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Chronic renal failure
ASSPITE
10
Medical
Undergraduate 3
05/17/2008

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Cards

Term
give the three classes (+examples) of chronic renal failure.
Definition
Pre-renal
1.renal artey disease eg stenosis = decreased glomerular filtration rate and hypertension
2. Severe HF = decreased kideny perfusion

Renal
1 chronic glomerularnephritis
2 diabetic nephropathy
3 toxic eg drugs cyclosporine and gold

Post renal
1 obstuctive uropathy
Term
What is the mechanism of disease in glomerulonephritis?
Definition
= inflammatory condition involving glomerular filtration membrane. Associated with loss of charge on membrane.
Excess glomerular filtration and protein leakage, but DECREASED glomerular filtration rate.
Term
What is the pathological mechanism of diabetic nephropathy?
Definition
BM thickening
Expansion of mesangium (increased glomerular kPa)
Hyaline thickening of afferent/efferent arterioles = stenosis
glomerular scarring
Term
Define chronic renal failure.
Definition
Progressive decline in renal function where GFR decreases until can no longer sustain life.
Term
What are the consequences of chronic renal failure?
Definition
Decreased EPO = normocytic normochromic anaemia
Volume overload = HR/Hypertension/oedema
Uraemic syndrome = N/V/jaundice/puritus/pericarditis/drowsiness
Bone disease - dec alpha-1-hydroxylase = decreaded formation of active Vit D = dec Calcium absorption from GIT (as decreased calbindin) = 2ry hyperparathyroidism
Impaired ecretion of water/Acid/K
Term
What are the 2 principles of management in acute renal failure?
Definition
1. renoprotection
2. Correct complications
Term
What constitutes "renoprotection"?
Definition
= Correct BP and decrease BP
ACE Inhibitior
Ang II recep blocker
Diuretics
Term
How do you manage the aditional complications of renal failure?
Definition
EPO injections
Replace viotamin D alfacalcidol
Oral CaCO3 = calcichew
low potassium diet
Term
What are the 2 different types of dialysis
Definition
Haemodialysis
Peritoneal dialysis
Term
What 4 problems are associated with haemodialysis?
Definition
Hypotension
allergy
clots
Infection
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