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RENAL

FAILURE

Prepared by:

Alhane Ann Enriquez

Pathophysiology - MAN

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INCIDENCE

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INCIDENCE

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RENAL FAILURE

Abrupt in onset

Reversible

Causes:

Prerenal Intrarenal

Postrenal

End result of thedamage to thekidneys

Irreversible

destruction

Acute Renal FailureChronic Renal Failure

Failure to remove metabolic end-products from the

blood and regulate the fluid, electrolyte and pH balanceof the ECF.

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PREDISPOSING FACTORS

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PREDISPOSING FACTORS

Diabetes It is the most common

cause of kidney failure,accounting for nearly 44percent of new cases.

Almost 40% of newdialysis patients havediabetes, making it thefastest growing riskfactor for kidney

disease. Type 2diabetes is the numberone cause of kidneyfailure

Source: United States Renal DataSystem. USRDS 2007 Annual Data

Report.

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o Hypertensiono is a major factor in the development of kidney problems in

people with diabetes.

High bloodpressure

Renal tubularperfusion

PREDISPOSING FACTORS

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o Atherosclerosis

o deposition of various fatty substances on the liningsof the arteries carrying blood; hence, causing

hardening of the arteries.

Hardening of thearteries

Blood supply tothe kidneys

PREDISPOSING FACTORS

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o Overuse of Painkillers and Allergic Reactionsto Antibiotics

o Heavy use of painkillers containing ibuprofen, or

naproxen have been linked to interstitial nephritis, akidney inflammation that can lead to kidneyfailure.

PREDISPOSING FACTORS

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o Drug Abuseo Use of certain nonprescription drugs, such as heroin

or cocaine, can damage the kidneys, and may leadto kidney failure

PREDISPOSING FACTORS

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Other factors:

a. Family History of Kidney Disease

b. Premature Birth

c. Age

d. Trauma or Accident

e. Certain Disease

PREDISPOSING FACTORS

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Prerenal Intrarenal Postrenal

A rapid decline in renal function sufficient toincrease blood levels of nitrogenous wastes andimpair fluid and electrolyte balance.

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INTRARENAL (ACUTE TUBULARNECROSIS)

THREE PHASES: Oliguric phase (lasting for 36 hours)

characterized by further damage to the renaltubular wall and membranes

Diuretic Phase source of obstruction has been removed but the

residual scarring and edema of the renal tubulesremains.

Recovery Phase edema decreases, the renal tubules begin to function

adequately

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INTRARENAL (ACUTE TUBULARNECROSIS)

Causes:Acute Tubular Necrosis

prolonged renal ischemia

exposure to nephrotoxic drugs, organicsolvents

acute renal disease (acuteglomerulonephritis)

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Tubule cell injury

Loss of cell

polarity Detachment

Nadelivery

Vasoconstriction

Luminalobstruction

IntratubularpressureHPN

GFR OLIGURIA

Edema

K

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Causes:Bilateral ureteral obstruction

Bladder outlet obstruction

POSTRENAL FAILURE

Obstruction ofurine outflow

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known as End-Stage Renal Disease (ESRD)

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Stages:

GFR

1. Renal Impairment 40 50% of normal

2. Renal Insufficiency 20% to 50%of normal

3. Renal Failure < 20% of normal

4. End-stage renal disease < 5% of normal

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Renal Failure

Sodium andwater balance

Elimination ofnitrogenous wastes

Erythropoietinproduction

Acid-basebalance

HPN

Vascularvolume

HeartFailure Uremia

Edema

GImanifestation

s

Neurologicmanifestation

s

Sexualitydysfunction

Anemia

Acidosis

Coagulopathies

Skeletalbuffering

Osteodystrophies

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THANK YOU!

On every thorn, delightful wisdom grows,In every rill a sweet instruction flows.

-Edward Young