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CKD

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Ahmad Baolayyan
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7 views

CKD

Uploaded by

Ahmad Baolayyan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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• Chronic renal failure is caused by a progressive decline in all kidney functions, ending with

terminal kidney damage. During this time, there is modulation and adaptation in the still-
functional glomeruli, which keeps the kidneys functioning normally for as long as possible. The
remaining glomeruli, therefore, experience a rise in pressure through hyperfiltration. The
release of various cytokines and growth factors leads to hypertrophy and hyperplasia. At the
same time, the function of the glomeruli suffers due to the excessive demands on them, leading
to increased permeability and proteinuria. Increased protein concentrations in the proximal
tube system are direct nephrotoxins and can further impair kidney function.

• The kidney functions are to regulate what's in the blood, like remove waste and steady
electrolytes and regulate water and even make hormones. So, the blood will inter from the renal
artery to tiny clumps of arterioles call glomerular which where it will be filtering and the stuffs
that filtered will move to the renal tubule.

• The normal of GFR is >90ml/min

• Let’s look at the kidney or specifically at the nephron because we are talking about a decrease in
renal function, we’re really talking about this glomerulus and how its filtering specifically the
glomerular filtration rate or GFR so we’ll using that term a lot GFR because if we understand the
GFR so everything else tends to make sense okay. So, the kidney the functional unit that actually
produces urine are the nephron, and each kidney has millions of these nephrons and the whole
goal is to filter our blood that are received from the heart and the glomerulus is the structure
that does that. So, filters substances such as water, ions which like electrolyzed like that, and
urea which is waste product from protein right down in liver, and creatinine which is waste
product from the breakdown of muscles.

• So, glomerulus does not filter proteins and blood cells, you should not find that in your filtrate
unless your glomerulus is messed up and in CKD its messed up.

• Normally it will filter in glomerulus and go down through the renal tubules which will tweak that
filtrate and take what the body need to maintain homeostasis so it reabsorbs water, urea and
electrolytes that we need but it will not reabsorb creatinine because its already filtered in
glomero from bloodstream and because that we care about creatineine when we measure the
urine in blood coz it will give a good indicator of glomerulus function.

If GFR id decrease the urea an, creatinine is going to increase in our body ofc which lead to problems like
Asia tinea, uranium or neurological changes and itching. So, the fluid status is overload coz the
glomerulus is not removing the water. Now what will happen if there’s too much water in the blood, we
have a lot of pressure in there mean our blood pressure is going to be high (hypertension) this can cause
a lot of pressure on the heart which can cause to become weak which can lead to fluid backing up into
the lung so mean pulmonary edema, cardiac issues.

So, if the glomerulus is not filtering, the urinary output will decrease ofc and electrolytes also (if
phosphate is high mean calcium is lower. Ofc if blood not filtered the protein is high in blood mean pt.
has proteinuria. And blood in urine
also, Patient is also experiencing anemia, (loosing RBC and decrease hormone EPO)/ evidence with a
hemoglobin level of 8.7 g/dL, and early signs of a bone and mineral metabolism disorder.

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