重庆医科大学：《内科学》课程教学课件（PPT讲稿）Chronic Renal Failure

Chronic Renal Failure Nephrology department The second affiliated hospital zhongling

Nephrology department The second affiliated hospital zhongling Chronic Renal Failure

contents ·Function of kidneys ●Definitions ·Causes ·pathogenesis ·Symptoms and signs ●Diagonosis o treatment

contents • Function of kidneys • Definitions • Causes • pathogenesis • Symptoms and signs • Diagonosis • treatment

I.Function of kidney oExcrete wastes with water to make urine oregulate and maintaine water,electrolyte and acid-base balance. Secrete hormomes erythropoietin;renin; 1-hydroxylase enzyme (active vitamin D) and prostaglandins

Ⅰ.Function of kidney • Excrete wastes with water to make urine • regulate and maintaine water , electrolyte and acid-base balance. • Secrete hormomes, erythropoietin; renin; 1- hydroxylase enzyme (active vitamin D) and prostaglandins

So,they are crucial in the regulation of blood pressure,formation of matured red blood cells,and metabolism of calcium and phosphorus

• So, they are crucial in the regulation of blood pressure, formation of matured red blood cells, and metabolism of calcium and phosphorus

I.Definitions Azotemia-is a medical condition characterized by abnormal levels of urea, creatinine,various body waste compounds, and other nitrogen-rich compounds in the blood as a result of insufficient filtering of the blood by the kidneys.(Cr> 1.5mg/L×88umol/L)

Ⅱ.Definitions • Azotemia—is a medical condition characterized by abnormal levels of urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood as a result of insufficient filtering of the blood by the kidneys.(Cr＞ 1.5mg/L×88umol/L)

oUremia-azotemia with symptoms or signs of renal failure.Uremia is a clinical syndrome associated with fluid,electrolyte, and hormone imbalances and metabolic abnormalities,which develop in parallel with deterioration of renal function

• Uremia—azotemia with symptoms or signs of renal failure.Uremia is a clinical syndrome associated with fluid, electrolyte, and hormone imbalances and metabolic abnormalities, which develop in parallel with deterioration of renal function

End stage renal disease(ESRD)-the kidneys permanently fail to work.ESRD is irreversible and lethal if untreated. Requiring transplantation or dialysis

• End stage renal disease(ESRD)—the kidneys permanently fail to work. ESRD is irreversible and lethal if untreated. Requiring transplantation or dialysis

Chronic renal failure(CRF)-is characterized by progressive and irreversible loss of large numbers of functioning nephrons.Serious clinical symptoms often do not occur until the number of functional nephrons falls to at least 70 per cent below normal

• Chronic renal failure(CRF)- is characterized by progressive and irreversible loss of large numbers of functioning nephrons. Serious clinical symptoms often do not occur until the number of functional nephrons falls to at least 70 per cent below normal

Chronic renal failure(CRF) Occurs when compensatory mechanisms of the diseased kidneys are no longer able to maintain the EXCRETORY, REGULATORY,and ENDOCRINE functions of the kidneys Resultant retention of nitrogenous solutes,derangements of fluid,electrolyte and acid-base balance,and failure of hormone production constitute CRF

Estimation of renal function GFR -glomerular filtration rate is the best test to measure the level of kidney function and determine the stage of kidney disease.GFR is the volume of fluid filtered from the renal glomerular capillaries into the Bowman's capsule per unit time

Estimation of renal function • GFR - glomerular filtration rate is the best test to measure the level of kidney function and determine the stage of kidney disease. GFR is the volume of fluid filtered from the renal glomerular capillaries into the Bowman's capsule per unit time