II.

Pathophysiology

Pre-disposing Factors:
A. PATHOPHYSIOLOGY Hereditary
a. Schematic Diagram Age greater than 60 years old
Gender: Male are more common
Race: African-American
Precipitating Factors:
Diabetic Mellitus, Hypertension,
Glomerolonephritis
Increase Protein and Cholesterol
Intake
Smoking, Continuous use of
opiods

Decreased renal blood flow

Primary kidney disease
Damage from other diseases
Urine outflow obstruction

BUN Decreased Serum

glomerular filtration Creatinine

Hypertrophy of
Dilute remaining nephrons Loss of Sodium Hyponatremia
Polyuria in Urine

Inability to
concentrate urine
Dehydration

Further loss of
nephron function

Loss of nonexcretory 2
renal function a

Failure to convert Failure to produce Impaired insulin Production of Immune Disturbances in

inactive forms of eryhtropoietin action lipids disturbances reproduction
calcium

Advanced
Calcium Anemia Erratic blood
atherosclerosis Delayed Infection Libido Infertility
absorption Pallor glucose levels
wound healing

1
 2
1 a
Hypocalcemia Osteodystrophy
Loss of excretory
renal function

Excretion of Decreased Decreased Decreased Decreased

nitrogenous sodium potassium phosphate hydrogen
waste reabsorption in excretion excretion excretion
tubule
Uremia Hyperkalemia Hyperphosphatemia
Water Retention Metabolic
acidosis
BUN,
Creatinine Hypertension Decreased
Uric Acid Heart Failure calcium
Edema absorption

Proteniuria
Diet Modification Hypocalcemia
Low salt low fat diet
Vital signs and
intake and outpur Hyperparathyroidism
Peripheral
nerve monitoring
changes Anti-hypertensive Decreased
drugs potassium excretion
Diuretics
Pericarditis
Other Treatments:
Increased
Dialysis
potassium
Kidney Transplant
CNS
changes

Pruritus

Altered Taste

Bleeding
Tendencies