Clinical presentation: Renal Failure
Acute renal failure (AKI: acute kidney injury): sudden, sharp decline in renal function… mostly reversible
Chronic renal failure (CKD: chronic kidney disease): gradual decline in renal function over time … irreversible Chronic kidney disease (CKD)
Chronic kidney disease is the irreversible loss of renal function that affects nearly all organ systems.
It is a complex disease that can be caused by a variety of different pathophysiological conditions.
It is a progressive loss of renal function over a period of months or years and may develop as a complication of systemic diseases (e.g., hypertension or diabetes mellitus) or as a complication of many renal diseases (e.g., chronic glomerulonephritis, chronic pyelonephritis or chronic obstruction).
Regional context
Chronic kidney disease is a significant problem in Australia and New Zealand. Approximately 1 in 3 adults have an increased risk of developing the disease.
In Australia, CKD also disproportionately affects Indigenous Australians. Indigenous Australians are 11 times more likely than other Australians to be hospitalised for regular. Dialysis and almost 4 times more likely than other Australians to die from CKD.
Renal Disease
Glomerular Diseases
Acute glomerulonephritis
Large, inflamed glomeruli with a decreased capillary lumen
Rapid onset of hematuria and proteinuria
Chronic glomerulonephritis
Glomerular scarring and eventual loss of functioning nephrons
Gradual development of uremia may be first sign
Glomerulonephritis: Pathophysiology
Clinical presentation: Renal Failure
Antigen–antibody complexes in the glomerular capillary wall Activation of biochemical mediators of inflammation Increases. Glomerular membrane permeability and reducs
glomerular membrane surface area. → GFR decreases Filtration of proteins into the filtrate; platelet aggregation and degranulation → proteinuria or haematuria
Glomerulonephritis: Clinical manifestations
The onset of glomerulonephritis may be sudden or insidious.
Oliguria (urine output of 30 mL/hour or less)
Hypertension
Renal failure
Two major changes distinctive of more severe glomerulonephritis are:
Hence, haematuria with red blood cell casts; and Proteinuria exceeding 3–5 g/day with albumin as the major protein. Lastly, gross proteinuria is associated with nephrotic syndrome APA