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Chronic Renal Failure

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Chronic Renal Failure

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  1. Chronic Renal Failure

  2. Kidney function test The BUN test is often done to check kidney function. Normal Results 7 - 20 mg/dL. Note that normal values may vary among different laboratories

  3. Creatinine – blood Creatinine levels also vary according to a person's size and muscle mass. Normal Results A normal value is 0.8 to 1.4 mg/dL. Females usually have a lower creatinine than males, because they usually have less muscle mass.

  4. Creatinine - urine Normal Results Urine creatine (24-hour sample) values can range from 500 to 2000 mg/day. Results are highly dependent on your age and amount of lean body mass.

  5. Creatinine clearance Normal Results Clearance is often measured as milliliters/minute (ml/min). Normal values are: Male: 97 to 137 ml/min. Female: 88 to 128 ml/min.

  6. Case 1 Mr. A. is a patient with CRF secondary to chronic interstitial nephritis. He complains of chronic fatigue and breathlessness on exertion; his hemoglobin concentration was found to be 5.6 g/dl. Question: How should he be treated?

  7. Case 2 Mr D, 19 year old male complaining of a 3 month history of fatigue, weakness, nausea and vomiting that he had attributed to examination stress . laboratory results are Sodium 137 mmol/L (135-145) Potassium 4.8 mmolL (3.5-5) Phosphate 2.5 mmol/L (0.9-1.5) Calcium 1.6mmol/L ( 2.2-2.55) Urea 52mmolL (3-6.5) Creatinine 620μmolL (50-120) HB 7.5 g/dl (13.5-18) Diagnosis : chronic renal failure secondary to reflux nephropathy Q: Explain the signs and symptoms and the likely course of his disease

  8. Answer of case 1 Symptoms are most likely to result from A normochromic normocytic anemia Treatment: Hemodialysis Recombinant erythropoietin for treatment of anemia

  9. Answer of case 2 Patient is suffering from the signs and symptoms of uremia resulting from CRF, this leads to accumulation of toxins (urea and creatinine ) and this causes nausea, vomiting and general malaise . Reduced erythropoietin production leads to low HB level .

  10. Answer of case 2 Renal osteodystrophy (inadequate vitamin D ) leads to hyperphosphatemia and hypocalcaemia . There is a failure in the ability of the damaged kidneys to compensate and the symptoms appears late in the condition.