE
DEFINITION
 CRF is defined as a permanent reduction in
glomerular filtration rate (GFR) sufficient to
produce detectable alterations in well-being and
organ function. This usually occurs at GFR below
25 ml/min.
 About 100 to 150 per million persons in the U.S.
develop CRF annual.
 Average annual cost is $25,000 – 35,000 per
patient per year

5. STAGES OF CHRONIC RENAL
FAILURE:

6. ETIOLOGY:
 Type 1 or type 2 diabetes.
 High blood pressure.
 Glomerulonephritis (gloe-mer-u-low-nuh-
FRY-tis), an inflammation of the kidney's
filtering units (glomeruli).
 Interstitial nephritis (in-tur-STISH-ul nuh-
FRY-tis), an inflammation of the kidney's
tubules and surrounding structures.
 Polycystic kidney disease.

7. ETIOLOGY:
Prolonged obstruction of the urinary tract,
from conditions such as enlarged prostate,
kidney stones and some cancers.
Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul)
reflux, a condition that causes urine to back up
into your kidneys.
Recurrent kidney infection, also called
pyelonephritis (pie-uh-low-nuh-FRY-tis).

8. RISK FACTORS:

9. SYMPTOMS:
 puffy eyes, hands, and feet (called edema).
 high blood pressure.
 fatigue.
 nausea and vomiting (this is a common
symptom).
 thirst.
 bad taste in the mouth or bad breath.

10. SYMPTOMS:
 weight loss.
 generalized, persistent itchy skin.
 muscle twitching or cramping.
 a yellowish-brown tint to the skin.
 Headache.
 Low urine output.
 shortness of breath.
 loss of appetite.

11. COMPLICATIONS:
 anemia.
 high blood pressure.
 increased risk of bleeding.
 increased risk of infection.
 fluid overload (called edema).
 dehydration.
 electrolyte abnormalities (e.g.,
hyperkalemia)

12. COMPLICATIONS:
 hyperphosphatemia [high levels of
phosphorus in the blood])
 brittle bones
 malnutrition
 seizure
 mineral abnormalities (e.g., hypercalcemia
[high calcium)

13. DIAGNOSIS:
 medical history.
 blood pressure (many people with chronic
renal failure have high blood pressure).
 urine tests (to detect proteinuria – excess
protein in the urine).
 blood tests.
 X-rays of the kidneys.
 abdominal CT or CAT (computed
tomography) scan.
 abdominal MRI (magnetic resonance

14. DIAGNOSIS:
 aabdominal MRI (magnetic resonance
imaging)
 abdominal ultrasound
 renal scan
 The X-rays, scans, and ultrasounds check
for abnormalities in the kidneys, such as
small size, tumours, or blockages.

15. TREATMENTS:
 Self-care - Low protein diet
 Medications:
 Vitamin, Calcium reducer, Bone marrow
stimulant, Diuretic and Dietary supplement
 Surgery Kidney - transplantation

16. Conservative
Treatment
Dialysis Transplant
Hemodialysis Peritoneal Related Donor Cadaver Donor
Home Center

18. Additional Resources and
Information from the Web
 Florida End Stage Renal Disease Network
(http://www.fmqai.com/ESRD/esrd.htm)
 University Renal Research and Education Association
(www.urrea.org)
 National Institute of Diabetes & Digestive & Kidney Diseases
(www.niddk.nih.gov)
 National Kidney & Urologic Diseases Information
Clearinghouse (NKUDIC) (http://kidney.niddk.nih.gov/)
 Life Options Rehabilitation Program (www.lifeoptions.org)
 American Society of Nephrology (www.asn-online.org)
 National Kidney Foundation (www.kidney.org)
 JAN’s webpage (www.jan.wvu.edu/soar/other/renal.html)

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