Chronic renal failure Flashcards
The classification for chronic renal failure consists of the following categories: (1).
- diminished renal reserve, renal insufficiency, chronic renal failure, and end-stage renal disease
In (1) the patients are still asymptomatic and have (2) BUN and creatinine and (3) GFR
- diminished renal reserve
- normal
- 50% decrease in GFR
(4) presents with (1) and is found when GFR is (2). These patients can also have (3) from decreased urine concentrating ability.
- Renal insufficiency
- azotemia, anemia and hypertension
- reduced between 50-80% (20-50% of normal)
- polyuria and nocturia
asymptomatic, normal BUN and creatinine, 50% decrease in GFR
diminished renal reserve chronic renal failure
azotemia, anemia, hTN, 50-80% decrease in GFR, polyuria, nocturia
renal insufficiency
Chronic renal failure is present when GFR has fallen to less than (1)% of normal and the patients have (2).
- 20%
2. edema, metabolic acidosis and hyperkalemia
End-stage renal disease is present when the GFR is less than (1)% of normal.
- 5%
GFR 20-50% of normal
renal insufficiency
GFR less than 5% of normal
end stage renal disease
GFR less than 20% of normal
chronic renal failure
edema, metabolic acidosis, hyperkalemia
chronic renal failure
Chronic renal disease has a number of symptoms and findings which include (1)
- renal osteodystrophy (secondary hyperparathyroidism)
Secondary vs. primary hyperparathyroidism
calcium
PTH
phosphate
Secondary hyperparathyroidism with a low serum calcium but elevated PTH. Serum phosphate levels are usually elevated because of decreased phosphate excretion by the kidney whereas in primary hyperparathyroidism, serum phosphate levels are usually decreased and serum calcium is increased
In addition, there is less conversion to (1) by the diseased kidney.
1,25 vitamin D (Active vitamin D)
End stage renal patients also have (1), a white frost on the skin (from (2), (3) and (4) in part because less (5) is produced by the diseased kidney
- pericarditis
- elevated urea
- hyperkalemia, acidosis
- anemia
- erythropoietin