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Encyclopedia > Chronic renal failure
Chronic renal failure
Classifications and external resources
ICD-10 N18
ICD-9 585
eMedicine med/374 

Chronic renal failure (CRF, or "chronic kidney failure", CKF, or "chronic kidney disease", CKD) is a slowly progressive loss of renal function over a period of months or years and defined as an abnormally low glomerular filtration rate, which is usually determined indirectly by the creatinine level in blood serum. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. ... Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into Bowmans capsule per unit time. ... Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). ...


CRF that leads to severe illness and requires some form of renal replacement therapy (such as dialysis) is called end-stage renal disease (ESRD). Renal replacement therapy is a term used to encompass treatments for renal disease. ... In medicine, dialysis is a type of renal replacement therapy which is used to provide an artificial replacement for lost kidney function due to renal failure. ...

Contents

Signs and symptoms

Initially it is without specific symptoms and can only be detected as an increase in serum creatinine. As the kidney function decreases: Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). ... Human kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ...

CRF patients suffer from accelerated atherosclerosis and have higher incidence of cardiovascular disease, with a poorer prognosis. A sphygmomanometer, a device used for measuring blood pressure. ... For other forms of hypertension see hypertension (disambiguation). ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... Urea is an organic compound of carbon, nitrogen, oxygen and hydrogen, with the formula CON2H4 or (NH2)2CO. Urea is also known as carbamide, especially in the recommended International Non-proprietary Names (rINN) in use in Europe. ... Azotemia is a medical condition characterized by abnormal levels of urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood as a result of insufficient filtering of the blood by the kidneys. ... Uremia is a toxic condition resulting from renal failure, when kidney function is compromised and urea, a waste product normally excreted in the urine, is retained in the blood. ... Pericarditis is inflammation of the pericardium. ... Encephalopathy is a container term for various conditions affecting the brain. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance brownish white Atomic mass 39. ... Hyperkalemia (hyper is high, kalium is the Latin name for potassium) is an elevated blood level (above 5. ... Malaise is a term used to refer to a general state of discomfort, tiredness, or illness. ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... Erythropoietin Erythropoietin (or EPO) is a glycoprotein hormone that is a growth factor for erythrocyte (red blood cell) precursors in the bone marrow. ... This article discusses the medical condition. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Edema (American English) or oedema (British English), formerly known as dropsy or hydropsy, is swelling of any organ or tissue due to accumulation of excess lymph fluid, without an increase of the number of cells in the affected tissue. ... Pulmonary edema is swelling and/or fluid accumulation in the lungs. ... Hyperphosphatemia is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood. ... In medicine, hypocalcaemia is the presence of less than a total calcium of 2. ... Chemical structure of cholecalciferol Cholecalciferol is a form of Vitamin D. Vitamin D3 is also a steroid much like testosterone, cholesterol and cortisol. ... Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). ... Renal osteodystrophy is a bone pathology, characterized by defective mineralization, that results from renal disease. ... In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ... In inorganic chemistry, a bicarbonate (IUPAC-recommended nomenclature: hydrogencarbonate) is an intermediate form in the deprotonation of carbonic acid. ... It has been suggested that this article or section be merged with Coronary heart disease. ...


Diagnosis

In many CRF patients, previous renal disease or other underlying diseases are already known. A small number presents with CRF of unknown cause. In these patients, a cause is occasionally identified retrospectively.


It is important to differentiate CRF from acute renal failure (ARF) because ARF can be reversible. Abdominal ultrasound is commonly performed, in which the size of the kidneys are measured. Kidneys in CRF are usually smaller (< 9 cm) than normal kidneys with notable exceptions such as in diabetic nephropathy and polycystic kidney disease. Another diagnostic clue that helps differentiate CRF and ARF is a gradual rise in serum creatinine (over several months or years) as opposed to a sudden increase in the serum creatinine (several days to weeks). If these levels are unavailable (because the patient has been well and has had no blood tests) it is occasionally necessary to treat a patient briefly as having ARF until it has been established that the renal impairment is irreversible. Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structure and any pathological lesions, making them useful for scanning the organs. ... Human kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ... Photomicrography of nodular glomerulosclerosis in Kimmelstein-Wilson syndrome. ... Polycystic kidney disease (PKD) is a progressive, genetic disorder of the kidneys. ...


Numerous uremic toxins (see link) are accumulating in chronic renal failure patients treated with standard dialysis. These toxins show various cytotoxic activities in the serum, have different molecular weights and some of them are bound to other proteins, primarily to albumin. Such toxic protein bound substances are receiving the attention of scientists who are interested in improving the standard chronic dialysis procedures used today.


Causes

The most common causes of CRF in North America and Europe are diabetic nephropathy, hypertension, and glomerulonephritis. Together, these cause approximately 75% of all adult cases. Certain geographic areas have a high incidence of HIV nephropathy. Photomicrography of nodular glomerulosclerosis in Kimmelstein-Wilson syndrome. ... For other forms of hypertension see hypertension (disambiguation). ... Glomerulonephritis is a primary or secondary autoimmune renal disease featuring inflammation of the glomeruli. ...


Historically, kidney disease has been classified according to the part of the renal anatomy that is involved, as:

Renal artery stenosis is the narrowing of the renal artery. ... In medicine, Hemolytic-uremic syndrome (or haemolytic-uraemic syndrome, abbreviated HUS) is a disease characterised by microangiopathic hemolytic anemia, acute renal failure and a low platelet count (thrombocytopenia). ... In medicine, vasculitis (plural: vasculitides) is a group of diseases featuring inflammation of the wall of blood vessels. ... Focal segmental glomerulosclerosis (FSGS) - a kidney disorder where the glomerulus is dysfunctional, leaks protein and has focal scaring. ... IgA nephritis (also known as Bergers disease and synpharyngitic glomerulonephritis) is a form of glomerulonephritis (inflammation of the glomeruli of the kidney). ... Photomicrography of nodular glomerulosclerosis in Kimmelstein-Wilson syndrome. ... Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. ... Polycystic kidney disease (PKD) is a progressive, genetic disorder of the kidneys. ... Bladder stone redirects here. ... Male Anatomy The prostate is an exocrine gland of the male mammalian reproductive system. ...

Treatment

The goal of therapy is to slow down or halt the otherwise relentless progression of CRF to ESRD. Control of blood pressure and treatment of the original disease, whenever feasible, are the broad principles of management. Generally, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are used, as they have been found to slow the progression to ESRD.[1][2] A sphygmomanometer, a device used for measuring blood pressure. ... ACE inhibitors, or inhibitors of Angiotensin_Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice. ... Wikipedia does not yet have an article with this exact name. ...


Replacement of erythropoietin and vitamin D3, two hormones processed by the kidney, is usually necessary, as is calcium. Phosphate binders are used to control the serum phosphate levels, which are usually elevated in chronic renal failure. Erythropoietin Erythropoietin (or EPO) is a glycoprotein hormone that is a growth factor for erythrocyte (red blood cell) precursors in the bone marrow. ... Chemical structure of cholecalciferol Cholecalciferol is a form of Vitamin D. Vitamin D3 is also a steroid much like testosterone, cholesterol and cortisol. ... General Name, Symbol, Number calcium, Ca, 20 Chemical series alkaline earth metals Group, Period, Block 2, 4, s Appearance silvery white Atomic mass 40. ... Phosphate binders are a group of medications used to reduce the absorption of phosphate and taken with meals and snacks. ... Above is a ball-and-stick model of the inorganic phosphate molecule (HPO42−). Colour coding: P (orange); O (red); H (white). ...


After ESRD occurs, renal replacement therapy is required, in the form of either dialysis or a transplant. Renal replacement therapy is a term used to encompass treatments for renal disease. ... In medicine, dialysis is a type of renal replacement therapy which is used to provide an artificial replacement for lost kidney function due to renal failure. ... An organ transplant is the transplantation of an organ (or part of one) from one body to another, for the purpose of replacing the recipients damaged or failing organ with a working one from the donor. ...


Prognosis

The prognosis of patients with chronic kidney disease is guarded as epidemiological data has shown that all cause mortality (the overall death rate) increases as kidney function decreases.[3] The leading cause of death in patients with chronic kidney disease is cardiovascular disease, regardless of whether there is progression to ESRD.[3][4][5] Epidemiology is the scientific study of factors affecting the health and illness of individuals and populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ...


While renal replacement therapies can maintain patients indefinitely and prolong life, the quality of life is severely affected.[6][7] Renal transplantation increases the survival of patients with ESRD significantly when compared to other therapeutic options;[8][9] however, it is associated with an increased short-term mortality (due to complications of the surgery). Transplantation aside, high intensity home hemodialysis appears to be associated with improved survival and a greater quality of life, when compared to the conventional thrice weekly hemodialysis and peritoneal dialysis.[10] Renal replacement therapy is a term used to encompass treatments for renal disease. ... The well-being or quality of life of a population is an important concern in economics and political science. ... Kidney transplantation or renal transplantation is the organ transplant of a kidney in a patient with chronic renal failure. ... Home hemodialysis (HHD), or home hemo, is a form of renal replacement therapy. ... The well-being or quality of life of a population is an important concern in economics and political science. ... A hemodialysis machine In medicine, hemodialysis, also haemodialysis, is a method for removing waste products such as potassium and urea, as well as free water from the blood when the kidneys are incapable of this (i. ... This article is about clinical dialysis; for the laboratory technique, see Dialysis (biochemistry) In medicine, dialysis is a method for removing waste such as urea from the blood when the kidneys are incapable of this, i. ...


References

  1. ^ Ruggenenti P, Perna A, Gherardi G, Gaspari F, Benini R, Remuzzi G. Renal function and requirement for dialysis in chronic nephropathy patients on long-term ramipril: REIN follow-up trial. Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). Ramipril Efficacy in Nephropathy. Lancet. 1998 Oct 17;352(9136):1252-6. PMID 9788454.
  2. ^ Ruggenenti P, Perna A, Gherardi G, Garini G, Zoccali C, Salvadori M, Scolari F, Schena FP, Remuzzi G. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet. 1999 Jul 31;354(9176):359-64. PMID 10437863.
  3. ^ a b Perazella MA, Khan S. Increased mortality in chronic kidney disease: a call to action. Am J Med Sci. 2006 Mar;331(3):150-3. PMID 16538076.
  4. ^ Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ, Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW; American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003 Oct 28;108(17):2154-69. PMID 14581387. Free Full Text.
  5. ^ Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, McAlister F, Garg AX. Chronic Kidney Disease and Mortality Risk: A Systematic Review. J Am Soc Nephrol. 2006 May 31; PMID 16738019.
  6. ^ Heidenheim AP, Kooistra MP, Lindsay RM. Quality of life. Contrib Nephrol. 2004;145:99-105. PMID 15496796.
  7. ^ de Francisco AL, Pinera C. Challenges and future of renal replacement therapy. Hemodial Int. 2006 Jan;10 Suppl 1:S19-23. PMID 16441862.
  8. ^ Groothoff JW. Long-term outcomes of children with end-stage renal disease. Pediatr Nephrol. 2005 Jul;20(7):849-53. Epub 2005 Apr 15. PMID 15834618.
  9. ^ Giri M. Choice of renal replacement therapy in patients with diabetic end stage renal disease. EDTNA ERCA J. 2004 Jul-Sep;30(3):138-42. PMID 15715116.
  10. ^ Pierratos A, McFarlane P, Chan CT. Quotidian dialysis--update 2005. Curr Opin Nephrol Hypertens. 2005 Mar;14(2):119-24. PMID 15687837.

External links

  • National Kidney Foundation
  • Renal Failure, Chronic and Dialysis Complications - emedicine.com
  • Chronic Renal Failure - emedicine.com
  • EUTox - Uremic Toxins Work Group of the ESAO - Uremic toxins accumulating in chronic renal failure

  Results from FactBites:
 
Chronic renal failure (426 words)
Chronic renal failure is a gradual and progressive loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes.
Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly damaged.
Chronic renal failure and ESRD affect more than 2 out of 1,000 people in the U.S. Diabetes and hypertension (high blood pressure) are the two most common causes and account for approximately two-thirds of the cases of chronic renal failure and ESRD.
  More results at FactBites »

 
 

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