Pathophysiology of Chronic Renal Failure

Chronic Renal Failure refers to the progressive deterioration of renal function. With the disease progression, the patients will present a series of symptoms like anemia, vomiting, fatigue and so on. The pathophysiology of Chronic Renal Failure is as follows:
At first, as the renal function declines, the patients only show few abnormalities because the kidneys’ compensatory capacity, the residual nephrons will increase their performance. When more than 75% of the renal tissues are damaged, the glomerular filtration rate (GFR) will decline to only 50% of the normal level.
With the renal function decreases, the renal function is interfered. The kidneys lose their function in keeping the fluid and electrolyte balance in body. Moreover, the concentration of urine ability declines leading to increased urination at night, which is followed by the decline in the secretion of phosphate and acid and potassium. When glomerular filtration rate (GFR) decreases (GFR≤ 10 mL/min/1.73 m2), the urine volume will reduces drastically and the patients even may experience anuria.
As the compensatory ability of kidneys, the creatinine and BUN levels do not elevate at the beginning of Kidney Disease. When GFR declines by 50%, the creatinine level will begin to rise. When the GFR declines below 10 mL/min/1.73 m2, M, the levels of creatinine and BUN increase along with the appearances of complications like anemia, vomiting, nausea and so on.
For the GFR diminishing, the water and sodium balance is disturbed, which is followed by hypervolemia. In severe case, heart failure may occur due to sodium and water overload.
Anemia is a characteristic in Chronic Renal Failure due to the decreased secretion of erythrogenin by kidneys. Also vomiting, nausea and poor appetite also contribute to the anemia.
Moreover, due to hyperparathyroidism, calcitriol deficiency and increased serum phosphate as well as lower serum Ca, it will cause increased bone turnover thus leading to renal osteodystrophy.
The above article has introduced the pathophysiology of Chronic Renal Failure and it can provide useful information for you. Any question? Email me at khkpcn@hotmail.com.