This notes is suitable for B.Pharma IInd semester students. This is prepared by Rajat Srivastava (M.Pharma).

2. Introduction
 A condition of gradual loss of kidney function is
termed as chronic renal failure (CRF) or chronic
renal disease (CRD).
 In case of chronic renal failure resulting in
accumulation of high levels of fluid, electrolytes and
waste product in the body.

3. Classification
It is classified in following types-
1) Stage-I : Kidney damage with normal or increase
GFR (>90ml/min)
2) Stage-II : Mild reduction in GFR (60-89ml/min)
3) Stage-III : Moderate reduction in GFR (30-
59ml/min)
4) Stage-IV : Severe reduction in GFR (15-29ml/min)
5) Stage-V : Kidney failure. GFR(<15ml/min)

4. Etiology/Causes
 Diabetes mellitus
 Glomerulonephritis (Inflammation of the glomeruli)
 Hypertension
 Polycystic kidney disease
 Interstitial nephritis (Inflammation of kidney tubules)
 Prolong obstruction of urinary tract
 Vesicoureteral reflux (condition that sends urine back
into the kidney)

5. Sign and Symptoms
 Nausea
 Vomiting
 Appetite loss
 Fatigue
 Protein in urine
 Hyperkalaemia
 Hypertension
 Azotemia
 Hypercalcemia
 Tubuler cell necrosis
 Shortness of breath
 Changes in urinating capacity
 Muscle twitches
 Chest pain
 Swelling of feet and ankles

6. Nephrons are completely damaged
Decreased number of nephrons
Hyperfiltration of glomerulus
Increased glomerular permeability
Increased filtration of proteins
Nephrotoxic Inflamamtion
Tubular necrosis
Decreased GFR
Decreased urinary
output
Development of systemic
complication
Activation of RAS
Release angiotensin-II
Leads to hypertension
Pathophysiology
RAS- Renin Angiotensin
Aldosteron System

7. Diagnosis/Test
1. Blood Test: Determine the level of waste
products(creatinine and urea)in blood.
2. Urine Test: Determine the abnormalities indicating
chronic renal failure
3. Kidney Biopsy: Analysing the cause of kidney
problem
4. Imaging Test (Ultrasound): To check the structure
and size of kidneys

8. Complication
 Cardiovascular disorder
 Weak bone and osteoporosis
 Anaemia
 Damaged CNS
 Decreased immune response
 Decreased sex drive, erectile dysfunction or reduced
fertility

9. Treatment
1. Changes in life style
 Quit smoking
 Eating low fat and cholesterol diet
 Regular exercising
 Controlling blood sugar
 Avoiding too much salt or potassium
 Taking medicine for lowering cholesterol levels

10. 2. Dietary changes
 Limiting protein rich diet
 Limiting salt, potassium, phosphorus and other
electrolytes
 Consuming calories to prevent weight loss
3. Other treatments
 Taking phosphate binders for preventing high
phosphorus level
 Taking extra calcium and vitamin D

11.  Taking extra iron in diet
 Angiotensin converting enzyme inhibitors drugs are
used that reduce high blood pressure
 Diuretics drugs used that help to eliminate extra
water from the body
 Calcium reducer that decrease the amount of calcium
in blood.

12. THANK
YOU