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Chronic Kidney Injury Osama
Chronic Kidney Injury Osama
3ed level
J. U. For Medical & Health sci.
Faculty Of Nursing Second term
BY:
OSAMA
1 ALSHOAPI Osama foud Alshoapi
Chronic kidney disease (CKD):
• Chronic kidney disease (CKD), previously termed chronic renal failure, irreversible
deterioration in renal function ,develop over a period of years .
• Initially, manifest only as a biochemical abnormality, eventually, loss of the
excretory, metabolic and endocrine functions of the kidney leads to the
symptoms and signs of renal failure, collectively referred to as uraemia.
• When death is likely without renal replacement therapy (RRT) (CKD stage 5), it is
called end-stage renal disease or failure (ESRD or ESRF).
3. Immune dysfunction:
Cellular and humoral immunity is impaired , increased susceptibility to
infections
4. Haematological:
• Increased bleeding tendency in advanced CKD, ecchymoses and mucosal bleeds.
• Platelet function is impaired.
• Anaemia is common. Haemoglobin can be as low as 50–70 g/L in CKD stage 5,
although it is often less severe or absent in patients with polycystic kidney
disease.
6 Osama foud Alshoapi
5. Endocrine function:
in both genders, there is loss of libido related, in part, to hypogonadism due
to hyperprolactinaemia
Insulin resistance.
6. Neurological and muscle function:
Myopathy occur due to poor nutrition, vitamin D deficiency
hyperparathyroidism, and electrolyte abnormalities.
Muscle cramps are common. Clinical features of CKD (continued)
7. Cardiovascular disease:
Left ventricular hypertrophy, secondary to hypertension.
Pericarditis complicate untreated or inadequately treated ESRD ,cause
pericardial tamponade or constrictive pericarditis.
Hyperphosphataemia contribute to the increased risk of CVD and itching.
Haemodialysis (HD):
Haemodialysis is the most common form of RRT in ESRD and is also used in AKI.
Haemodialysis involves gaining access to the circulation, either through an arteriovenous
fistula, a central venous catheter or an arteriovenous shunt, (a Scribner shunt).
The patient’s blood is pumped through a haemodialyser, which allows bidirectional
diffusion of solutes between blood and the dialysate across a semipermeable membrane
down a concentration gradient .
Haemodialysis is usually carried out for 3–5 hours three times weekly, either at home or in
an outpatient dialysis unit.