What is chronic renal failure || What is cause, clinical features and management of chronic renal failure ?

Chronic renal failure:-

What is chronic renal failure || What is cause, clinical features and management of chronic renal failure ?

* Chronic kidney disease is characterized by an irreversible deterioration of renal function that gradually progress to endstage renal disease.

Causes :-

¤Genetic

    -Hereditary disorders including juvenile.        nephronophthisis.

- Autosomal recessive polycystic kidney disease

- Congenital nephrotic sydrome 

- Laurence moon biedl syndrome

¤Chronic glomerulonephritis 

¤ Reflux nephropathy 

¤ Obstructive uropathy 

¤ Neurogenic bladder

¤ HUS 

¤ Renal dysplasia

¤ Hereditary nephropathy

¤ Miscellaneous

¤ Chronic pyelonephritis.

Clinical Features:-

• Polydipsia and nocturia

The signs and symptoms in advanced chronic kidney disease may includes:-

 -Volume overload

  Hyperkalemia

Metabolic acidosis

Cardiac abnormalities

Hypertension

Anemia

Bone disease

Cardiovascular disease

Anorexia

Nausea 

Vomiting.

Management:-

• Close monitoring of a patients clinical and laboratory status
• Blood studies: Hemoglobin level and serum electrolytes, blood urea nitrogen, creatinine, calcium, phosphorus, albumin and alkaline phosphatase
• Intact parathyroid hormone level and roentgen graphic studies
• Echocardiography
• Strict blood pressure control
• Angiotension converting enzyme 
• Angiotension 2nd receptor blocker
• Lipid lowering therapy 
• Correction of anemia
• Management of proteinuria and blood pressure
• Antihypertensive therapy for both renal protection and cardiovascular protection
• Whose renal failure is a consequence of renal dysplasia may be polyuric with significant urinary sodium losses
• Sodium restriction and diuretic therapy
• Fluid restriction is rarely necessary until the development
• ESRD requires the intitiation of dialysis.

Hemodialysis:-

• Performed in a hospital setting
• 3-4 hours. Session with frequency of 3 sessions per week.
• Acess surgically created arteriovenous fistula graft or indewelling subclavin or internal jugular catheter.
• Blood is circulated through an extracorpprenal circuit that includes a hollow dialyzer ( artificial kidney )
• Anticoagulation of the circuit is done through systemic heparinization.

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