MDL 470

Case study

Academic year 2021

(Draft)

Case title: Chronic Renal Failure

Presentation Date: 27/10

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Introduction 
- A kidney removes excess water and wastes from the blood.
The kidney also regulate sodium, potassium, calcium,
phosphorus, and other chemicals inside the body. Nephrons
are the structures in the kidney that filter the fluid. The kidneys
eliminate urine, which combines wastes and fluids. There are
approximately one million nephrons in each kidney. It is the
damage to these units that results in chronic kidney disease. 
- Anatomy and physiology of kidney
- Disease that causes kidney
- Chronic renal failure (CRF) is commonly known as
chronic kidney disease (CKD). It occurs when the kidneys' ability
to filter waste and fluid from the blood decreases and it is
chronic mean develops over long period of time.
- Stages of CKD can be classified according to the eGFR:
Stage 1: Kidney damage with normal or increased GFR greater
than 90
Stage 2: Mild reduction in GFR between 60 - 89
Stage 3a: Moderate reduction in GFR between 45 - 59
Stage 3b: Moderate reduction in GFR between 30 - 44
Stage 4: Severe reduction in GFR between 15 - 29
Stage 5: Kidney failure GFR less than 15 or dialysis

Epidemiology 
- About 30 million people or 15% of adult in
the united states are have kidney disease at some stage.
The prevalence of CKD increases with age (6% at age 18-44
years and 38.1% at >65 years) that
indicate CKD commonly affect older people   
Causes 
- The cause of CKD is damage nephrons that responsible
filtering fluid and waste from blood

Etiology
- The causes of CKD can be:
1- Glomerulonephritis,
2- interstitial nephritis,
3- polycystic kidney disease,
4- prolonged obstruction of urinary tract,
5- vesicoureteral reflux,
6- or pylonephritis
Risk factor 
People with Diabetes, hypertension, heart disease and family
history of CKD 
 
Signs and symptoms 
- Most people don’t show symptoms until they reach
an advanced stage. However, some symptoms may appear
such as: trouble sleeping, muscles cramping at night, swollen
feet and ankles, or need to urinate more often especially at
night 

Complications 
- Progression of CKD can lead to number of
serious complications include anemia, hyperlipidemia and
metabolic bone disease 

Investigations 
- Laboratory test such as complete blood count (CBC), blood
urea nitrogen, serum albumin levels and serum cycstin C
levels 
- Renal biopsy 
- Imaging

Preventive  
- Eating health food 
- Stop smoking 
- Regular check-up 
- losing weight 
- Get enough sleep 

Treatment 
- The treatment of chronic kidney disease is management of
underlying cause like keeping blood pressure and blood
sugar under control that will decrease kidney damage

Recent advances 
- Chronic kidney disease is currently understood based on a
wide range of studies focusing on genetic risk factors for
development and progression of Chronic kidney disease

Case study

Interpretation

References 
 Kidney Care UK. “Chronic kidney disease.” 2016.
 Kidney Disease Statistics for the United States. National
Institute of Diabetes and Digestive and Kidney Diseases.
Available at https://www.niddk.nih.gov/health-
information/health-statistics/kidney-disease#urologic.
 National Kidney Foundation. “About Chronic Kidney
Disease.” 
 American Kidney Fund. “Chronic Kidney Disease.” .
 Thomas, R., Kanso, A., & Sedor, J. R. (2008). Chronic kidney
disease and its complications. Primary care: Clinics in office
practice, 35(2), 329-344.
 Yamaguchi, J., Tanaka, T., & Nangaku, M. (2015). Recent
advances in understanding of chronic kidney
disease. F1000Research, 4.
 National Kidney Foundation. “About Chronic Kidney
Disease.” 2017.