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CHRONIC KIDNEY INSUFFICIENCY

CRF is a pathological condition of the body, characterized by permanent progressive renal dysfunction.

Etiology

1) Chronic glomerulonephritis.

2) Chronic pyelonephritis (it is believed that the main reason).

3) Polycystic kidney disease.

4) Malignant hypertension with outcome in nephrosclerosis.

5) Amyloidosis of the kidneys.

6) A variety of urological pathology (urolithiasis, etc.).

7) Diabetic glomerulosclerosis.

8) Adenoma and prostate cancer (consequence of prostate). CKD is a common cause of disability and death in a young age.

Pathogenesis

1. Accumulation of nitrogenous slags:

a) urea> 40 mg% (8 mmol / l), but blood nitrogen can be both endogenous and exogenous - from food, therefore it is better to determine the kidney function by creatinine.

b) Creatitin 1.0-1.2 mg% is excreted by filtration, is not reabsorbed, therefore, filtration is judged by the level of creatitin.

c) uric acid (but it may increase with gout).

2
Water - electrolyte balance disturbance:

a) excess sodium - cut -> hyponatremia:

b) excess potassium - cutoff -> hypokalemia (but in the terminal stage of chronic kidney disease with severe oliguria, there may be hyperkalemia). The rate of 3.6 - 5.0 mmol / l.

c) a change in the excretion of calcium and phosphorus: calcium is washed out of the bones - osteoporosis, osteomalacia; hyperphosphatemia; the blood Ca / P ratio is changing - there may be a picture of secondary parathyroidism.

d) magnesium retention;

e) changes in water metabolism: first dehydration due to polyuria, then overhydration - edema, left ventricular heart failure.

3. Change in acid-base balance: acidosis: vomiting joins in the terminal stage, diarrhea - loss of sodium and chlorides -> hypochloremic alkalosis occurs.
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CHRONIC KIDNEY INSUFFICIENCY

  1. Chronic glomerulonephritis in children. Acute and chronic renal failure
    Questions for repetition: 1. Samples used to study the functional state of the kidneys. Test questions: 1. Definition, etiopathogenesis of chronic glomerulonephritis. 2. Classification of chronic glomerulonephritis. 3. The clinical picture and laboratory diagnosis of various forms of chronic glomerulonephritis. 4. Differential diagnosis of chronic glomerulonephritis. 5. Kidney biopsy
  2. Chronic renal failure
    (Table 21) Table 21. Stages of chronic renal failure (with some modification according to Wetzels) - the norm; I downgrade; f elevation. Surgical interventions for hidden and overt chronic renal diseases often impair renal function up to a full picture of renal failure. It was repeatedly emphasized that patients suffering from chronic kidney disease, with
  3. Chronic renal failure
    DEFINITION OF CRF is a gradually developing irreversible renal failure caused by slowly increasing kidney changes with abnormalities of their development, metabolic diseases, chronic inflammation, etc. This is a nonspecific syndrome, which is an irreversible violation of the homeostatic functions of the kidneys, associated with severe progressive disease. The term "uremia" is identified
  4. Chronic renal failure (CRF)
    Chronic renal failure gradually develops as a result of progressive irreversible loss of a functioning parenchyma. It is diagnosed in children with diseases of the urinary system while keeping them for 3-6 months and reducing glomerular filtration to less than 20 ml / min, increasing serum creatinine and urea levels. Over 50 diseases are affected
  5. Chronic renal failure
    The prognosis of nephropathy different in its genesis is determined by the degree of impaired renal functions and the possibility of their recovery. Detection of early signs of chronic renal failure (CRF) in children is necessary not only for timely conservative therapy, but also for the timely use of extracorporeal treatment methods, which include peritoneal dialysis, hemodialysis,
  6. Chronic renal failure
    Chronic renal failure (CRF) is a syndrome that develops as a result of a gradual decrease in renal function due to progressive nephron death. CRF is in most cases an irreversible process. The term "uremia" is usually used to designate the final stage of CRF, when a complex of biochemical and pathophysiological disorders is determined and clinical signs are particularly pronounced.
  7. Chronic renal failure
    CHRONIC KIDNEY INSUFFICIENCY (CRF) is a snn-core that develops due to a decrease in the number and change of functionally remaining nephrons, which leads to a violation of the excretory and secretory functions of the kidneys, which can no longer maintain the normal internal environment of the body. Sometimes a decrease in the rate of Kluoochkov STATE (GFR) for a long time is asymptomatic and the patient
  8. Chronic renal failure
    • The morphological substrate is nephrosclerosis - wrinkling of the kidneys in the outcome of chronic diseases with bilateral kidney damage. • At the end of chronic renal failure, uremia develops, which is characterized by: ° hyperazotemia; ° metabolic acidosis (due to the accumulation of sulfates, phosphates and organic acids); ° electrolyte imbalance (hyperkalemia,
  9. CHRONIC KIDNEY INSUFFICIENCY
    - a syndrome that develops as a result of a gradual decrease in the number and changes in the function of the remaining nephrons, leading to impaired renal blood flow, glomerular filtration, tubular reabsorption and secretion, as well as kidney concentration ability and characterized by azotemia, impaired water and electrolyte balance, acid-base balance . Major Clinical
  10. CHRONIC KIDNEY INSUFFICIENCY
    Chronic renal failure (CRF), a very common pathology in older cats. This is a non-specific diagnosis, which is understood to mean a progressively manifested progressive incurable clinical syndrome, due to the limited ability of the kidneys to excrete certain substances with urine, regulate acid-base balance, and perform renal endocrine functions.
  11. CHRONIC KIDNEY INSUFFICIENCY
    CKD develops as a result of a significant decrease in the number of actively functioning nephrons, which leads to impaired excretory and endocrine function of the kidney. With CRF, the maintenance of homeostasis of the internal environment is disturbed, which is manifested by a change in all metabolic processes: water-electrolyte, protein, carbohydrate and lipid. As a result, pathological processes in
  12. Food in chronic renal failure
    Chronic renal failure can be caused by various long-lasting kidney diseases that impair their function. If the work of the kidneys is weakened, they are poorly removed from the body of substances that are formed as a result of protein metabolism. These substances accumulate in the blood and have a toxic effect on the body. To reduce their concentration in the blood, it is necessary to sharply
  13. CHRONIC KIDNEY INSUFFICIENCY: PATHOPHYSIOLOGICAL AND CLINICAL FEATURES
    Barry M. Brenner, J. Michael Lazarus (Barry M. Brenner, J. Michael Lazarus) In contrast to the ability of the kidneys to restore their function after suffering various types of acute renal failure discussed in the preceding chapter, damage of a more resistant nature is often irreversible. The function of the organ is not restored, moreover, there is a progressive
  14. Chronic renal failure
    -detective sm: edema of varying severity, rapid mass increase, oliguria, anuria, pallor of the skin -metabolic disorders: acidosis, azotemia, hyperkalemia, hypernatremia -hypertonic sm expressed-urea sm: impaired renal function - concentration, filtration, nitrogenous, electrolyte, regulation of water and electrolyte
  15. ACUTE AND CHRONIC KIDNEY INSUFFICIENCY FORMED DIURESIS
    ACUTE AND CHRONIC KIDNEY INSUFFICIENCY, FORCED
  16. Sample weekly menu for chronic renal failure (diet 76)
    MONDAY First breakfast: cottage cheese - apple pudding, apple puree with whipped whites, fruit juice. The second breakfast: grated carrots with sugar. Lunch: vegetarian vegetable soup, boiled meat with tomato sauce. Lunch: decoction of wild rose. Dinner: omelette protein, tea with sugar. For the night: fruit juice. TUESDAY First breakfast: cereal “Hercules” cereal with milk, vegetable salad on
  17. KIDNEY INSUFFICIENCY
    The main functions of the kidneys (excretion of metabolic products, maintaining the constancy of the water-electrolyte composition and acid-base state) are carried out by the following processes: renal blood flow, glomerular filtration and tubules (reabsorption, secretion, concentration). Not every change in these renal processes leads to severe renal dysfunction and may be called
  18. Renal failure
    Renal failure can be both a cause of arterial hypertension, such as glomerulonephritis, vasculitis or renal artery stenosis, and the result of a hypertensive crisis. If hypertension is the cause of renal failure, the increased concentrations of creatinine and urea nitrogen in the blood, associated with perfusion disorders, often decrease after a decrease in blood pressure. In these conditions
  19. Acute renal failure
    Definition of the term The term "acute renal failure" is not always understood unambiguously. By acute renal failure, we understand the secondary and sudden violation of renal excretory function, which develops in the process of other, non-renal diseases. This renal failure is reversible, but is not amenable to etiotropic treatment. Obstructive uropathies ("postrenal renal
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