CHRONIC RENAL FAILURE TO ESRD

Thickening and/or an in the amount of collagen in the basement membranes of the small vessels

Impaired/sluggish blood flow

Glomerulosclerosis

GFR (Glomerular Filtration Rate) proteinuria

Renal blood

Stage I DIMINISHED RENAL RESERVE GFR 50%

Normal BUN, creatinine More than 75% damage

Stage II RENAL INSUFFICIENCY GFR 20-50% BUN, creatinine levels begin to rise

Remaining nephrons undergo changes to compensate for those damaged nephrons

Filtration of more concentrated blood by the remaining nephrons

Hypertrophy of nephrons Intolerance and exhaustion of the remaining nephrons Further damage of the nephrons 80-90% damage

Stage III RENAL FAILURE GFR 10-20%

Impaired kidney function and Uremia

- Reduction in renal capillaries -Scarring of Glomeruli - Atrophy & Fibrosis of Renal tubules

> 90 % of kidney damage

Malfunction of RAAS

Nitrogenous wastes impairs platelets Bleeding tendencies ANEMIA

Decreased Erythropoietin Production Continuous decline in renal function -fatigue - weakness

Toxins irritate pericardial sac Pericarditis

Toxins impair immune system Decreased Immune system Risk for superinfection

Urea deposits on the skin

Na & H2O retention

Cardiac Tamponade

Uremic frost

Decreased Urine Output Oliguria Hypertension Continuous Multisystem Affectation Multiple Organ Failure Increased blood pressure Edema Pulmonary Edema, Peripheral Edema Stage IV END-STAGE RENAL DISEASE (ESRD) GFR <10% Sepsis

Toxins affect CNS

Uremic Encephalopathy -changes in mentation/ psychiatric symptoms -irritability -fatigue -insomnia

Heart Failure

DEATH