Renal Failure Overview

Definition: Sudden decrease in kidney function; can be reversible.
Causes:
- Pre-renal: Decreased blood flow (e.g., dehydration, heart failure).
- Intra-renal: Damage to kidney tissue (e.g., acute tubular necrosis, glomerulonephritis).
- Post-renal: Obstruction of urine outflow (e.g., kidney stones, tumors).
Symptoms:
- Oliguria or anuria
- Edema
- Electrolyte imbalances
- Nausea and vomiting
Diagnosis:
- Serum creatinine and blood urea nitrogen (BUN) levels
- Urinalysis
- Imaging (ultrasound, CT scans)
Management:
- Treat underlying cause
- Fluid management
- Medications (e.g., diuretics)

Definition: Gradual loss of kidney function over time; often irreversible.
Causes:
- Diabetes mellitus
- Hypertension
- Chronic glomerulonephritis
- Polycystic kidney disease
Symptoms:
- Fatigue and weakness
- Anemia
- Hypertension
- Changes in urine output
- Electrolyte imbalances
Stages:
- Stage 1: Mild damage, normal GFR (≥ 90 mL/min)
- Stage 2: Mild decrease in GFR (60-89 mL/min)
- Stage 3: Moderate decrease in GFR (30-59 mL/min)
- Stage 4: Severe decrease in GFR (15-29 mL/min)
- Stage 5: Kidney failure (GFR < 15 mL/min)
Management:
- Control blood sugar and hypertension
- Dietary modifications
- Renal replacement therapy (dialysis/transplantation)

Definition: Treatment that removes waste products and excess fluid when kidneys can't perform these functions.
Types:
- Hemodialysis: Blood is filtered through a machine; typically done 3 times a week.
- Peritoneal Dialysis: Uses the lining of the abdomen to filter blood; can be done at home.
Indications:
- Severe electrolyte imbalances
- Fluid overload
- Acidosis
- Uremic symptoms (nausea, vomiting, fatigue)
Complications:
- Infection (e.g., access site)
- Hypotension
- Anemia
- Bone disease

Cardiovascular Issues:
- Hypertension
- Heart failure
- Increased risk of cardiovascular disease
Electrolyte Imbalances:
- Hyperkalemia (high potassium)
- Hyperphosphatemia (high phosphate)
- Hypocalcemia (low calcium)
Metabolic Disorders:
- Metabolic acidosis
- Uremia (buildup of waste in blood)
Bone and Mineral Disorders:
- Osteodystrophy (bone pain, fractures)
- Calciphylaxis (calcification of small blood vessels)
Anemia:
- Decreased erythropoietin production
Infections:
- Increased susceptibility due to immune dysfunction and dialysis access sites

Sudden decline in kidney function; potential for reversibility.
Pre-renal causes include decreased blood flow from dehydration or heart failure.
Intra-renal causes involve damage to kidney tissue, such as acute tubular necrosis and glomerulonephritis.
Post-renal causes arise from urinary obstruction, e.g., kidney stones or tumors.
Common symptoms: oliguria (low urine output) or anuria (no urine output), edema, electrolyte imbalances, nausea, and vomiting.
Diagnosis performed through serum creatinine and blood urea nitrogen (BUN) tests, urinalysis, and imaging (ultrasound or CT).
Management focuses on treating the underlying cause, fluid management, and medications like diuretics.

Gradual and often irreversible decline in kidney function.
Major causes include diabetes mellitus, hypertension, chronic glomerulonephritis, and polycystic kidney disease.
Symptoms may include fatigue, anemia, hypertension, altered urine output, and electrolyte imbalances.
Progresses through five stages based on Glomerular Filtration Rate (GFR):
- Stage 1: Normal GFR (≥ 90 mL/min) with mild damage.
- Stage 2: Mild GFR decrease (60-89 mL/min).
- Stage 3: Moderate GFR decrease (30-59 mL/min).
- Stage 4: Severe GFR decrease (15-29 mL/min).
- Stage 5: Kidney failure (GFR < 15 mL/min).
Management strategies include controlling blood sugar and hypertension, dietary changes, and renal replacement therapy (dialysis or transplantation).

A therapeutic procedure that eliminates waste products and excess fluids when kidneys fail.
Hemodialysis filters blood via a machine, typically administered three times weekly.
Peritoneal Dialysis utilizes abdominal lining for blood filtration and can be performed at home.
Indications for dialysis include severe electrolyte imbalances, fluid overload, acidosis, and uremic symptoms such as nausea and fatigue.
Possible complications involve infection at access sites, hypotension, anemia, and bone disease.

Cardiovascular Issues: Hypertension, heart failure, and heightened risk of cardiovascular diseases.
Electrolyte Imbalances: Conditions like hyperkalemia (high potassium), hyperphosphatemia (high phosphate), and hypocalcemia (low calcium).
Metabolic Disorders: Metabolic acidosis and uremia, reflecting waste accumulation in the bloodstream.
Bone and Mineral Disorders: Osteodystrophy leading to bone pain and fractures, and calciphylaxis characterized by small blood vessel calcification.
Anemia: Results from decreased erythropoietin production.
Infections: Increased risk due to immune system impairment and dialysis-related access points.