Chronic Kidney Disease

Modifiable Factors
Non-Modifiable Factors
A. PATHOPHYSIOLOGY -Hereditary
a. Schematic Diagram -Age greater than 60 years
old
-Gender
-Race
-Diabetic Mellitus
-Hypertension
-Increase Protein and
Cholesterol Intake
-Smoking
-Use of analgesics

Decreased renal blood flow

Primary kidney disease
Damage from other diseases
Urine outflow obstruction

Decreased Serum
BUN glomerular filtration Creatinin
e

Hypertrophy of
remaining nephrons Loss of Sodium Hyponatremia
Dilute
Polyuri in Urine
a Inability to
concentrate urine
Dehydration

Further loss of
nephron function

Loss of nonexcretory 2
renal function a

Failure to convert Failure to produce Impaired insulin Production of Immune Disturbances in

inactive forms of eryhtropoietin action lipids disturbances reproduction
calcium

Advanced
Calcium Anemi Erratic blood
atherosclerosis Delayed Infectio Libid Infertility
absorption a glucose
wound n o
Pallor levels
healing
1
 2
1 a
Hypocalcemi Osteodystroph
Loss of excretory
a y renal function

Excretion of Decreased Decreased Decreased Decreased

nitrogenous sodium potassium phosphate hydrogen
waste reabsorption in excretion excretion excretion
tubule
Uremia
Water Retention Hyperkalemia Hyperphosphatemi Metabolic
a acidosis
BUN,
Creatinine Hypertension Decreased
Uric Acid Heart Failure calcium
Edema absorption

Proteniuria
Hypocalcemi
a

Hyperparathyroidism
Peripheral
nerve
changes Decreased
potassium excretion

Pericarditi
s Increased
potassium

CNS
changes

Pruritu
s
Altered
Taste

Bleeding
Tendencie
s