Renal failure – B. Pharma 2nd Semester Pathophysiology notes pdf

Renal failure

Renal failure, Explain the pathogenesis involved in acute renal failure, Explain the pathogenesis involved in chronic renal failure

Objective

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

Introduction

In the intricate realm of human physiology, the kidneys play a vital role in maintaining the body’s overall health. Renal failure, whether acute or chronic, can be a daunting health condition. This article delves into the pathogenesis of acute renal failure (ARF) and chronic renal failure (CRF), shedding light on the underlying causes, risk factors, and potential treatments.

Understanding Renal Function

Before delving into the complexities of renal failure, let’s first grasp the fundamental role the kidneys play in maintaining our well-being. The kidneys are responsible for filtering the blood, eliminating waste products, regulating electrolytes, and balancing bodily fluids. They also contribute to blood pressure regulation and the production of essential hormones, including erythropoietin.

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

•       Chronic renal failure

Acute renal failure,  Chronic renal failure

Acute renal Failure

       Kidney stops functioning all of a sudden

Acute renal failure, also known as acute kidney injury (AKI), is a sudden and often reversible decline in kidney function. This condition can be triggered by various factors, including:

1. Prerenal Causes

Prerenal causes of ARF are often related to insufficient blood flow to the kidneys. Conditions such as dehydration, severe blood loss, and heart failure can lead to prerenal ARF.

2. Intrinsic Causes

Intrinsic ARF arises from direct kidney damage, which can result from infections, medications, or contrast dyes used in medical imaging.

3. Postrenal Causes

Postrenal ARF is caused by obstructions in the urinary tract, preventing the normal flow of urine. Common culprits include kidney stones, tumors, or an enlarged prostate.

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

Manifestations of acute renal failure

Chronic renal failure

       Progressive & irreversible damage in GFR

       Slow destruction of renal tubule

       Leads to death

Chronic renal failure, also known as chronic kidney disease (CKD), is characterized by a gradual and irreversible decline in kidney function over an extended period. This condition often progresses in stages, ranging from mild to severe.

1. Diabetes

Diabetes mellitus is a leading cause of CRF. Prolonged high blood sugar levels can damage the small blood vessels in the kidneys, leading to impaired renal function.

2. Hypertension

Chronic hypertension places a constant strain on the blood vessels in the kidneys, ultimately leading to reduced kidney function over time.

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

Extra renal manifestation

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

Diagnosis and Treatment

Both ARF and CRF are diagnosed through blood tests, urine analysis, and imaging studies. Timely diagnosis is crucial for effective management.

Treatment Options

  • In the case of ARF, treatment focuses on addressing the underlying cause and supporting kidney function through fluid and electrolyte balance.
  • For CRF, management includes dietary modifications, blood pressure control, and medications to alleviate symptoms and slow down the progression of the disease.

Conclusion

Renal failure, whether acute or chronic, is a serious health concern that can significantly impact one’s quality of life. Understanding the pathogenesis of these conditions is the first step towards prevention and effective management. It is imperative to maintain a healthy lifestyle, manage underlying health conditions, and seek prompt medical attention when symptoms arise.

FAQs

1. What are the early signs of acute renal failure?

The early signs of acute renal failure may include decreased urine output, swelling, fatigue, and confusion.

2. Can chronic renal failure be prevented?

While some causes of chronic renal failure, like genetics, cannot be prevented, lifestyle changes and managing conditions like diabetes and hypertension can help reduce the risk.

3. Is dialysis the only treatment for chronic renal failure?

Dialysis is a common treatment for severe chronic renal failure, but it is not the only option. Early intervention and management can delay or prevent the need for dialysis.

4. How can I protect my kidney health?

To protect your kidney health, stay hydrated, maintain a balanced diet, control blood pressure and blood sugar levels, and avoid excessive use of over-the-counter pain medications.

5. What is the link between acute and chronic renal failure?

Acute renal failure can, in some cases, lead to chronic renal failure if not treated promptly and effectively. Early intervention is critical in preventing the progression of the disease.

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

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