Early Stage Chronic Renal Failure

Causes of kidney disease are wide-ranging in number; however diabetes, high blood pressure, inherited disease, and infection remain to be the contenders of cause (Davidson, 2011). Acute kidney disease can be identified by anuria and oedema. CKD is often called a “silent” killer, because instead of a sign, that would render immediate evidence, CKD only provides symptoms that many don’t know to correlate to renal issues. The symptoms may also increase at the latter stages of the

All the symptoms that were described were based on the kidney functions, so more and further

Acute renal failure occurs quickly over a period of days or weeks with a reduction in GFR and elevation of BUN, plasma creatinine and crystatin C levels. Oliguria (urine output of < 30ml/hr or < 400 ml/day) is usually associated with ARF, although urine output may be normal or increased as well. Fluid is still filtered at the glomerulus but there is an alteration in tubular secretion or reabsorption. Most types of ARF are reversible if diagnosed and treated early (Perrin, 2009).

Creatinine and BUN levels are high related to the kidneys not functioning properly due to the C. Diff. Infection. The kidneys are not filtering out waste products of the body.

According to “MedlinePlus,” U.S. National Library of Medicine, "End-stage kidney disease is the last stage of chronic kidney disease. This is when your kidneys can no longer support your body's needs. End-stage kidney disease is also called end-stage renal disease (ESRD)” (“End-stage Kidney Disease”). Renal failure is a disease that prevents the kidneys from getting rid of wastes and extra fluids. It can damage other organs, and it may cause death.

M.T. has a 1-year history of atrial fibrillation. She takes warfarin daily, and her INR is within the therapeutic range, between 2 and 3. Her creatinine level is 1.3 mg/dL, and a normal level is 0.6-1.2 mg/dl for women. This indicates that she has slightly reduced renal function at this time, possibly due to her diabetes, medications, age, or urinary tract infection (UTI). She has been diagnosed with acute uncomplicated UTI. The 24-hour history of dysuria, urinary frequency, and urgency combined with the urinalysis result

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

Chronic Kidney Disease (CKD) is a disease that is described as a loss of kidney function gradually over time. As kidney function decreases, the waste collection in the body’s blood becomes high and makes the individual feel sick. This disease can lead to other complications in the body such as anemia, poor nutritional health, high blood pressure, and nerve damage. These complications will begin to progress and show as CKD progresses to advanced stages. Early detection of this disease is essential when it comes to treatment. If CKD is diagnosed early enough the disease progression can be slowed down and managed. This disease will eventually lead to failure of the kidneys

pain. The second stage is the chronic renal failure, which is accompanied by feelings of

We were told the patient had oliguria which is low urine output, the patient passed 100ml in 24 hours which is well below the normal 750ml. This indicates some serious damage somewhere in the genitourinary system but this does necessarily indicate a kidney prognosis and could be due to other organ pathologies which cause low urine output such as prostatitis or a UTI (Klahr and Miller 1998). Microscopic analysis of the urine revealed high numbers of red blood cells both burst and intact and red blood cell casts but no crystals. This is evidence for damage to the kidneys as bleeding further down the urinary tract e.g. the bladder would be less likely to result in burst cells in the urine plus the formation of red blood cell casts is an indicator of glomerular damage such as inflammation (Sigala, Biava and Hulter 1978). The dipstick confirmed the presence of protein at 30mg/dL and also showed there were 250 ERY/uL with normal glucose levels. While the protein level is not that high, the number of red blood cells is huge, this is a clear indicator of glomerular damage as the filtration membrane is clearly not functional, as there are blood cells in the urine, the fenestrated endothelium is likely damaged. The GFR of 20 ml/min/1.73m2 is extremely low, indicating severely decreased function (Medsci 301 Course Guide 2015), providing further evidence for damage to the glomerulus as this is where filtration occurs. When observing the photomicrographs, the glomeruli are hard to see amongst large amounts of hyaline material, there is clearly an exudate in capsular space and there are large numbers of inflammatory cells. All these factors point to inflammation as the cause of the damage as this would cause the deposition of the hyaline material, lead to the exudate as vascular permeability is increased and also lead to the infiltration of immune cells into the reactive tissue.

In patients with heart failure, hypovolemia, cirrhosis, nephrotic syndrome, or hypoalbuminemia, renal function may be further compromised. BUN, creatinine clearance, and urine output should be monitored closely (Lexi-Comp, 2016).

Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,

Chronic Kidney Disease (CKD) is among the leading causes of mortality throughout the world, and its prevalence and the health care costs resulting from it are considerable and increasing. CKD commonly is silent and asymptomatic until its late stages. Accordingly, CKD is diagnosed prior to symptomatic stage of kidney failure, resulting in delays in proper interventions and the emergence of adverse consequences in the CKD patients

What health issues has Mr. Armstrong had that can factor into the development of renal failure?

common in patients who have had kidney transplantation.22 There are several causes that lead to