Crn

Chronic Renal Failure
Synonyms	Chronic Kidney Disease (CKD)
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, edema, hypertension, anemia, uremia
Complications	Cardiovascular disease, bone disease, anemia
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Diabetes mellitus, hypertension, glomerulonephritis, polycystic kidney disease
Risks	Diabetes, hypertension, family history, age
Diagnosis	Blood tests, urinalysis, imaging studies
Differential diagnosis	N/A
Prevention	N/A
Treatment	Dietary management, medications, dialysis, kidney transplant
Medication	N/A
Prognosis	Variable
Frequency	Common
Deaths	N/A

Chronic Renal Failure (CRF), also known as Chronic Kidney Disease (CKD), is a progressive loss of kidney function over a period of months or years. It is characterized by a gradual decline in the kidneys' ability to filter waste products from the blood, leading to an accumulation of toxins and other metabolic waste products in the body.

Pathophysiology

Chronic Renal Failure occurs when there is a significant reduction in the number of functioning nephrons, the basic structural and functional units of the kidney. This reduction can be due to various underlying conditions that cause damage to the nephrons, such as diabetes mellitus, hypertension, and glomerulonephritis. As the number of functioning nephrons decreases, the remaining nephrons undergo hypertrophy and hyperfiltration to compensate for the loss, which eventually leads to further nephron damage and progression of the disease.

Causes

The most common causes of Chronic Renal Failure include:

• Diabetes mellitus: High blood sugar levels can damage the blood vessels in the kidneys, leading to diabetic nephropathy.
• Hypertension: High blood pressure can cause damage to the kidney's blood vessels, leading to hypertensive nephrosclerosis.
• Glomerulonephritis: Inflammation of the glomeruli can lead to scarring and loss of kidney function.
• Polycystic kidney disease: A genetic disorder characterized by the growth of numerous cysts in the kidneys.

Symptoms

The symptoms of Chronic Renal Failure may not become apparent until the disease is advanced. Common symptoms include:

• Fatigue
• Edema (swelling, particularly in the legs and ankles)
• Hypertension (high blood pressure)
• Anemia
• Uremia (buildup of waste products in the blood)

Diagnosis

Chronic Renal Failure is diagnosed through a combination of:

• Blood tests: Measuring serum creatinine and blood urea nitrogen (BUN) levels to assess kidney function.
• Urinalysis: Checking for proteinuria and other abnormalities in the urine.
• Imaging studies: Ultrasound or CT scans to assess the size and structure of the kidneys.

Stages

Chronic Renal Failure is classified into five stages based on the glomerular filtration rate (GFR):

• 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)

Treatment

The management of Chronic Renal Failure involves:

• Dietary management: Restricting protein, sodium, potassium, and phosphorus intake to reduce the burden on the kidneys.
• Medications: Controlling blood pressure, managing diabetes, and treating anemia with erythropoiesis-stimulating agents.
• Dialysis: A treatment that performs the function of the kidneys by removing waste products and excess fluid from the blood.
• Kidney transplant: Replacing the diseased kidney with a healthy one from a donor.

Prognosis

The prognosis of Chronic Renal Failure varies depending on the underlying cause, the stage at diagnosis, and the effectiveness of treatment. Early detection and management can slow the progression of the disease and improve quality of life.

Prevention

Preventive measures include:

• Controlling blood pressure and blood sugar levels.
• Regular monitoring of kidney function in individuals at risk.
• Lifestyle modifications such as maintaining a healthy diet and regular exercise.

See also

• Acute kidney injury
• End-stage renal disease
• Nephrology

Classification
External resources