Chronic Kidney Disease

A. PATHOPHYSIOLOGY a. Schematic Diagram

Non-Modifiable Factors -Hereditary -Age greater than ! years old -"ender -#ace Modifiable Factors -Diabetic Mellitus -Hypertension -Increase Protein and Cholesterol Intake -Smoking -Use of analgesics

Decreased renal blood flo$ Primary kidney disease Damage from other diseases Urine outflo$ obstruction Decreased glomerular filtration Hypertrophy of remaining nephrons Inability to concentrate urine Dehydration (urther loss of nephron function Serum Creatinin e

%U&

Dilute Polyuria

'oss of Sodium in Urine

Hyponatremi a

'oss of none)cretory renal function

Failure to convert inactive forms of calcium Calcium absorption

Failure to produce eryhtropoietin

Impaired insulin action

Production of lipids Advanced atherosclerosis

Immune disturbances

Disturbances in reproduction

Anemi a Pallor

Erratic blood glucose levels

Delayed wound healing

Infection

Libid o

Infertility

1 Hypocalcemi a +)cretion of nitrogenous $aste Uremia %U&, Creatinine Uric Acid *steodystroph y Decreased sodium reabsorption in tubule /ater #etention Hypertension Heart (ailure +dema

'oss of e)cretory renal function Decreased potassium e)cretion Decreased phosphate e)cretion Decreased hydrogen e)cretion

Hyperkalemia

Hyperphosphatemi a Decreased calcium absorption Hypocalcemi a Hyperparathyroidism Decreased potassium e)cretion

Metabolic acidosis

Proteniuria

Peripheral ner-e changes

Pericarditi s C&S changes

Increased potassium

Pruritu s Altered .aste

%leeding .endencie s