The document discusses renal failure, including acute renal failure (ARF) and chronic renal failure (CRF). It defines renal failure as when the kidneys cannot remove metabolic waste or perform regulatory functions. ARF is a reversible clinical syndrome with sudden loss of kidney function over hours to days. CRF is kidney damage for 3+ months with decreased GFR. CRF management focuses on slowing progression, limiting complications like anemia and bone disease, and preparing for renal replacement therapies like dialysis and transplantation.
Renal failure and its homeopathy treatment in Chembur, Mumbai, India Shewta shetty
"Treatment & remedies for renal failure and its homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."/>
Brief Information regarding the disorders of the genitourinary system. This presentation involves the disorders of the urinary system including Chronic Kidney Disease, Congenital problems related to the urinary system, and renal cancers.
Renal failure and its homeopathy treatment in Chembur, Mumbai, India Shewta shetty
"Treatment & remedies for renal failure and its homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."/>
Brief Information regarding the disorders of the genitourinary system. This presentation involves the disorders of the urinary system including Chronic Kidney Disease, Congenital problems related to the urinary system, and renal cancers.
The main function of the kidney is excretion of water soluble waste products from our body.
Derangement of any of these function would result in either decreased excretion of waste products and hence their accumulation in the body or loss of some vital nutrient from the body.
Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours
CKD is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.
Acute renal failure or acute kidney injury is characterized by determination of renal functions over a period of hours to few days, resulting in failure of the kidney to excrete nitrogenous waste product and to maintain fluid, electrolytes and acid-base homeostasis.
Acute Kidney Failure is a sudden reduction in kidney function that results in nitrogenous wastes accumulating in the blood.
Chronic renal failure is a Progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic, fluid and electrolyte balance fails resulting in Uremia and Azotemia.
Definition, Etiology, Risk Factors, Stages, Clinical Manifestations, Management, Surgical Management, Prevention, Complications. Nursing Management
Medical considerations in dental treatment of patients with liver disease. Main types of liver disease, clinical manifestations, lab tests, treatment considerations.
The main function of the kidney is excretion of water soluble waste products from our body.
Derangement of any of these function would result in either decreased excretion of waste products and hence their accumulation in the body or loss of some vital nutrient from the body.
Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours
CKD is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.
Acute renal failure or acute kidney injury is characterized by determination of renal functions over a period of hours to few days, resulting in failure of the kidney to excrete nitrogenous waste product and to maintain fluid, electrolytes and acid-base homeostasis.
Acute Kidney Failure is a sudden reduction in kidney function that results in nitrogenous wastes accumulating in the blood.
Chronic renal failure is a Progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic, fluid and electrolyte balance fails resulting in Uremia and Azotemia.
Definition, Etiology, Risk Factors, Stages, Clinical Manifestations, Management, Surgical Management, Prevention, Complications. Nursing Management
Medical considerations in dental treatment of patients with liver disease. Main types of liver disease, clinical manifestations, lab tests, treatment considerations.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
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M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
2. RENAL FAILURE
• Renal failure Results when the kidneys cannot
remove the body’s metabolic wastes or perform
their regulatory functions.
• The substances normally eliminated in the urine
accumulate in the body fluids as a result of
impaired renal excretion, leading to a disruption in
endocrine and metabolic functions as well as fluid,
electrolyte, and acid-base disturbances.
• It is a systemic disease and is a final common
pathway of many different kidney and urinary tract
diseases
3. ACUTE RENAL FAILURE
It is a reversible clinical syndrome where there
is a sudden and almost complete loss of kidney
function (decreased GFR) over a period of hours to
days with failure to excrete nitrogenous waste
products and to maintain fluid and electrolyte
homeostasis.
ARF manifests as an increase in serum creatinine
and BUN, Urine volume may be normal, or
changes may occur. Possible changes include
oliguria(<400ml/day), nonoliguria (>400ml/ day), or
anuria (<50 ml/day)
4. Categories of Acute Renal Failure
1. Prerenal:
occurs in 60%-70% of cases, it is the
result of impaired blood flow to kidney that
leads to hypoperfusion of the kidney and a
decrease in the GFR.
Common clinical conditions are volume-
depletion states (hemorrhage or GI losses),
impaired cardiac performance (cardiogenic
shock), and vasodilation (sepsis, infection)
5. 2. Intrarenal:
Conditions such as burns, infections,
crush injuries, and severe blood transfusion
reactions can lead to intrarenal ARF.
With burns and crush injuries,
myoglobin and hemoglobin are liberated,
causing obstruction, renal toxicity, and
ischemia
Medications such as NSAIDs interfere
with the normal auto regulatory mechanisms
of the kidneys and may cause hypoperfusion
and eventual ischemia.
6. 3. Postrenal :
it is usually the result of an
obstruction somewhere distal to the
kidneys. Pressure rises in the kidney
tubules and eventually, the GFR
decreases
7.
8.
9. Clinical Features
•Asymptomatic
• elevations in the plasma creatinine
• abnormalities on urinalysis
Signs and symptoms resulting from loss of kidney function:
•decreased or no urine output, flank pain, edema,
hypertension, or discolored urine
10. Clinical Features
Symptoms or signs of renal failure:
•weakness
•easy fatiguability (from anemia)
•vomiting, mental status changes
•Seizures
•edema
11. Diagnosis
•Detailed history
•Blood urea nitrogen and serum creatinine
•CBC, peripheral smear, and serology
•Urinalysis
•Urine electrolytes
•Ultrasonography, CT
•Serology: Anti DNA, HBV, HCV, cryoglobulin, urinary
Myoglobulin, HBsAG
13. Treatment
•Optimization of hemodynamic and volume status
•Avoidance of further renal insults by medications
•Optimization of nutrition
• If necessary, institution of renal replacement therapy
14. Chronic renal failure
•Kidney damage for >= 3 months, as defined by
structural or functional abnormalities of the kidney,
with or without decreased GFR, manifest by either:
•Pathological abnormalities kidney damage,
including abnormalities in the composition of blood
and urine, or abnormalities in the imaging tests.
•GFR <60 ml/min/1.73m2 for >=3 months, with or
without kidney damage
15.
16. Staging
Stage Description GFR (ml/min/1.73m2)
I Kidney damage with normal or
increased GFR
>=90
II Kidney damage with mild decrease in
GFR
60-89
III Kidney damage with moderate decrease
in GFR
30-59
IV Kidney damage with severe decrease in
GFR
15-29
V Kidney failure <15 (or dialysis)
18. Clinical features
•Most asymptomatic till GFR falls below 30 ml/min
•GFR < 20 ml/min- affect almost all systems
•Tiredness, breathlessness- anemia, fluid
overload, Itching, weight loss, nausea, vomiting
and hiccups
•Advanced renal failure- metabolic acidosis,
muscular twitching, drowsiness and coma
20. Management
•High blood pressure medications.
•Medications to relieve swelling.
•Medications to treat anemia.
•Medications to lower cholesterol levels.
•Medications to protect your bones.
•A lower protein diet to minimize waste products in
your blood.
21. Management
Conservative
⚫Slowing the Progession
⚫Limiting the adverse
effects
⚫Preparing for Renal
Replacement Therapy
Definitive
RENAL REPLACEMENT
THERAPY (RRT)
• Dialysis:
• Hemodialysis
• Peritoneal Dialysis
• Renal Transplantation
• Live
• Cadaveric
22. Limiting the adverse effects of CKD
•Anemia
•Fluid and electrolyte balance
•Acidosis
•Cardiovascular disease and lipids
•Renal Osteodystrophy
•Infection
23. Anaemia
• Defined as Hemoglobin < 13.5 g/dl in males
< 12 g/dl in females
• Anemia is a condition in which you lack enough
healthy red blood cells to carry adequate oxygen to
your body's tissues.
• Primary cause : insufficient production of
Erythropoetin
24. Other factors causing anemia
• Iron deficiency/Folate and Vit B12 deficiency
• Chronic inflammation
• Hyperparathyroidism / bone marrow fibrosis
• Decreased erythropoiesis
• Decreased RBC survival
• Increased blood loss
• Occult gastrointestinal bleeding
• Platelet dysfunction
• Blood loss during hemodialysis
• Blood sampling
25. Anemia - goals
⚫Target Hb : not less than 11.5g/dl
⚫Check Hb monthly while on ESAs (Erythropoeisis
stimulating agents)
⚫Iron studies monthly when started on ESA
⚫On stable ESA Therapy : Iron studies can be done 3times in
a month
26. Anemia – treatment options
⚫Oral iron
⚫IV Iron Dextran
⚫IV Iron Sucrose
⚫IV Sodium Ferric Gluconate Complex
⚫Folic acid and Vitamin B 12 supplements
⚫Erythropoetin Stimulating Agents : Epoetin alfa*
Epoetin beta, Darbepoetin alfa
⚫Epoetin alfa / beta : 50 -100 IU / Kg SC per week
⚫Darbepoetin alfa : 40 mcg SC every 2 weeks
27. Bone disorder
•Renal bone disease- There are changes in the
concentrations of calcium, phosphate, vitamin d and
parathyroid hormone.
• Systemic complications include renal osteodystrophy
and soft tissue calcification, which contribute to morbidity
and mortality.
28. Preparation for Renal Replacement
Therapy
⚫Patients of CKD Stage IV approaching Stage V should be referred for
Vascular access ifhemodialysis is preferred
Peritoneal dialysis catheter placement if peritoneal dialysis is
preferred
⚫AVF is most preferred access for HD patients
Ideally created 6 months prior to start of HD
Non dominant upper extremity
And that arm is to be preserved – no iv lines
⚫AVG : 3-6 weeks prior to start of HD
⚫PD Catheter : 2 weeks prior to start of HD