REVIEW ON RENAL FAILURE

A project Report submitted to

Faculty of Pharmacy, Dharmsinh Desai University, Nadiad.
In partial fulfillment for the degree of
Bachelor Of Pharmacy

Submitted By: Guided by:

Desai Divya Dr. Anand B. Pithadia
ID No: 16PHUOS016 Assistant professor
Department Of Pharmacology
 CERTIFICATE

This is to certify that Project report entitled To study Renal failure", was carried
out by Ms. Divya Desai under my supervision and guidance for partial
fulfillment of B.Pharm degree to be awarded by Dharmsinh Desai University,
Nadiad. This work has been carried out under my supervision and is to my
satisfaction.

Date:
Place:

GUIDE: DEAN:
Dr.Anand Pithadia Dr.B.NSuhagia
Faculty of pharmacy Faculty of pharmacy
Department of Pharmacology
andDharmsinh Desai

University,toxicologyNadiad
 ACKNOWLEDGEMENT

This thesis has become a reality with the kind support and help of many individuals. I would like
extend my gratitude and sincere thanks to all of them. foremost, I would like to express my sincere
gratitude to my mentor Dr. Anand B. pithadia of department of pharmacology and toxicology for the
continuous support towards my review, for his patience, motivation, enthusiasm and immense
knowledge. His guidance helped me during review and writing thesis.

Humble thanks to Dr B. N suhagia, dean of faculty of pharmacy DDU,nadiad for enlightening me

with his knowledge.

Finally, I must express my very profound gratitude to my parents, Mr. Santosh Desai and Mrs. Kokila
Desai for providing me with unfailing support and continuous encouragement throughout my years of
study and through the process of review and writing this thesis. This accomplishment would not have
been possible without them.

I would also like to thanks Priya bachanito help during my review.

My thanks and appreciation also goes to my colleagues and people who willingly helped me out with
my abilities.
 INDEX
Sr.no. Content
1 Abstact
2 Introduction
3 Classification
4 Acute renal fuilure
4.1 Introduction
4.2 Epidemiology
4.3 Causes,sign& symptoms
4.4 Pathophysiology
4.5 Diagnosis
4.6 Treatment
5 Chronic renal failure
5.1 Introduction
5.2 Epidemiology
5.3 Causes & symptoms
5.4 Diagnosis
5.5 Stages
5.6 Treatment
5.7 Supportive treatment
6 Life style changes
7 References
 INTRODUCTION

 Renal Failure are known as end-stage kidney failure. In this disease the kidney
work less than 15% than normal condition.
 In kidney failure the kidney indicate incapacity to perform excretory function it
stop to retention of nitrogenous waste products from the blood. Function of
kidney are ; 

1) Electrolyte and volume regulation.

2) Elimination of nitrogenous waste product.
3) Elimination of external moleceules.
4) Synthesis of a variety of hormones.
5) Metabolism of low molecular weight protein.
 CLASSIFICATION

1. Acute kidney failure

2 .Chronic kidney failure

 Acute kidney failure

Acute renal failure is characterize

by duration of renal function over a
period of hours to few day resulting
in failure of kidney to remove
nitrogenous waste product and to
maintain fluid electrolyte and acid
base equilibrium or balance
 Introduction

Acute renal failure defined as a suddenly decrease in renal filtration

function. Condition is usually marked by a increase in serum creatinine
concentration or by uremia ( A increase in blood urea nitrogen [BUN]
concentration).
Acute renal failure is syndrome in which glomerular filtration decrease
suddenly and is generally reversible. According to KDIGO criteria in 2012
acute renal failure can diagnosed is following

1) Creatinine increase 0.3mg/dL in 48 hours.

2) Creatinine increase to 1.5 time baseline within last one week
3) Urine volume less than 0.5ml/kg/hr for 6 hour
  EPIDEMIOLOGY

In 2013 the unadjusted rate of acute renal

failure hospitalize in major medical
population decrease by 4.9%. This decrease
was observed all age and race group.

In medicare patients ages 66 and older

with acute renal failure hospitalize in 2011
the additive expectation of a repeated acute
renal failure hospitalize within 2 year was
48%.

Among medicare patient ages 66 and

older with first acute renal failure
hospitalize in death rate in 2013 was 9.5%
and less than half patient were discharge to
their home.
 CAUSES

Acute renal failure most frequently a complication of serious sickness is

heart and liver failure ,serious infection dehydration , sever burn and
excessive bleeding.

Also caused by barrier to the urinary track or direct kidney disease, injury
and side effect of drug.

•In these condition acute renal failure divided in to three type;

1. Prerenal
2. Postrenal
3. intrinsic
 PATHOPHYSIOLOGY

•Pathophysiology of acute renal failure is divided into three part:

1. Prerenal
2. Intrarenal
3. Postrenal

Three Distinct Phases

1) Oliguric,
2) diuretic,
3) recovery
 DIAGNOSING

 . Urine specific gravity: Prerenal value is more than 1.020 and intrarenal value is
1.010 to 1.020

 BUN: Prerenal value is more than 20:1 and intrarenal value is 10-20:1

 Urine osmolality: Prerenal value is more than 500 mosm/kg and intrarenal value
is 300-500 mosm/kg

 Urine sodium: Prerenal value is 10 mEq/L or less and intrarenal value is 20

mEq/L or more

 Urine sediment: Prerenal vsalue is hyaline casts and itrarenal value is granular
casts

 Fraction excretion of sodium percent: Prerenal value is less than 1 and intrarenal
value is more than 1.
  TREATMENT
 Treatment of acute renal failure commonly requires a hospital stay.

 Most of patient with acute renal failure are already hospitalize. In some cases kidney
are recover at home

 If kidney are not completely filtering potassium from blood ,doctor are prescribe
calcium,glucose or sodium polystyrene sulfonate to prevent to collection of high level
of potassium in blood

 If calcium level of blood is very low in these case doctor are recommend infusion of
calcium

 If toxin build up in blood,so patient can need temporary hemodialysis. Simple dialysis
to help remove toxin and excess fluid from body.

 If kidney are not completely filtering potassium from blood ,doctor

are prescribe calcium, glucose or sodium polystyrene sulfonate to
prevent to collection of high level of potassium in blood. High level of
potassium in blood is dangerous irregular heartbeat and muscle
weakness.
 CHRONIC RENAL FAILURE

Chronic renal failure also known as chronic kidney

disease is a continues loss in renal function over a period of
months or years.

Chronic renal failure is identify as result of screening of

patient know to be a risk of renal problem such as those
with high blood pressure and diabetes and those blood
relative with chronic renal failure.

 It is a different from acute renal failure in that reduction

in kidney function mustbe present over 3 month.

Chronic renal failure is recognize by blood test for

creatinine. High level of creatinine specify low glomerular
filtration rate and a result decrease ability of renal to
remove waste product.

Kidney damage for grater than or equal to 3 months as

define functional abnormalities of the kidney with or
without decrease glomerular filtration rate.
 EPIDEMIOLOGY

16.5
18
16 16
14
15.5 12
10
15 8
6
14.5 Series 3
4 Series 3
2
14
0

13.5

13
male female total

Age-adjusted prevalence of Age-adjusted prevalence of chronic

chronic renal failure stage 1-4 by renal failure stage 1-4 by race 1999-
gender 1999-2012 2012
 CAUSE AND SYMPTOMS

Causes of chronic renal failure like hypertension,diabetic renal failure,

vascular disease,glomerular disease ,cystic renal failure, urinary track
dysfunction, nephritis, kidney stone, birth defects of renal blader and
unrecovered acute renal failure.

Symptoms of chronic renal failure like tiredness,weakness, change taste,

change in mental state, sleeping disturbance,nausea,itching,shortness of
breath,high blood pressure vomiting, cheast pain , loss of appetite, change in
urine output ,hiccups and muscle crams.
 DIAGNOSIS

Blood test: In these test kidney function look for the waste products level, like
creatinine and urea in blood.

Urine test: In these test urine sample is analyzed it is reveal abnormalities maximum
level is identify the chronic renal failure.

Imaging test: In these test use computerize and ultrasound help in evaluate the size and
structure of kidney.

Removing the kidney tissue sample for testing the chronic renal failure. Doctor can
recommend a biopsy of kidney to remove the kidney tissue sample.
 TREATMENT

Chronic renal failure is cannot be cure, it is possible the damage to the kidney in most of
patient. Doctor are recommend the following,
Control the protein in the urine by limit the amount of protein in the deit plan.
In some cases of patient taking the ace inhibitor or angiotensin III receptor antagonist to
responsible for slow development of chronic renal failure.
Also reduce the dose of drug that may toxic to the kidney.
Lowering high blood pressure, blood sugar and lipid level are control, control salt in diet
plan, avoid smoking, if undergoing dialysis a medical prosess is clean blood, and kidney
transplant.
Treatment are depend on stage of chronic renal failure.stage 1,stage 2,and stage 3 are
usually treated by GP.
Treatment involves making the changes to lifestyle and other cases take the like blood
pressure, cholesterol level. This should help to prevent damage to kidney circulation.
If some cases patient have stage 4 and stage 5chronic renal failure ,to be referred to a
specialist.
If the patient have renal failure, need to decide on next stage of treatment. choise are
treatment with dialysis and kidney transplant or other treatment called supportive care.
 LIFE STYLE CHANGES

The following lifestyle changes are known as help to decrease blood pressure
and control of acute renal failure like to avoid smoking, eating healthy ,

low fat, maintain diet food, reduce your salt intake to less than 6g a day not
using over the counter no steroidal anti-inflammatory drug, such as ibuprofen.
Avoid alcohol consumption.

Loss weight if patient is overweight.

Most importantly to decrease the development of renal damage

is to maintain high blood pressure.Good control of blood
presuure is to protect the kidney

Ramipril,enalpril,lisinopril,perindopril etc. Side effect are ace

inhibitors like dry cough,dizziness weakness,headaches.
 
thank you