PMED (F5) GASTRO

CHRONIC KIDNEY DISEASES

caused by bacterial infections, urinary tract obstruction, renal

parenchyma damage

CHRONIC KIDNEY DISEASES

can also be caused by hypertension, diabetes, long-standing

renal disease

CHRONIC KIDNEY DISEASES

a worldwide issue with rising prevalence

CHRONIC KIDNEY DISEASES

defined as abnormal kidney structure/function that lasts for

≥3 months

CHRONIC KIDNEY DISEASES

top 4 causes: Diabetes mellitus – 44%, Hypertension – 28% Chronic glomerulonephritis – 16%, Polycystic kidney disease –

4.5%

CHRONIC KIDNEY DISEASES

Deposition of carotene-like pigments appears

when renal filtration is decreased

CHRONIC KIDNEY DISEASES

Salivary flow may be diminished, resulting in

xerostomia and parotid infections

CHRONIC KIDNEY DISEASES

Patients frequently complain of an altered or

metallic taste, and saliva is altered in

composition, has a higher pH, and may have a

characteristic ammonia-like odor, which results

from a high urea content.

Erythropoietin

stimulates red blood

cell production

1,25- dihydroxylcholecalciferol-

activates vitamin D

Renin

regulates blood pressure

Kidney

normal function is maintained until greater than

50% of nephrons are destroyed

Staphylococcus aureus-

most common cause of

vascular access infection and related bacteremia in

these patients

Uremia

condition wherein waste products

accumulate in the blood and condition na

prone ang patients with advanced renal

disease

Pruritis

red orange discoloration of

the cheeks and mucosa

Uremic stomatitis

a rare condition generally

associated with acute renal

failure and BUN levels are

greater than 55 mg/dL.

Uremic stomatitis

early changes typically

include red, burning mucosa

covered with gray exudates

and later by frank ulceration

Uremic frost

adherent white patches

caused by urea crystal

deposition

AZOTEMIA

result of the buildup of nonprotein nitrogen compounds

in the blood, mainly urea, as a consequence of loss of

glomerular filtration function

AZOTEMIA

measured as blood urea nitrogen (BUN)

END STAGE RENAL DISEASE (TYPE 5) **ESRD

demonstrate several hematologic abnormalities,

including anemia, leukocyte and platelet dysfunction,

and coagulopathy

END STAGE RENAL DISEASE (TYPE 5) **ESRD

leads to demineralization, weak bones, and

calcium–phosphate complexes in blood

END STAGE RENAL DISEASE (TYPE 5) **ESRD

wherein the the failing kidney does not synthesize

1,25-dihydroxycholecalciferol

END STAGE RENAL DISEASE (TYPE 5) **ESRD

Cardiovascular manifestations of

include hypertension,

congestive heart failure (shortness of

breath, orthopnea, dyspnea on

exertion, peripheral edema), and

pericarditis

END STAGE RENAL DISEASE (TYPE 5) **ESRD

Patients demonstrate mental

slowness or depression and become

psychotic in later stages

END STAGE RENAL DISEASE (TYPE 5) **ESRD

When this condition begins at an

early stage, it may result to enamel

hypoplasia and hypoclacification

Uremic syndrome

commonly causes

malnutrition and diarrhea.

RENAL OSTEODYSTROPHY

variety of bone disorders that are seen in pt

with ESRD

Parathyroid hormone

Inhibiting the tubular reabsorption of

phosphorus

Parathyroid hormone

Stimulating renal production of the

vitamin D necessary for calcium

metabolism

Parathyroid hormone

Enhancing vitamin D absorption

within the intestine

Fibroblast growth factor 23

key regulator of phosphorus and vitamin D

metabolism,

Osteomalacia

increased

unmineralized osteoid bone matrix

Osteitis fibrosa

bone resorption

with lytic lesions and marrow fibrosis

Osteosclerosis

enhanced bone

density

URINALYSIS

most basic test of kidney function

URINALYSIS

the physical, chemical, and microscopic

examination of urine

GFR

measure of overall kidney function and albumin

Albumin

most significant protein in the

urine (albuminuria)

Albumin and GFR

used to determine the severity

and prognosis of CKD

SERUM CREATININE LEVEL

measure of muscle breakdown and filtration capacity

of the nephron

BLOOD UREA NITROGEN (BUN)

commonly used indicator of kidney function

BLOOD UREA NITROGEN (BUN)

also influenced by liver function and conditions that

affect blood flow

DIALYSIS

medical procedure that artificially filters blood

DIALYSIS

necessary when the number of nephrons

diminishes to the point that azotemia is unpreventable

or uncontrollable

DIALYSIS

becomes important when the GFR drops below 30

mL/minute/1.73 m2

DIALYSIS

provides only about 15% of normal renal function

PERITONEAL DIALYSIS

low initial cost, ease of performance, reduced likelihood

of infectious disease transmission, and absence of

requirement for anticoagulation

PERITONEAL DIALYSIS

include the need for frequent sessions, risk of peritonitis

, frequent association with abdominal hernia

PERITONEAL DIALYSIS

lower effectiveness than that for

hemodialysis

PERITONEAL DIALYSIS

principal use is in patients in acute renal failure or

those who require only occasional dialysis

Continuous cyclic peritoneal dialysis

(CCPD

known as automated peritoneal

dialysis (APD)

Continuous cyclic peritoneal dialysis

(CCPD

uses a machine to perform three to

five dialysate exchanges while the

patient sleep

Chronic ambulatory peritoneal dialysis

(CAPD)

more commonly used procedure.

Chronic ambulatory peritoneal dialysis

(CAPD)

dialysis requires shorter exchange

periods of 30 to 45 minutes four to

five times per day

HEMODIALYSIS

method of choice when azotemia occurs and

dialysis is needed on a long-term basis.

HEMODIALYSIS

performed every 2 or 3 days

HEMODIALYSIS

usually 3 to 4 hours is required for each session

HEMODIALYSIS

consumes an enormous amount of the patient’s time

and is extremely confining,

HEMODIALYSIS

however, between dialysis

sessions, patients lead relatively normal lives

HEMODIALYSIS

a lifesaving technique

HEMODIALYSIS

can cause uremic odor, dry mouth, taste change, and

tongue and mucosal pain

DIALYSIS RELATED AMYLOIDOSIS

common in persons on dialysis for more than 5 years as

a consequence of deposition of proteins present in the

blood on joints and tendons, causing pain and stiffness

Anemia

common feature of renal failure

and dialysis

RENAL TRANSPLANTATION

an alternative to long term dialysis

RENAL TRANSPLANTATION

provides an average of 17.2 years of expected life

remaining but also is associated with a significant

number of issues

Anemia

common feature of renal failure

and dialysis