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    Kidney Failure

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    Kash Jamasali
    Kidney failure can be acute or chronic. Acute kidney failure results in a sudden reduction in kidney function that is usually reversible with treatment. Chronic kidney failure progresses over time and results in permanent kidney damage. The kidneys filter waste from the blood, regulate fluid and mineral balance, produce hormones, and activate vitamin D. Risk factors include diabetes, hypertension, smoking, and age over 65. Symptoms of kidney failure include fatigue, nausea, edema, electrolyte imbalances, and neurological changes as toxins accumulate in the body. Treatment involves managing symptoms, addressing underlying causes, and renal replacement therapies like dialysis.

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    Kidney Failure

    Uploaded by

    Kash Jamasali
    134 views27 pages
    Kidney failure can be acute or chronic. Acute kidney failure results in a sudden reduction in kidney function that is usually reversible with treatment. Chronic kidney failure progresses over time and results in permanent kidney damage. The kidneys filter waste from the blood, regulate fluid and mineral balance, produce hormones, and activate vitamin D. Risk factors include diabetes, hypertension, smoking, and age over 65. Symptoms of kidney failure include fatigue, nausea, edema, electrolyte imbalances, and neurological changes as toxins accumulate in the body. Treatment involves managing symptoms, addressing underlying causes, and renal replacement therapies like dialysis.

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    Kidney failure can be acute or chronic. Acute kidney failure results in a sudden reduction in kidney function that is usually reversible with treatment. Chronic kidney failure progresses over time and results in permanent kidney damage. The kidneys filter waste from the blood, regulate fluid and mineral balance, produce hormones, and activate vitamin D. Risk factors include diabetes, hypertension, smoking, and age over 65. Symptoms of kidney failure include fatigue, nausea, edema, electrolyte imbalances, and neurological changes as toxins accumulate in the body. Treatment involves managing symptoms, addressing underlying causes, and renal replacement therapies like dialysis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    134 views27 pages

    Kidney Failure

    Uploaded by

    Kash Jamasali
    Kidney failure can be acute or chronic. Acute kidney failure results in a sudden reduction in kidney function that is usually reversible with treatment. Chronic kidney failure progresses over time and results in permanent kidney damage. The kidneys filter waste from the blood, regulate fluid and mineral balance, produce hormones, and activate vitamin D. Risk factors include diabetes, hypertension, smoking, and age over 65. Symptoms of kidney failure include fatigue, nausea, edema, electrolyte imbalances, and neurological changes as toxins accumulate in the body. Treatment involves managing symptoms, addressing underlying causes, and renal replacement therapies like dialysis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 27

    Kidney Failure

    Overview of How Our Kidneys


    Work

    What Kidneys do
    Filter the blood
    Balance the fluid content in the
    body
    Produce the enzyme renin that
    helps control blood pressure

    What Kidneys do
    Produce the hormone
    erythropoetin to help make red
    blood cells
    Activate vitamin D to maintain
    healthy bones
    Adjust levels of minerals and other
    chemicals to keep the body
    working properly

    Risk Factors and Etiology

    Diabetes
    Hypertension
    Heart / Cardiac Diseases
    Smoking
    Obesity
    High Cholesterol
    Family History of Kidney Disease
    Age 65 or older

    Classifications
    Acute versus Chronic
    Pre renal, Renal, Post Renal
    Anuric, Oliguric, Poly uric

    Acute versus Chronic


    Acute
    Sudden onset of
    Rapid reduction in urine output
    Usually reversible
    Tubular death and regeneration

    Acute Kidney Failure


    Sudden interruption of kidney function
    resulting from obstruction, reduced
    circulation, or disease of the renal tissue
    Results in retention of toxins, fluids, and
    end products of metabolism
    Usually reversible with medical
    treatment
    May progress to end stage renal
    disease, uremic syndrome, and death
    without treatment

    Acute Kidney Failure


    Persons at Risks
    Major surgery
    Major trauma
    Receiving nephrotoxic medications
    Elderly

    Acute Kidney Failure


    Causes
    Prerenal
    Hypovolemia, shock, blood loss, embolism,
    pooling of fluid d/t ascites or burns,
    cardiovascular disorders, sepsis

    Intrarenal
    Nephrotoxic agents, infections, ischemia and
    blockages, polycystic kidney disease

    Postrenal
    Stones, blood clots, BPH, urethral edema from
    invasive procedures

    Acute Kidney Failure


    Stages
    Onset 1-3 days with ^ BUN and creatinine
    and possible decreased UOP
    Oliguric UOP < 400/d, ^BUN,Crest, Phos,
    K, may last up to 14 d
    Diuretic UOP ^ to as much as 4000 mL/d
    but no waste products, at end of this stage
    may begin to see improvement
    Recovery things go back to normal or may
    remain insufficient and become chronic

    Acute Kidney Failure


    Subjective symptoms
    Nausea
    Loss of appetite
    Headache
    Lethargy
    Tingling in extremities

    Acute Kidney Failure


    Objective
    symptoms
    Oliguric phase
    vomiting
    disorientation,
    edema,
    ^K+
    decrease Na
    ^ BUN and
    creatinine
    Acidosis
    uremic breath

    CHF and
    pulmonary edema
    hypertension
    caused by
    hypovolemia,
    anorexia
    sudden drop in
    UOP
    convulsions, coma
    changes in bowels

    Acute Kidney Failure


    Objective systoms
    Diuretic phase
    Increased UOP
    Gradual decline in BUN and creatinine
    Hypokalemia
    Hyponaturmia
    Tachycardia
    Improved LOC

    Acute Kidney Failure


    Diagnostic tests
    H&P
    BUN, creatinine, sodium, potassium. pH,
    bicarb. Hgb and Hct
    Urine studies
    US of kidneys
    KUB
    ABD and renal CT/MRI
    Retrograde pyloegram

    Chronic Kidney Failure


    Chronic
    Progressive
    Not reversible
    Nephron Loss
    75 % of function can be lost before its
    noticeable

    Chronic Kidney Failure


    Results form gradual, progressive loss of
    renal function
    Occasionally results from rapid
    progression of acute renal failure
    Symptoms occur when 75% of function
    is lost but considered cohrnic if 90-95%
    loss of function
    Dialysis is necessary D/T accumulation
    or uremic toxins, which produce
    changes in major organs

    Chronic Kidney Failure


    Subjective symptoms are relatively
    same as acute
    Objective symptoms
    Renal
    Hyponaturmia
    Dry mouth
    Poor skin turgor
    Confusion, salt overload, accumulation of K with
    muscle weakness
    Fluid overload and metabolic acidosis
    Proteinuria, glycosuria
    Urine = RBCs, WBCs, and casts

    Chronic Kidney Failure


    Objective
    symptoms
    Cardiovascular
    Hypertension
    Arrythmias
    Pericardial effusion
    CHF
    Peripheral edema

    Neurological
    Burning, pain, and
    itching, parestnesia
    Motor nerve
    dysfunction
    Muscle cramping
    Shortened memory
    span
    Apathy
    Drowsy, confused,
    seizures, coma, EEG
    changes

    Chronic Kidney Failure


    Objective
    symptoms
    GI
    Stomatitis
    Ulcers
    Pancreatitis
    Uremic fetor
    Vomiting
    consitpation

    Respiratory
    ^ chance of
    infection
    Pulmonary edema
    Pleural friction rub
    and effusion
    Dyspnea
    Kussmauls
    respirations from
    acidosis

    Chronic Kidney Failure


    Objective symptoms
    Endocrine
    Stunted growth in
    children
    Amenorrhea
    Male impotence
    ^ aldosterone
    secretion
    Impaired glucose
    levels R/T impaired
    CHO metabolism
    Thyroid and
    parathyroid
    abnormalities

    Hemopoietic
    Anemia
    Decrease in RBC
    survival time
    Blood loss from
    dialysis and GI bleed
    Platelet deficits
    Bleeding and clotting
    disorders purpura
    and hemorrhage
    from body orifices ,
    ecchymoses

    Chronic Kidney Failure


    Objective
    symptoms
    Skeletal
    Muscle and bone
    pain
    Bone
    demineralization
    Pathological
    fractures
    Blood vessel
    calcifications in
    myocardium,
    joints, eyes, and
    brain

    Skin
    Yellow-bronze skin
    with pallor
    Puritus
    Purpura
    Uremic frost
    Thin, brittle nails
    Dry, brittle hair,
    and may have
    color changes and
    alopecia

    Chronic Kidney Failure


    Lab findings
    BUN indicator of glomerular filtration rate
    and is affected by the breakdown of protein.
    Normal is 10-20mg/dL. When reaches 70 =
    dialysis
    Serum creatinine waste product of skeletal
    muscle breakdown and is a better indicator
    of kidney function. Normal is 0.5-1.5 mg/dL.
    When reaches 10 x normal, it is time for
    dialysis
    Creatinine clearance is best determent of
    kidney function. Must be a 12-24 hour urine
    collection. Normal is > 100 ml/min

    Chronic Kidney Failure


    K+ The kidneys are means which K+ is
    excreted. Normal is 3.5-5.0 ,mEq/L.
    maintains muscle contraction and is
    essential for cardiac function.
    Both elevated and decreased can cause
    problems with cardiac rhythm
    Hyperkalemia is treated with IV glucose and
    Na Bicarb which pushes K+ back into the
    cell
    Kayexalate is also used

    Chronic Kidney Failure


    Ca
    With disease in the kidney, the enzyme for
    utilization of Vit D is absent
    Ca absorption depends upon Vit D
    Body moves Ca out of the bone to
    compensate and with that Ca comes
    phosphate bound to it.
    Normal Ca level is 4.5-5.5 mEq/L
    Hypocalcemia = tetany
    Treat with calcium with Vit D and phosphate
    Avoid antacids with magnesium

    Chronic Kidney Failure


    Other abnormal findings
    Metabolic acidosis
    Fluid imbalance
    Insulin resistance
    Anemia
    Immunoligical problems

    Chronic Kidney Failure


    Nursing diagnosis
    Excess fluid volume
    Imbalanced nutrition
    Ineffective coping
    Risk for infection
    Risk for injury

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