Renal failure is divided into acute renal failure (ARF) and chronic renal failure (CRF). ARF is characterized by rapid onset of renal dysfunction and increased waste products in the blood. It can be caused by issues with blood flow (pre-renal), the kidneys themselves (intra-renal), or urine outflow (post-renal). CRF is a progressive loss of renal function that eventually leads to end-stage kidney disease. It is caused by damage to the glomeruli or tubulointerstitial tissues and develops over four stages with declining kidney function and increasing symptoms of uraemia.
Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance
Acute kidney failure happens when your kidneys suddenly lose the ability to eliminate excess salts, fluids, and waste materials from the blood. Acute kidney failure is also called acute kidney injury or acute renal failure. It's common in people who are already in the hospital. It may develop rapidly over a few hours.
CHRONIC RENAL FAILURE (CRF) or CHRONIC KIDNEY DISEASE (CKD)
Chronic or irreversible renal failure is a progressive reduction of functioning of renal tissue such that the remaining kidney mass can no longer maintain the body’s internal environment.
This PPT cover the concepts of Pathophysiology of Renal failure. It includes different types of renal failure ie. Acute renal Failure and Chronic renal Failure
Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance
Acute kidney failure happens when your kidneys suddenly lose the ability to eliminate excess salts, fluids, and waste materials from the blood. Acute kidney failure is also called acute kidney injury or acute renal failure. It's common in people who are already in the hospital. It may develop rapidly over a few hours.
CHRONIC RENAL FAILURE (CRF) or CHRONIC KIDNEY DISEASE (CKD)
Chronic or irreversible renal failure is a progressive reduction of functioning of renal tissue such that the remaining kidney mass can no longer maintain the body’s internal environment.
This PPT cover the concepts of Pathophysiology of Renal failure. It includes different types of renal failure ie. Acute renal Failure and Chronic renal Failure
This includes a comprehensive study of Renal Failure - both AKI & CKD (ESRD). It is very helpful for those who are managing the clients with renal failure.
Chronic kidney disease (CKD) means your kidneys are damaged and can't filter blood the way they should. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They're usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.
Chronic kidney disease (CKD) consists of a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR).
This includes a comprehensive study of Renal Failure - both AKI & CKD (ESRD). It is very helpful for those who are managing the clients with renal failure.
Chronic kidney disease (CKD) means your kidneys are damaged and can't filter blood the way they should. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They're usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.
Chronic kidney disease (CKD) consists of a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR).
Genitourinary disorders are conditions that affect the genitourinary system, which includes the urinary and reproductive systems. Some are congenital, and others are acquired later in life.
Large numbers of patients suffer from a variety of diseases in the genitourinary system, which is composed of kidneys, ureters, bladder, urethra, and genital organs. Genitourinary diseases include congenital abnormalities, iatrogenic injuries, and disorders such as cancer, trauma, infection, and inflammation.
Respiratory stimulants: types, complete discussion on indications, contraindications, assessment, patient notes and examples of stimulants both central and respiratory
Expectorants and Antitussives: types, complete discussion on indications, contraindications, assessment, patient notes and examples of expectorants and antitussives
Complete pharmacology of Non steroidal Anti inflammatory Drugs, classification, Mechanism of action, Pharmacological actions, Indications, Contraindications, Adverse effects
Pharmacology laboratory experiment, both invivo and invitro includes interpolation, matching , bracketing, three point, four point bioassays with a note on hypoglycemic activity, acute skin irritation, acute eye irritaiton, pyrogen test, gastrointestinal motility test, physiological salt solutions
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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!
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
2. RENAL DISEASE: RENAL FAILURE
Diseases of the kidneys are divided into 4 major groups according to the predominant
involvement of corresponding morphologic components:
Glomerular diseases: These are most often immunologically-mediated and may be acute or
chronic.
Tubular diseases: These are more likely to be caused by toxic or infectious agents and are
often acute.
Interstitial diseases: These are likewise commonly due to toxic or infectious agents and quite
often involve interstitium as well as tubules (tubulo-interstitial diseases).
Vascular diseases: These include changes in the nephron as a consequence of increased intra-
glomerular pressure such as in hypertension or impaired blood flow.
3. The major morphologic involvements of the kidneys in the initial
stage is confined to one component (glomeruli, tubules, interstitium
or blood vessels), but eventually all components are affected leading to
end-stage kidneys.
Regardless of cause, renal disease usually results in the evolution of
major pathological syndromes
4. Acute renal failure and chronic renal failure. The term ‘azotaemia’ is
used for biochemical abnormality characterised by elevation of the
blood urea nitrogen (BUN) and creatinine levels,
while ‘uraemia’ is defined as association of these biochemical
abnormalities with clinical signs and symptoms.
5. Acute Renal Failure (ARF)
Acute renal failure (ARF) is a syndrome characterised by rapid onset
of renal dysfunction, chiefly oliguria or anuria, and sudden increase
in metabolic waste-products (urea and creatinine) in the blood with
consequent development of uraemia.
6. ETIOPATHOGENESIS.
The causes of ARF may be classified as pre-renal, intra-renal and post-renal in nature.
Pre-renal causes. Pre-renal diseases are those which cause sudden decrease in blood
flow to the nephron. Renal ischaemia ultimately results in functional disorders or
depression of GFR (cardiac output and hypovolemia)
Intra-renal causes. disease of renal tissue itself. These include vascular disease of the
arteries and arterioles within the kidney, diseases of glomeruli, acute tubular necrosis
due to ischaemia, or the effect of a nephrotoxin, acute tubulointerstitial nephritis
and pyelonephritis.
7. Post-renal causes. caused by obstruction to the flow of urine
anywhere along the renal tract distal to the opening of the collecting
ducts, ureter, bladder neck or urethra.
It is important to note that ARF originating in pre- and post-renal
disease, such as by renal ischaemia or renal infection, eventually leads
to intra-renal disease.
8. CLINICAL FEATURES.
Depend on the underlying cause of ARF and on the stage of the disease at which the patient
presents:
1. Syndrome of acute nephritis. associated with acute streptococcal
glomerulonephritis and rapidly progressive glomerulonephritis.
Renal dysfunction results from extensive proliferation of epithelial cells in the
glomeruli , increase in glomerular permeability and decrease in GFR.
Features are: mild proteinuria, hematuria, edema and mild hypertension.
Fluid retention in acute nephritis syndrome appears to be due to both diminished
GFR and increased salt and water reabsorption in distal nephron.
9. 2. Syndrome accompanying tubular pathology.
When the ARF is caused by destruction of the tubular cells of the nephron the disease typically
progresses through 3 characteristic stages from oliguria to diuresis to recovery.
Oliguria phase: The initial oliguria phase lasting on an average from 7 to 10 days with urinary
output of less than 400 ml per day.
leads to accumulation of waste products of protein metabolism in the blood and resultant
azotaemia, metabolic acidosis, hyperkalaemia, hypernatraemia and hypervolaemia.
The specific gravity of the urine is low but the concentration of sodium in urine tends to be
elevated
10. Diuretic phase: With the onset of healing of tubules, there is
improvement in urinary output. This is believed to occur due to
drawing of water and sodium as they move through the nephron so
as to be excreted.
Phase of recovery: Full recovery with healing of tubular epithelial
cells occurs in about half the cases, while others terminate in death.
The process of healing may take up to one year with restoration of
normal tubular function.
11. 3. Pre-renal syndrome.
Secondary to disorders in which neither the glomerulus nor the tubules are damaged, results
in pre-renal syndrome.
Typically, this is seen in ischaemia caused by renal arterial obstruction, hypovolaemia,
hypotension or cardiac insufficiency.
Due to depressed renal blood flow, there is decrease in GFR causing oliguria, azotaemia
(elevation of BUN and creatinine) and possible fluid retention and oedema.
Since the tubular cells are functioning normally, the nephron retains its ability to concentrate
the glomerular filtrate according to the adaptive needs.
12. Chronic Renal Failure (CRF)
Chronic renal failure is a syndrome characterised by progressive and
irreversible deterioration of renal function
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.
13. 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.
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.
14. 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.
15. The important examples of chronic glomerular diseases causing CRF are covered under
two headings: primary and systemic.
i) Primary glomerular pathology: The major cause of CRF is chronic glomerulonephritis,
initiated by 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.
16. 2. Diseases causing tubulointerstitial pathology.
Damage to tubulointerstitial tissues results in alterations in reabsorption and secretion of
important constituents leading to excretion of large volumes of dilute urine.
Tubulointerstitial diseases can be categorised according to initiating etiology into 4 groups
i) Vascular causes: Long-standing primary or essential hypertension produces characteristic
changes in renal arteries and arterioles referred to as nephrosclerosis.
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.
17. iii) Toxic causes: 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.
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.
18. 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.
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
occurs.
3. Renal failure. At this stage, about 90% of functional renal tissue has been destroyed. The GFR is
approximately 10% of 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.
19. CLINICAL FEATURES.
Clinical manifestations of full blown CRF culminating in uraemic syndrome are described under 2 main
headings:
Primary (renal) uraemic manifestations
Secondary (systemic or extra-renal) uraemic.
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:
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.
2. The clinical symptoms of metabolic acidosis include: compensatory breathing, hyperkalaemia and
hypercalcaemia.
20. 2. Hyperkalaemia. A decreased GFR results in excessive accumulation of potassium in the blood since
potassium is normally excreted mainly in the urine. The clinical features of hyperkalaemia are: cardiac
arrhythmias, weakness, nausea, intestinal colic, diarrhoea, muscular irritability and flaccid
paralysis.
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.
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.
21. 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.
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.
2. Integumentary system. Deposit of urinary pigment such as urochrome in the skin causes sallow-yellow
colour. 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’.
22. 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.
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.
23. 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. As the
GFR is decreased, increasing levels of phosphates accumulate in the
extracellular fluid which, in turn, cause decline in calcium levels.
Decreased calcium level triggers the secretion of parathormone which
mobilises calcium from bone and increases renal tubular reabsorption of
calcium thereby conserving it.