Chronic renal failure (CRF)

chronic renal failure

1. MR .ROMAN BAJRANG BASIC BS.C NURSING 2 ND YEAR RELIANCE INSTITUTE OF NURSING LIMTARA DHAMTARI CHRONIC RENAL FAILURE

2. INTRODUCTION Chronic renal failure (CRF) affects approximately 290.000 people in the united states. It occurs with a gradual decrease in the function of the kidneys over time this loss of function is not reversible. Chronic kidneys disease also know as the chronic renal failure is a rapidly progressive deterioration or loss of renal function.

3. DEFINATION “According to BT basavanthappa ” Chronic renal failure commonly classified as chronic kidney disease and is listed as stage based on the patient level of glomerular filtration capacity of the kidney stage 2 is used for patient with a GRF of 60 to 90 ml per minute “According to medical dictionary” Chronic kidney disease also know as the chronic renal disease, chronic renal failure or chronic kidney failure and usually means the gradual loss of kidney function

4. INCIDENCE Chronic renal failure is a globel threed to health in general and for developing countries in particular because therepy is expensive and life long. In India 90% patient can not afford the case. Over 1 million people word wide are alive on dialysis or with a functioning graft. Incidence of chronic renal failure has doubled in the last 15 years. In the 30 million people suffer from chronic renal failure.

5. ANATOMY & PHYSIOLOGY Structure of the Kidney:- Kidney is a bean shaped organ. About 11 cm long, 6 cm wide, 3cm thick and 150 gram weight. They are embaded in and held in position by a mass of fat a sheath of fibrous connective tissue the renal fascia enclosed the kidney and the renal fat. The kidney lie on the posterior abdominal wall on are each side of vertebral column. Behind the peritoneum and below the diaphagm . They extend from the level of 12 th thoracic vertebra to the 3 rd lumber vertebra.

6. Function of the Kidney:- Formation and secration of urine which regulated total body water electrolyte and acid base balance and enable excretion of water. Production and secration of erythropoietin the hormone that stimulate formation of red blood cells. Production and secration of urine or renin on important enzyme in the contral of blood pressure. Excretion of waste product. Production and secretion of renin.

7. ETIOLOGY:- Hypertension. Diabetes mellitus. Kidney stone and infection. Injury or troama . Nephrotic agent. Certain and chemical.

8. PATHOPHYSIOLOGY Due to etiological factors renal function declines. Nephron damage is progessive damage nephron can not function and to not recover. Decreased glomerular filtration rate. Remaining nephrons under go change.

9. To compensate for those damaged nephrons. Compensatory excretion continue GFR diminished. Filtration of more concentrated blood by the remaining nephrons. Damage of nephron results in hypertrophy and hyper phosphatenia of remaining nephron. Urine may contain abnormal amount of protein RBCs, white blood cells or casts.

10. Increased serum creatinine bun level and retention of urea and other introgenous Futher damage of the nephron 80-90% damage CFR 10-20%. Than lead to chronic renal failure.

11. CLINICAL MANIFESTATION:- Chronic renal failure(CRF) usually produce symptoms when renal function which measured as the glomerular filtration rate falls below the 30 million per minutes this is approximataly 30%of the normal value. Chronic symptom:- Chronic symptoms can affect every organ system. Most of noticeably the following :- Neurologocal systems. Gastrointestinal system. Blood forming system. Pulmonary system. Cardiovascular system.

12. Other symptoms:- General illness feeling and fatigue. Weakness. Oliguria. Weight loss. Bone pain. Sleeping disturbance. Menstrual periods stops

13. DIAGNOSTIC EVALUATION History taking. Physical examination. Blood testing. Urine testing. Electrocardiogram. Imaging test. Kidney biopsy. Renal function test.

14. MANAGEMENT:- ( A) Medical management:- Kidney has excellent ability to recover the treatment aims to restore normal chemical balance and prevent complication. Shock and infection it present should be treated. For maintained of fluid balance daily weight monitoring. Excess of fluid can be distended neck veins plural effusion occurs circulatory failure can take place diaretic are provided to the patient. Dialysis is some times necessary to prevent serious complication related to electrolytes.

15. (B) Pharmacological management:- s.no Name of the drug Dose Route Action Side effect 01 Azathioprine IV 02 Carticasteroids methyl prednisolone IV 03 Cycla phasphamide IV, IM 04 Cycla sporine IV 05 Ranitidine 150mg Orally, IM 06 Anatacids Orally

16. ( C) Surgical management:- kidney transplant surgary . Dialysis. Hemodialysis. ( D) nursing management:- to monitor and manage fluid and electrolyte balance. To reduce metabolic rate. To promote pulmonary function. To prevent infection. To provide skin care. To provide support. To provide nutritonal therepy .

17. COMPLICATION Food retention which could lead to sweeling in your arms and langs high blood presure or fluid in your langs ( palmonary adema ). A sudden risk in potassium levels in your blood which could impair your heats ability to function and may be life threating . Heart ans blood vessels . Weak bones and on increased risk of bone fractures. Anemia. Decreased sex drive erectile dys functions or reduced fertility. Damage to your central nervous system which can cause difficulty concentration personality change or seizures. Decrease immune response which makes you more vulnerable to infaction . Pregnecy complication that carry risk for the mother and the deucloping factor.

18. PREVENTION:- Maintain healthy weight. Donot smooke . Eat a healthy food. Physical activity part of your routine. Get enough sleeps. Explore stress – reducing activity. Regular exercise. Be careful with pain killas . Lower salt in your diet.

19. HEALTH EDUCATION:- Intake output:- Drink safe water. Drink water 50ml/dl. Use chlorine in drinking water. Hygiene:- maintain person hygiene. Wash the hand before intake water and food. Excersize :- Active and pasive excersize . To protecte the injury. To maintain health. Rest and sleep:- Giving the active in patient to feel better in rest, sleep. Rest for 8-10 hour.