21 Renal Failure

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• chronic renal failure = CKD

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• uremia: urine in blood

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• poor filter of kidney

ARF

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• rising levels of BUN and Cr, filtered by the kidney, will rise in blood if kidney starts to fail

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• usually found on routine labs

Prerenal

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• kidney perceive less blood, absorb more water

Intrinsic

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• cannot filter blood because not working for some reason

Post

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• in real life

• may get high Bun/Cr

• in real life

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• dehydrated: initially pre-renal failure, severe then progress to ATN

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Chronic

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• stage 1: >90 but with risk factors

Dialysis

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• AEIOU

• dialysis if overdozed

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• central lines problems: infections, blood clots, don't last

Complications

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• normocytic anemia

• low Ca constantly stimulate PTH

• enough secondary stimulation causes tertiary

• renal osteodystrophy

• bones begin to degrade

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• drugs for osteodystrophy

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• any of these meds increases BUN/Cr