Chronic Renal Failure
Chronic renal failure is rhe results of any renal injury that decreases renal excretory and regulatory function chronically. Characteristic findings include nitrogen retention, acidosis, and anemia.
Glomerular renal parenchymal damage can be caused by: membranous nephropathy, membranoproliferative glomerulonephritis, systemic lupus erythematosus, focal glomerulosclerosis, diabetes mellitus, proliferative glomerulonephritis, amyloidosis, Alport's syndrome, connective tissue disease.
Interstitial-tubular renal parenchymal damage can be caused by: heavy metals, drugs, nephrotoxins, multiple myeloma, hypertension, gout, thrombotic microangiopathies, oxalate deposition, infection, renal artery stenosis, connective tissue disease, autosomal dominant polycystic kidney disease, congenital.
Pre-renal damage can be caused by: Cirrhosis, cardiac, volume, nephrotic, or drugs (e.g., NSAID's)
Risk factors include: Contrast (diabetes, myeloma), Circulatory failure,Urinary tract obstruction, Analgesic abuse, Untreated hypertension, and Diabetes mellitus.
Blood tests will reveal normochromic, normocytic anemia; decreased immune responsiveness; thrombocytopenia; decreased hematocrit; increased capillary fragility; and increased bleeding time. Blood chemistry will reveal: azotemia; elevated ammonia; Type IV hyperlipidemia; decreased active Vitamin D; Increased parathyroid hormone; elevated glucose, insulin resistance; elevated phosphate; elevated potassium; elevated sulfate; elevated uric acid; and reduced calcium Urinalysis will show proteinuria and casts.
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