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Metabolic Acidosis In Renal Failure Pathophysiology

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Chronic Kidney Disease (ckd)

Progressive loss of renal function over time; based on a gradual decline in the GFR and creatinine clearance. The diagnosis of CKD requires the following: Decline of kidney function for 3 months or more AND Evidence of kidney damage (e.g. albuminuria or abnormal biopsy) OR GFR <60 mL/min/1.73 m2 Each patient is classified into one of the following 5 stages of CKD because management and prognosis varies according to the progression of damage. Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2) Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2) Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m2) Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2) Stage 5: Kidney failure (GFR <15 mL/min/1.73 m2 or dialysis) Etiology and pathogenesis Many causes of CKD exist, however, this chapter will focus on the most prevalent causes including hypertension, diabetes, glomerulonephritis and urinary tract obstructions. Glomerular and vascular changes: Elevated systemic blood pressures cause a hypertrophic response leading to intimal thickening of the large and the small vasculature. The mechanisms are compensatory at first, but later lead to glomerular damage Global s Continue reading >>

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Popular Questions

  1. duranie

    ketones in urine

    Ok so should I worry, if so how much. My ketones have been neutral since about 1 weeks after starting insulin therapy, however I've just tested and they're on the "faible" pink. What should I do?, I don't want to make a huge thing out of something that might not be??

  2. l0vaduck

    Nothing to worry about. Just keep an eye on it.
    Most people get traces of ketones now and again, is it a long time since you last ate?
    Only time to worry is if your blood sugar's high with it and you can't get it down. Even then weak ketones aren't going to hurt you.

  3. Caraline

    Yup, like Duck says just keen an eye on it. If you are otherwise well, it is likely nothing to worry about. You can have trace or small amounts of ketones for a number of reasons, some quite innocent... like getting a bit dehydrated, fasting, skipping meals, eating a very low carb diet. Even non diabetic folk can spill ketones & is not uncommon in people following diets like Atkins.

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