Why separate acute from chronic renal failure?
Management is different
Manifestations may be similar
Prognosis is different: Chronic Renal Failure – irreversible; Acute Renal Failure – reversible
Functions of the Kidney
Maintenance of Acid – BaseBalance
pH, HCO3, pCO2
Maintenance of Fluid andElectrolyte Balance
Osmolality,water, Na, K, Cl
Maintenance of Ca-PhosphateBalance
(Mineral balance)Ca, Phosphates(Mg)
Vitamin D production
Hgb, hct for confirmation
Chronic Renal Failure (CRF)
-Pathophysiologic process which is a result of varied conditions that leads to irreversible destruction of nephrons, ultimately leading to End Stage Kidney Disease (ESRD).
-Sum of all processes that happen cause by various diseases such as DM, hpn, GN, lupus, secondary causes due to multiple myeloma, etc.- Slow deterioration of kidney function- Loss of nephrons
other nephrons try to compensateduring CRF phase, you don’t see manifestations of ESRD- Normal GFR men:100ml/min; women:85ml/min- Just keep in mind that the key word in CRF is COMPENSATION- DO NOT MAKE THE MISTAKE OF DIALYSING A PATIENT WITH CRF!