Friday, September 23, 2011

Chronic Renal Failure

Chronic renal failure or in English known as Chronic Renal failure is a public health problem worldwide and is now recognized as a common condition associated with an increased risk of heart failure and renal chronic.

The definition of chronic renal failure

National Kidney Foundation (NKF) defines the disease to kidney failure chronic damage such as kidney or glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for 3 months or more in the same period. Whatever the underlying etiology, the destruction of renal mass with irreversible sclerosis and loss of nephrons causes a progressive decline in GFR. Various stages of kidney disease chronic form continuum. There is no uniform classification of the stages of chronic kidney disease.

Approximately 1 million nephrons in each kidney are present, each contributing to the total GFR. Regardless of the causes of kidney injury, with progressive damage to the nephron, the kidney has the innate ability to maintain GFR by hyperfiltrasi and hypertrophy which is the compensation of the remaining healthy nephrons. This is the nephron adaptations that allow for clearance of plasma solutes continued normal so that substances such as urea and creatinine began to show significant improvement in which the total plasma levels, GFR decreased by 50% when renal reserves have been depleted. Plasma creatinine value will double with a 50% reduction in GFR. The increase in plasma creatinine from baseline of 0.6 mg / dL to 1.2 mg / dL in patients Chronic renal failure

Other factors than the underlying disease process and hypertensive glomerular which can cause kidney damage is progressive systemic hypertension, nephrotoxins or decreased perfusion, proteinuria, increased ammoniagenesis with interstitial injury, hyperlipidemia, hyperphosphatemia with calcium phosphate deposition, decreased levels of nitrous oxide, smoking, etc. .

Patients with kidney failure Chronic generally asymptomatic and had no real clinical disorders in electrolyte balance or endocrine / metabolic. But at a very advanced clinically severe disorders such as uremic real, the accumulation of toxic secondary, and identity that is generally not known without any investigation by a doctor.