Chronic Renal Failure Flashcards
What is Chronic Renal Failure?
End-stage kidney failure
What can cause Chronic Renal Failure?
- May result from glomerular (RPGN, Nephrotic syndrome), tubular, inflammatory or vascular insults
- Can come from any compartment of the kidney
What are the three most common causes of Chronic Renal Failure?
- Diabetes Mellitus
- Hypertension
- Glomerular Disease
What can Chronic Renal Failure cause that leads to a constellation of symptoms?
Uremia!
What is Uremia?
Increased nitrogenous waste products in the blood (azotemia)
What does uremia cause?
- Nausea
- Anorexia
- Pericarditis
- Platelet dysfunction (inhibits adhesion and aggregation)
- Encephalopathy with asterixis (flapping hand tremor)
- Deposition of urea crystals in the skin
What causes HTN in Chronic Renal Failure?
Salt and water retention –> leads to resultant HTN
With Chronic Renal Failure, you can’t excrete K+ or get rid of organic acids. What does this cause?
- Hyperkalemia
- Metabolic acidosis with an anion gap
What causes anemia in Chronic Renal Failure?
Decreased Erythropoietin production by renal peritubular interstitial cells
What two things cause Hypocalcemia in CRF?
- Decreased 1-alpha-hydroxylation of vitamin D by proximal renal tubule cells
- Hyperphosphatemia
What causes hyperphosphatemia in CRF? How does this lead to hypocalcemia?
- Kidney is failing –> can’t excrete PO4-
- Inc. PO4- binds free Ca2+
- Causes Hypocalcemia
How does decreased 1-alpha hydroxylation of vitamin D cause hypocalcemia?
Vitamin D promotes absorption of Ca2+ so less Vitamin D leads to less Ca2+.
Where does 1-alpha hydroxylation of Vitamin D occur?
Proximal Renal Tubule Cells
What is renal osteodystrophy?
Bone damage caused by renal failure. It has 3 parts.
What are the three parts of osteodystrophy?
- Osteitis fibrosa cystica
- Osteomalacia
- Osteoporosis
