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Cl15mlmin lethargyirritablefitscoma

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Unformatted text preview: 30 ml / Min ) – Nausea, Anorexia, Diarrhoea – Odema, Infections, Occult bleeding, Mouth ulcers – Phosphate retention – Metabolic acidosis – Anaemia ( Exception : Polycyctic disease ) CLINICAL EVOLUTION CLINICAL EVOLUTION • Uremia ( Cr.Cl < 15 ml / Min ) – Lethargy, irritable : Fits, coma – Pruritis, Hiccups, Flapping tremor – Pericarditis : Pulmonary edema – Bone pain – Hyperkalemia – Hypocalcemia – Increased Alkaline phosphate CAUSES OF CKD CAUSES OF CKD CAUSES OF CKD CAUSES OF CKD • Diabetic Kidney disease – History of Diabetes, Proteinuria, Retinopathy • Hypertension – Elevated blood pressure, normal urinalysis, Family history • Nondiabetic glomerular disease – Nephritic or Nephrotic presentation • Cystic kidney disease – UTI, Abnormal urinary sediments, Radiologic imaging abnormalities CAUSES OF CKD CAUSES OF CKD • TUBULOINTERESTITIAL DISEASE – History of UTI and reflux – Chronic medication and exposure – Abnormalities in urinary tract imaging – Tubular syndromes including urine concentrating defects – Abnormal urinalysis PATHOPHYSILOGY PATHOPHYSILOGY • CONCEPT OF GLOMERULAR HYPERTENSION • ROLE OF ACE INHIBITORS IN CKD CLINICAL FEATURES CLINICAL FEATURES SIGN AND SYMPTOMS SIGN AND SYMPTOMS • FLUID AND ELECTROLYTE ABNORMALITIES – Volume expansion and contraction – Hypernatremia / Hyponatremia – Hyperkalemia / Hypokalemia – Metabolic acidosis – Hyperphosphatemia – Hypocalcemia SIGN AND SYMPTOMS SIGN AND SYMPTOMS • CVS AND PULMONARY – Arterial hypertension – CCF or Pulmonary odema – Pericarditis...
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  • Spring '12
  • Profsuneth
  • Hyperparathyroidism, ANAEMIA, renal replacement, stage renal disease, endogenous renal function, renal replacement  therapy

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