In: Nursing
Pathophysiology of end of stage renal failure. please at the minimum of 8 to 10 sentence.
CHRONIC RENAL FAILURE (CRF) is a slow, progressive, irreversible loss in kidney function.it occurs in stages and results in uremia or END STAGE RENAL DISEASE.
STAGES OF CHRONIC RENAL FAILURE
STAGE I: DIMINISHED RENAL RESERVE.
Renal function reduced.
No accumulation of metabolic wastes.
Decreased ability to concentrate urine.
Nocturia and polyuria.
Healthier kidney compensates.
STAGE II: RENAL INSUFFICENCY.
Metabolic wastes begin to accumulate.
Decreased responsiveness to diuretics.
Decreased ability of the healthier kidney to compensate oliguria and edema.
STAGE III: END STAGE.
Excessive accumulation of metabolic wastes.
Kidneys unable to maintain homeostasis.
Dialysis or other renal replacement therapy required.
PATHOPHYSIOLOGY
The pathogenesis of CRF involves deterioration and destruction of nephrons with progressive loss of renal function. As the total GFR decreses and clearance is reduced, serum urea nitrogen and creatinine levels increase. Remaining functioning nephrons hypertrophy as they filter a larger load of solutes. A consequence is that the kidneys lose their ability to concentrate urine adequately. To continue excreting the solutes, a large volume of dilute urine may be passed, which makes the client susceptible to fluid depletion. The tubules gradually lose their ability to reabsorb electrolytes. Occasionally, the result is salt wasting, in which urine contains large amounts of sodium, which leads to more polyuria.
As renal damage advances and the number of functioning nephrons declines, the total GFR decreses further. Thus the body becomes unable to rid itself of excess water, salt, and other waste products through the kidneys. When the GFR is < 10-20 ml/minute, the effect of uremic toxins on the body becomes evident. If the disease is not treated by dialysis or transplantation, the outcome of CRF is uremia and death.