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Pathophysiology of Chronic Renal Failure: By: Jonnel Montoya Musngi BSN 4-B
Pathophysiology of Chronic Renal Failure: By: Jonnel Montoya Musngi BSN 4-B
Chronic Glomerulonephritis
Chronic Pyelonephritis
HPN
Renal Blood Renal Reserve Damage to Nephrons 50% damage More than 75% damage Renal Insufficiency As nephrons are destroyed, the remaining nephrons undergo changes to compensate for those Remaining nephrons must filter more solute particles from the Hypertrophy of remaining nephrons Nephrons cannot tolerate the work Further damage of nephrons 80-90% damage Renal Failure Impaired kidney function & Uremia GFR 20-50% BUN, Creatinine GFR 50% Normal BUN, Creatinine
As cysts fill, enlarge & multiply, kidneys also enlarge Renal blood vessels & nephrons are compressed & obstructed & functional tse. are destroyed Renal Parenchyma atrophies & become fibrotic & scarred
Production of large variety of auto antibodies against normal body components such as nucleic acids, RBC, platelet, and WBC SLE antibodies react with their corresponding antigen
Glomerulosclerosis impairs the filtering fxn. of the glomerulus thus protein lost in urine
Stage
Stage
K retention
+
H retention
+
Blood
Erythropoietin production
Mg retention
+
Vit. D activation
Continuous decline in renal fxn. > 90% kidney Reduction in renal capillaries Scarring of Glomeruli Atrophy & Fibrosis of Stage End Stage Renal Dse. (ESRD) Continuous Multisystem Affectation Death
Bleeding tendencies
Hypermagnesemia Anemia
Toxins impair WBCs, humoral & cell mediated immunity; Fever is suppressed; Phagocyte becomes defective
Toxins affect the nerve fibers Atrophy & Demyalination Peripheral Neuropath Restless Leg Syndrome
Toxins causes CNS affectation Uremic Encephalopathy Reduction in alertness & awareness Changes in mentation Difficulty of concentrating Fatigue Insomnia Psychiatric symptoms
Retentio n of Cells become resistant to insulin Erratic blood glucose level Because of glucose intracellularly, liver produces tryglycerides & HDL
Malfunction of RAAS
GI bleeding
Hypocalcemia Parathyroid overworks (Hyperparathyroidism) PTH secretion Ca+ resorption from bone + Ca absorption from GI tract Renal Osteodysthrophy Osteomalacia Osteoporosis Bone tenderness Bone pain Muscle Weakness
Edema
Heart Failure
Atherosclerosis