renal function over a period of months or years in which there is less than 10% of
remaining renal function and dialysis or kidney transplant is required to
sustained life.
PATHOPHYSIOLOGY
Renal Injury
Proteinuria Systemic
hypertension
Tubulointerstitial
inflammation and
fibrosis
Renal scaring
EMERGENCY CARE MANAGEMENT:
Diagnostic Test:
Low-protein diet
High-calorie diet prevents Ketoacidosis
Restrict sodium, phosphorus and potassium
Maintaining fluid balance
Monitoring vital signs, weight changes and urine volume
Loop diuretic (furosemide)
Cardiac glycosides in small amount does used to mobilize the fluids
causing the edema
Antihypertensive
Antiemetics given before meals
Cimitidine, omreprazole or ranitidine may decrease gastric irritation
Methylcellulose or docusate can help prevent constipation
Folate supplements
Severe anemia requires infusion of fresh frozen packed cells or washed
packed cells
Synthethic erythropoietin (epoietin alfa)
Antipruritic, such as trimeprazine or diphenydramine, can relieve itching,
Aluminum hydroxide gel can lower serum phosphate levels
Supplementary vitamins and essential amino acids
Calcium and phosphorus imbalance may be treated with phosphate
binding agents, calcium supplements and reduction of phosphorus in the
diet
Hemodialysis or peritoneal dialysis
Kidney transplantation best choice of treatment
NURSING MAMNGEMENT: