Pathophysiology of renal failure

Posted by e-Medical PPT
The most important functions of the kidney
To keep osmotic pressure
To regulate salt and water balance
To excrete metabolic byproducts
To excrete toxic compounds
Acid-base regulation
Endocrine function (erythropoetin, etc)
Synthesis of enzymes and regulatory compounds

Definition of acute renal failure
It develops in days or weeks
It can be best characterized as a serious decrease in the glomerular filtration (GFR).

Causes
Prerenal-blood supply failure
Postrenal-obstruction of the urinary system
Intrinsic (40%)-damage to the kidney itself

Prerenal
Hypovolemia
Hepatorenal syndrome
Atheroembolic renal disease
Renal vein thrombosis


Consequences of acute renal failure
Thirst feeling increases-
 Increased fluid intake
 Hyposmotic hypervolaemia
 Edema - hyponatraemia
Hyperkalaemia
Disturbed H+ excretion - metabolic acidosis
Increase in plasma urea and creatinine concentrations
Thromboses, anemia, hemolysis
Plasma phosphate conc. increases,Plasma Ca++ level decreases

Chronic renal failure
Slow but irreversible death of nephrons, accompanied by a continuous decrease of renal function.

Pathomechanisms
Hypertension
Diabetes mellitus
Glomerulonephritis
HIV nephropathy
renal artery stenosis and small vessel disease
hemolytic-uremic syndrome and vasculitis
lupus nephritis
drug and toxin-induced chronic tubulointerstitial nephritis and reflux nephropathy
Obstructive such as with bilateral kidney stones and diseases of the prostate

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