Chronic Renal Failure

1
Chronic Renal Failure
2
Kidney function test

• The BUN test is often done to check kidney
  function.
• Normal Results
• 7 - 20 mg/dL. Note that normal values may vary
  among different laboratories

3
Creatinine blood

• Creatinine levels also vary according to a
  person's size and muscle mass.
• Normal Results
• A normal value is 0.8 to 1.4 mg/dL.
• Females usually have a lower creatinine than
  males, because they usually have less muscle mass.

4
Creatinine - urine

• Normal Results
• Urine creatine (24-hour sample) values can range
  from 500 to 2000 mg/day. Results are highly
  dependent on your age and amount of lean body
  mass.

5
Creatinine clearance

• Normal Results
• Clearance is often measured as milliliters/minute
  (ml/min). Normal values are
• Male 97 to 137 ml/min.
• Female 88 to 128 ml/min.

6
Case 1

• Mr. A. is a patient with CRF secondary to chronic
  interstitial nephritis. He complains of chronic
  fatigue and breathlessness on exertion his
  hemoglobin concentration was found to be 5.6
  g/dl.
• Question
• How should he be treated?

7
Case 2

• Mr D, 19 year old male complaining of a 3 month
  history of fatigue, weakness, nausea and vomiting
  that he had attributed to examination stress .
  laboratory results are
• Sodium 137 mmol/L (135-145)
• Potassium 4.8 mmolL (3.5-5)
• Phosphate 2.5 mmol/L (0.9-1.5)
• Calcium 1.6mmol/L (
  2.2-2.55)
• Urea 52mmolL
  (3-6.5)
• Creatinine 620µmolL
  (50-120)
• HB 7.5 g/dl
  (13.5-18)
• Diagnosis chronic renal failure secondary to
  reflux nephropathy
• Q
• Explain the signs and symptoms and the likely
  course of his disease

8
Answer of case 1

• Symptoms are most likely to result from
• A normochromic normocytic anemia
• Treatment
• Hemodialysis
• Recombinant erythropoietin for treatment of
  anemia

9
Answer of case 2

• Patient is suffering from the signs and symptoms
  of uremia resulting from CRF, this leads to
  accumulation of toxins (urea and creatinine ) and
  this causes nausea, vomiting and general malaise
  .
• Reduced erythropoietin production leads to low HB
  level .

10
Answer of case 2

• Renal osteodystrophy (inadequate vitamin D )
  leads to hyperphosphatemia and hypocalcaemia .
• There is a failure in the ability of the damaged
  kidneys to compensate and the symptoms appears
  late in the condition.