Chronic Renal Failure_STU_2015.pdf - Functions of the...

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10/23/2015 1 CHRONIC RENAL FAILURE ESRD C. Jamaris-Stauts Functions of the Kidney Urine Formation Excretion of waste products Regulation of electrolytes and water Control of Blood pressure Regulation of RBC production Synthesis of Vitamin D to active form Secretion of prostaglandins Urine Formation- Glomerular Filtration Blood flows through kidney ~1200 ml /min 20 % of blood is filtered into the nephron Filtrate contains water, lytes and small molecules Large molecules stay in bloodstream- proteins, glucose, RBC Affected by BP, oncotic pressure, obstruction Excretion of Waste Products Urea by-product of protein metabolism Creatinine by-product of muscle metabolism Phosphates Sulfates Uric acid Drug metabolites Regulation of Na and K Na - in healthy kidney amount ingested= amount excreted Sodium volume excreted depends on aldosterone K- 90% is excreted, affected by acid base balance and aldosterone Retention of K most life threatening problem in renal failure Regulation of Water and Acid-Base Balance In distal tubules, ADH allows H2O to be absorbed into the capillaries and returned to blood volume Aldosterone- reabsorbs water and NA HCO3 is re-absorbed, H+ is excreted Atrial- Naturetic Factor with atrial stretch, inhibits the effect of ADH diuresis
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10/23/2015 2 Other functions Produces renin in response to low renal artery blood flow In response to decrease in O2 in renal blood flow erythropoetin is released, stimulates the bone marrow to produce RBCs Vitamin D- kidneys convert inactive vit D to its active form- vitD necessary for maintaining normal calcium balance Prostaglandins- cause vasodilation Definition CRF is a condition in which the kidney ceases to remove metabolic wastes and excessive water from the blood Acute renal failure is a reversible syndrome that results in decreased GFR and oliguria End stage renal failure (ESRD) is a progressive, irreversible deterioration of renal function that results in azotemia Definitions to Know Glomerular filtration rate (GRF): the volume of plasma filtered at the glomerulus into the kidney tubules each minute. Normal 120mL/min Nephron Creatinine: waste product of muscle wasting Urea nitrogen: nitrogenous end product of protein metabolism Azotemia: > accumulation of nitrogenous waste in blood. Classic in renal failure 10 Incidence Varies widely by state and country In US, 268 cases per I million population More than 300,000 people are being treated for CRF or “end - stage renal disease” (ESRD) More than 191,000 people are being dialyzed More than 86,000 people have functioning renal transplants 11 Risk Factors that Cause ESRD Diabetes mellitus (leading Cause) 38% HTN (24%) Glomerulonephritis (12%) Polycystic kidney disease Vascular disorders
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  • Spring '14
  • Brinkley
  • Chronic Renal Failure, renal insufficiency, azotemia

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