Chronic renal failure (CRF) is to create several causes chronic progressive renal damage, resulting in a dramatic drop in the kidneys can not maintain basic functions, clinical metabolites retaining water, electrolytes, acid-base appearance, all the commitment body system as the main manifestation of the clinical syndrome.
The causes of chronic renal failure
The main causes no primary glomerulonephritis, chronic pyelonephritis, renal arteriosclerosis, hypertension, diabetic nephropathy, secondary glomerulonephritis, tubulointerstitial lesions, hereditary kidney disease and long-term use of antipyretic analgesics and exposure to heavy metals ect.
1. They must strive to define the etiology of chronic renal failure, renal failure should be clear is based glomerular damage or renal tubular interstitial disease base, or to prominent renal vascular lesions, so based on the clinical features, targeted therapy.
2. Chronic renal failure should be identified to promote the progressive deterioration of renal function reversiblescomo factors infection, drug-induced renal injury, metabolic acidosis, dehydration, heart failure, low blood pressure too fast, too low ect.
3. You must find certain factors exacerbate chronic renal failure progressive deterioration, such as hypertension, hyperlipidemia, hypercoagulable state, high protein intake, proteinuria, etc.
The various periods of chronic renal failure
When chronic renal failure, is called uremia, is not an independent disease, is caused by a variety of causes progressive deterioration of renal damage, when the development of renal function in terminal stage near the normal 10% to 15% there were a number of clinical syndromes.
Especially due to renal dysfunction in a long process of development, different stages have different levels and features of the level of kidney function traditionally divided into the following period.
1. decompensated renal function
When the glomerular filtration rate (GFR) ≥Normal value 1/2, BUN and creatinine is not high, the metabolic balance, no symptoms (Serum creatinine (Scr) in 133 ~ 177μmol / L (2 mg / dl)).
2. The time of renal failure
The glomerular filtration rate (GFR) <50% lower than normal value, serum creatinine (Scr) rose to above 177μmol / L (2 mg / dl), levels of blood urea nitrogen (BUN) rises > 7.0mmol / L (20mg / dl), patients with fatigue, loss of appetite, bedwetting, mild anemia and other symptoms.
3. The time of renal failure
When the rate of endogenous creatinine clearance (Ccr) Pasha to the next 20ml / min, BUN levels above 17.9 ~ 21.4mmol / L (50 ~ 60mg / dl), Scr rose 442μmol / L (5mg / dl) over the patients with anemia, increased phosphorus levels, decreased blood calcium, metabolic acidosis, water, electrolyte disorders.
4. Uremia end stage
Ccr to 10ml / min least rose Scr 707μmol / L more obvious acidosis symptoms occur each system, resulting in coma.
American Renal Disease Foundation DOQI expert on the method of chronic kidney disease (CKD) stage submitting new proposals. The phased approach has been widely recognized and used by clinicians.
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