Hipopotasemia și Funcția Renală

Hipopotasemia and Related Conditions

• Hipopotasemia is caused by digestive losses, parenteral glucose solutions, alkalosis, or a return to diuresis.
• Hyponatremia is often below 130 mEq/L and results from hyperhydration, favoured by endogenous water release due to protein catabolism or oral/parenteral water intake (dilutional hyponatremia).
• Hypocalcemia is often associated with acidosis and hyperphosphatemia, though tetany attacks are not always present.
• Metabolic acidosis is constant, stemming from sulfate and phosphate accumulation in the plasma, and excessive hydrogen ion production (due to hypercatabolism).

Kidney Failure Stages and Phases

• Chronic Kidney Disease (CKD): A progressive and irreversible reduction in glomerular filtration determined by nephron damage. Various possible causes, including glomerular nephropathies (e.g., chronic glomerulonephritis, diabetic nephropathy), interstitial nephropathies (e.g., chronic pyelonephritis), tubulopathies, vascular nephropathies (e.g., nephrosclerosis), polycystic kidney disease, cancer, and chronic urinary tract obstruction.
• Phase of Diuresis Return (or Reabsorption): Lasts 2-3 weeks, characterized by polyuria (2000-4000 ml), low-concentrated urine, and frequently occurring fluid and electrolyte imbalances. A progressive decrease in nitrogenous substances occurs.
• Recovery Stage: May take weeks to 12 months, and often results in complete recovery, though residual damage is possible.

Kidney Failure Physiology and Etiology

• Kidney functions: The main functions include excretion of nitrogenous waste, regulating water and electrolyte balance, and endocrine functions. Impaired kidney function leads to nitrogenous waste retention, potentially worsening pre-existing hypertension, and reduced erythropoietin production causing anemia. Vitamin D deficiency contributes to renal osteodystrophy.
• Kidney Disease Classifications: Several classifications exist, including those based on the degree of renal function impairment (e.g., stage I-IV, using glomerular filtration rate [GFR] or levels of creatinine and urea in blood), and the presence of clinical symptoms.
• CKD classifications: A commonly used classification system, K/DOQI CKD, categorizes stages based on GFR. Common stages I-V exist ranging from a GFR greater than 90 ml/min to less than 15ml/min.
• Important Note:* This information is for summary purposes and requires further clinical investigation for proper diagnosis and treatment.