Title
Chronic Renal Failure
Group 5B
Instructor Name:Dr/Heba Osman
Student Name:Abdallah Mohamed Elahmar
Group: 5B
Definition
Chronic renal failure is a condition involving a decrease in
the kidneys' ability to filter waste and fluid from the
blood. It is chronic, meaning that the condition develops
over a long period of time and is not reversible. The
condition is also commonly known as chronic kidney
disease (CKD).
Causes
Chronic renal failure mostly occurs in people who have
other medical conditions which cause damage to the
small units in the kidneys, called nephrons, which are
responsible for filtering waste and fluid from the blood.
Common conditions which can cause chronic renal
failure include:
1- Diabetes
One in three adults with diabetes are likely to
develop chronic renal failure
2- Hypertension
One in five adults with high blood pressure are
likely to develop chronic renal failure. People with
diabetes and hypertension, who are at high risk of
developing chronic renal failure, should have
regular health checks to measure their glomerular
filtration rate. Diabetics should also have regular
microalbumin tests. These tests can detect early
signs of the condition.
Less common conditions that can cause chronic renal
failure include:
1- Polycystic kidney disease, a range of genetic
disorders
2- Nephrotic syndrome, also called nephritis and
glomerulonephritis, is a condition which damages
the glomeruli and can be caused by strep throat
and lupus, among other conditions
3- Inflammation of the kidneys
4- Repeated kidney infections and frequent kidney
stones
5- People who have some malformation of their
kidneys or urinary tract are at higher risk of
eventually developing chronic renal failure. Once
the kidneys have lost a significant amount of
function, they may not be able to recover, and the
person may progress to end-stage renal disease.
Diagnosis
Chronic renal failure can be diagnosed by measuring
kidney function and is typically tested for by taking blood
and urine samples to measure creatinine levels. This is a
waste product of creatine, which is a chemical the body
produces to supply energy, primarily to muscles and the
brain.
The two main diagnostic tests are:
1- Glomerular filtration rate (GFR).
Checks how well the glomeruli are working. To
check the filtration rate, a blood sample is taken
which is then tested in a lab. The results are
combined with factors including age, ethnicity,
gender, height and weight to estimate a person’s
glomerular filtration rate.
2- Creatinine clearance test.
Another way of calculating the glomerular
filtration rate. To perform the test, a person needs
to collect all their urine for a 24 hour period and
then provide a blood sample. Comparing
creatinine levels in the blood and urine allows a
person’s glomerular filtration rate to be estimated.
If a person has a glomerular filtration rate of less than
60mL/min/1.73m2 for three months or more, they are
classed as having chronic renal failure or kidney
damage.14 Normal results are in the 90mL/min/1.73m2
to 120mL/min/1.73m2 range.
Additionally, an ultrasound of the kidneys and urinary
tract may be necessary. In some cases, it may be
necessary to take a small sample of the kidney, called a
biopsy, in order to find the underlying cause for the
condition.
Treatment
Treatment involves controlling the condition that is
harming the kidneys. In particular, people
with hypertension or diabetes should make sure that
these conditions are well controlled.
Keeping blood sugar and blood pressure under
control will slow down further kidney damage.
Angiotensin-converting enzyme (ACE) inhibitors or
angiotensin receptor blockers (ARBs) are the preferred
option for managing hypertension.
Other medical conditions involving the kidneys can be
managed with the help of a nephrologist (a specialist
kidney doctor).
If chronic renal failure is diagnosed early and carefully
managed, this may help to prevent the condition from
worsening and progressing to end-stage renal failure.
People with kidneys that no longer work well enough to
filter blood and fluid may need dialysis, a process in
which the blood is cleaned by a machine. Everyone with
end-stage renal failure should be evaluated for a kidney
transplant.
References
1- MedlinePlus. “Creatine.” January 2018. Accessed May 17, 2018.
↩
2- MedlinePlus. “Glomerular filtration rate.” July 2017. Accessed
May 17, 2018. ↩ ↩
3- MedlinePlus. “Creatinine clearance test.” July 2017. Accessed May
17, 2018. ↩
4- MedlinePlus. “Urine 24-hour volume.” August 2015. Accessed
May 17, 2018. ↩
5- US National Library of Medicine. “Chronic renal disease.” July
2002. Accessed May 17,
6- https://www.cdc.gov/kidneydisease/prevention-risk.html
7- https://ada.com/conditions/chronic-renal-
failure/#:~:text=Chronic%20renal%20failure%20is%20a,chronic%2
0kidney%20disease%20(CKD).
