Renal failure

Contents

• Renal failure

• Pathogenesis of acute renal failure

• Pathogenesis of chronic renal failure

Objectives

At the end of this PDF Notes, student will be able to

• Define Renal failure

• Explain the pathogenesis involved in acute renal failure

• Explain the pathogenesis involved in chronic renal failure

Renal Failure

• Cessation of glomerular filtration as kidney fails to function normally

• Leads to accumulation of Urea, creatinine

Two type of Renal failure

• Acute renal failure

• Chronic renal failure

Acute renal Failure

• Kidney stops functioning all of a sudden

Categorized by

• Oliguria

• Anuria

• Accumulation of metabolites

Etiology of acute renal Failure

Pre renal cause

• Causes above the level of kidney

• Reduction in blood volume

• Renal ischemia

Intra renal causes

• Glomerular disease

• Disease of renal tubules

• Pyelonephritis

Post renal causes

• Obstruction of urine flow

Other causes – kidney stones drugs

Manifestations of acute renal failure

Chronic renal failure

• Progressive & irreversible damage in GFR

• Slow destruction of renal tubule

• Leads to death

Etiology of Chronic renal failure

• Chronic glemerulo nephritis

• Diabetic nephropathy

• Polycystic kidney disease

• Exprosure to nephrotxins

Clinical Manifestations of Chronic renal failure

Renal manifestation

• Metabolic acidosis

• Hyperkalaemia

• Sodium & water retention

• Azotemia

Extra renal manifestation

• Anaemia

• Ureamic frost

• Pulmonary congestion

• Azotemia

• Osteomalacia

Pathogenesis of Chronic renal failure

Mild CRF

• Decreased renal reserve

• GFR 50% of normal filtration

• Renal parenchyma is marginally lost

• Patient asymptomatic

Moderate CRF (Renal insufficiency)

• 75% of renal parenchyma gets destroyed

• GFR 25% of normal value

Severe chronic renal failure

• 90% renal parenchyma damage

• GFR 10% of normal values

• Tubular cells non functional

• Imbalance in sodium & water retention

Final stage of kidney

• Renal parenchyma completed destroyed

• GFR 5% of normal value

• Complete accumualtion of waste products

• Require dialysis therapy

Summary

• Renal failure is the cessation of glomerular filtration as kidney fails to function normally

• It Leads to accumulation of Urea, creatinine

• Renal failure is of two kinds - Acute and chronic renal failure

• In ARF, kidney stops functioning all of a sudden and is categorized by oliguria, anuria, accumulation of metabolites

• CRF is characterized by Progressive & irreversible damage in GFR , slow destruction of renal tubule, leading to death