Chapter 12 Chronic Kidney Disease and DialysisKalvinSmith4
For DH Theory III, students must give a presentation on a specific module in the class. The purpose of these presentations is to inform students on how treat patients in a dental setting who may be compromised by a certain medical condition. I was tasked with presenting on chronic kidney disease and dialysis, as well as on sexually transmitted diseases. This is the presentation that I modified on CKD and dialysis.
Chapter 12 Chronic Kidney Disease and DialysisKalvinSmith4
For DH Theory III, students must give a presentation on a specific module in the class. The purpose of these presentations is to inform students on how treat patients in a dental setting who may be compromised by a certain medical condition. I was tasked with presenting on chronic kidney disease and dialysis, as well as on sexually transmitted diseases. This is the presentation that I modified on CKD and dialysis.
Biochemical investigations and management of sickle cell nephropathy.pptxAuwalAhmad6
Sickle cell disease is a disorder that affect all systems including urinary systems, biochemical investigations may be used to identify early events and institute measures that will prevent progression to ESRD
Topics Covered:
Basic kidney physiology (just enumeration).
Manifestations of renal impairment.
AKI vs. CRF , definitions, causes and their classifications (in brief) .
Clinical evaluation of a case of renal failure.
indications for renal replacement therapy.
Approach for real-Life patient with renal impairment: group-case discussion.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Biochemical investigations and management of sickle cell nephropathy.pptxAuwalAhmad6
Sickle cell disease is a disorder that affect all systems including urinary systems, biochemical investigations may be used to identify early events and institute measures that will prevent progression to ESRD
Topics Covered:
Basic kidney physiology (just enumeration).
Manifestations of renal impairment.
AKI vs. CRF , definitions, causes and their classifications (in brief) .
Clinical evaluation of a case of renal failure.
indications for renal replacement therapy.
Approach for real-Life patient with renal impairment: group-case discussion.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Chronic Renal Failure.pptx
1. CLINICAL PATHOLOGY
CHRONIC RENAL FAILURE
BY MAKOKHA L. G. (BScCM)
MASINDE MULIRO UNIVERSITY OF SCIENCE AND TECHNOLOGY
3/14/2023
BY Makokha L.G.
1
2. CHRONIC RENAL FAILURE (CRF)
Chronic renal failure is a syndrome characterised by
progressive and irreversible deterioration of renal function
due to slow destruction of renal parenchyma, eventually
terminating in death when sufficient number of nephrons
have been damaged.
Acidosis is the major problem in CRF
with development of biochemical azotaemia and clinical
uraemia syndrome.
3/14/2023
BY Makokha L.G.
2
3. 3/14/2023
BY Makokha L.G.
3
ETIOPATHOGENESIS.
All chronic nephropathies can lead to CRF. The diseases
leading to CRF can generally be classified into two major
groups: those causing glomerular pathology, and those causing
tubulointerstitial pathology.
Though this classification is useful to facilitate study, the
disease rarely remains confined to either glomeruli or
tubulointerstitial tissue alone.
In the final stage of CRF, all parts of the nephron are involved.
4. 3/14/2023
BY Makokha L.G.
4
1. Diseases causing glomerular pathology.
A number of glomerular diseases associated with CRF have their
pathogenesis in immune mechanisms
Glomerular destruction results in changes in filtration process and leads to
development of the nephrotic syndrome characterised by proteinuria,
hypoalbuminaemia and oedema.
The important examples of chronic glomerular diseases causing CRF are
covered under two headings: primary and systemic.
5. 3/14/2023
BY Makokha L.G.
5
i. Primary glomerular pathology: The major cause of CRF is
chronic glomerulonephritis, usually initiated by various types of
glomerulonephritis such as membranous glomerulo-nephritis,
membrano-proliferative glomerulonephritis, lipoid nephrosis
(minimal change disease) and anti-glomerular basement
membrane nephritis
ii. Systemic glomerular pathology: Certain conditions originate outside the
renal system but induce changes in the nephrons secondarily. Major
examples of this type are systemic lupus erythematosus, serum sickness
nephritis and diabetic nephropathy.
6. 3/14/2023
BY Makokha L.G.
6
2. Diseases causing tubule-interstitial pathology.
Damage to tubule-interstitial tissues results in alterations in reabsorption and secretion of
important constituents leading to excretion of large volumes of dilute urine.
Tubulo-interstitial diseases can be categorized according to initiating etiology into 4
groups:
Vascular
Infectious
Toxic
Obstructive
i) Vascular causes: Long-standing primary or essential hypertension produces
characteristic changes in renal arteries and arterioles referred to as nephrosclerosis.
Nephrosclerosis causes progressive renal vascular occlusion terminating in ischaemia
and necrosis of renal tissue.
7. 3/14/2023
BY Makokha L.G.
7
ii) Infectious causes: A good example of chronic renal infection causing CRF is
chronic pyelonephritis.
The chronicity of process results in progressive damage to increasing number of
nephrons leading to CRF.
iii) Toxic causes: Some toxic substances induce slow tubular injury, eventually
culminating in CRF.
The most common example is intake of high doses of analgesics such as
phenacetin, aspirin and acetaminophen (chronic analgesic
nephritis).
Other substances that can cause CRF after
prolonged exposure are lead, cadmium and uranium
8. 3/14/2023
BY Makokha L.G.
8 iv) Obstructive causes: Chronic obstruction in the urinary tract
leads to progressive damage to the nephron due to fluid
backpressure.
The examples of this type of chronic injury are stones, blood clots,
tumours, strictures and enlarged prostate.
9. 3/14/2023
BY Makokha L.G.
9
Regardless of the initiating cause, CRF evolves progressively
through 4 stages:
1. Decreased renal reserve.
At this stage, damage to renal parenchyma is marginal and the
kidneys remain functional.
The GFR is about 50% of normal, BUN and creatinine values
are normal and the patients are usually asymptomatic except
at times of stress.
10. 3/14/2023
BY Makokha L.G.
10
2. Renal insufficiency.
At this stage, about 75% of functional renal parenchyma has been
destroyed. The GFR is about 25% of normal accompanied by
elevation in BUN and serum creatinine.
Polyuria and nocturia occur due to tubulointerstitial damage.
Sudden stress may precipitate uraemic syndrome.
11. 3/14/2023
BY Makokha L.G.
11
3. Renal failure.
At this stage, about 90% of functional renal tissue has been
destroyed.
The GFR is approximately 10% normal.
Tubular cells are essentially nonfunctional.
As a result, the regulation of sodium and water is lost resulting in
oedema, metabolic acidosis, hypocalcaemia, and signs and
symptoms of uraemia
12. 3/14/2023
BY Makokha L.G.
12
4. End-stage kidney.
The GFR at this stage is less than 5% of normal and results in
complex clinical picture of uraemic syndrome with progressive
primary (renal) and secondary systemic (extra-renal) symptoms
13. CLINICAL FEATURES of CHRONIC R.F
Clinical manifestations of full-blown CRF culminating in uraemic
syndrome are described under 2 main headings:
A. primary (renal) uraemic manifestations and
B. secondary (systemic or extra-renal) uraemic
manifestations.
A. Primary uraemic (renal) manifestations.
Primary symptoms of uraemia develop when there is slow and
progressive deterioration of renal function.
The resulting imbalances cause the following manifestations:
3/14/2023
BY Makokha L.G.
13
14. 3/14/2023
BY Makokha L.G.
14 1. Metabolic acidosis.
As a result of renal dysfunction, acid base balance is progressively
lost.
Excess of hydrogen ions occurs, while bicarbonate level declines in
the blood, resulting in metabolic acidosis.
The clinical symptoms of metabolic acidosis include: compensatory
Kussmaul breathing, hyperkalaemia and hypercalcaemia
15. 3/14/2023
BY Makokha L.G.
15 2. Hyperkalaemia.
A decreased GFR results in excessive accumulation of potassium in
the blood since potassium is normally excreted mainly in the urine.
Hyperkalaemia is further worsened by metabolic acidosis.
The clinical features of hyperkalaemia are: cardiac arrhythmias,
weakness, nausea, intestinal colic, diarrhoea, muscular irritability
and flaccid paralysis.
16. 3/14/2023
BY Makokha L.G.
16 3. Sodium and water imbalance.
As GFR declines, sodium and water cannot pass sufficiently into
Bowman’s capsule leading to their retention.
Release of renin from juxtaglomerular apparatus further aggravates
sodium and water retention.
The main symptoms referable to sodium and water retention are:
hypervolaemia and circulatory overload with congestive heart
failure.
17. 3/14/2023
BY Makokha L.G.
17 4. Hyperuricaemia.
Decreased GFR results in excessive accumulation of uric acid in the blood.
Uric acid crystals may be deposited in joints and soft tissues resulting in gout.
5. Azotaemia.
The waste-products of protein metabolism fail to be excreted resulting in
elevation in the blood levels of urea, creatinine, phenols and guanidines causing
biochemical abnormality, azotaemia.
The secondary manifestations of uraemia are related to toxic effects of these
metabolic waste-products.
18. 3/14/2023
BY Makokha L.G.
18
B. Secondary uraemic (extra-renal) manifestations.
A number of extra-renal systemic manifestations develop secondarily
following fluid-electrolyte and acid-base imbalances.
These include the following:
1. Anaemia.
Decreased production of erythropoietin by diseased kidney results in decline in
erythropoiesis and anaemia.
Besides, gastrointestinal bleeding may further aggravate anaemia.
19. 3/14/2023
BY Makokha L.G.
19
2. Integumentary system.
Deposit of urinary pigment such as urochrome in the skin causes sallow-yellow
colour. (Jaundice)
The urea content in the sweat as well as in the plasma rises.
On evaporation of the perspiration, urea remains on the facial
skin as powdery ‘uraemic frost’.
3. Cardiovascular system.
Fluid retention secondarily causes cardiovascular symptoms such as increased
workload on the heart due to the hypervolaemia and eventually congestive heart
failure. (CCF/CHF)
20. 3/14/2023
BY Makokha L.G.
20
4. Respiratory system.
Hypervolaemia and heart failure cause pulmonary congestion and pulmonary
oedema due to back pressure.
Radiologically, uraemic pneumonitis shows characteristic central, butterfly-
pattern of oedema and congestion in the chest radiograph.
5. Digestive system.
Azotaemia directly induces mucosal ulcerations in the lining of the stomach and
intestines.
Subsequent bleeding can aggravate the existing anaemia.
Gastrointestinal irritation may cause nausea, vomiting and
diarrhoea.
21. 3/14/2023
BY Makokha L.G.
21
6. Skeletal system.
The skeletal manifestations of renal failure are referred to as renal osteodystrophy.
Two major types of skeletal disorders may occur:
i) Osteomalacia occurs from deficiency of a form of vitamin D which is normally activated
by the kidney Since vitamin D is essential for absorption of calcium, its deficiency results
in inadequate deposits of calcium in bone tissue.
ii) Osteitis fibrosa occurs due to elevated levels of parathormone.
How parathormone excess develops in CRF is complex. As the GFR is decreased,
increasing levels of phosphates accumulate in the extracellular fluid which, in turn, cause
decline in calcium levels.
22. 3/14/2023
BY Makokha L.G.
22
Decreased calcium level triggers the secretion of parathormone
which mobilises calcium from bone and increases renal tubular
reabsorption of calcium thereby conserving it.
However, if the process of resorption of calcium phosphate
from bone continues for sufficient time, hypercalcaemia may
be induced with deposits of excess calcium salts in joints and
soft tissues and weakening of bones (renal osteodystrophy).