Question

1. Why may the following occur in renal failure?
   • Decreased GFR
   • Increased bone breakdown
   • Increased K+
   • Increased phosphorus
   • Itching
   • Increased BUN/Cr
   • Decreased albumin

Answer 1

DECREASED GFR--

Glomerular Filtration Rate tells about how well kidneys are working.Kidneys remove waste and excess fluid from the blood,when kidneys are not working properly,they do not filter the waste and should remain in body.GFR number estimate the kidney function.if number low means kidneys are not functioning well.

Normal GFR number is 90 or higher in adults.

60 and 89 may be normal.

Below 60 is abnormal

Below 15 indicates renal failure.

INCREASED BONE BREAKDOWN--

Kidneys play an important role in maintaining healthy bone mass and structure by balancing phosphorus and calcium levels in the blood.Hwalthy kidneys activate a form of Vitamin D that a person consume in food,turning it into calcitriol.Calcitriol helps the kidneys to maintain blood calcium levels and promote the formation of bone.

Chronic kidney disease cause bone disorder because the kidneys do not properly balance.The kidneys stop activating calcitriol.The low levels of calcitriol in the body create an imbalance of calcium in the blood.Another factor is,when kidneys are damaged,the parathyroid gland relaease parathyroid hormone into the blood to pull calcium from the bone and raise calcium levels in blood.The response the balance of calcium however,it starves the bones of much needed calcium.

INCREASED K+

The extra potassium that body does not need is removed from blood by kidneys.When kidneys fail they can not remove extra potassium then that level builds up in the body.It is also called hyperkalemia.It occur mostly in Advanced stage of kidney disease.

INCREASED PHOSPHORUS---

Phosphorous in the blood is also known as hyperphosphatemia.Phosphorus is a mineral.It works with calcium and vitamin D in body to keep bones healthy and strong.Healthy kidneys keep the right amount of phosphorus in body but when kidneys are not working well,phosphorus can build up to dangerous levels in blood.When too much phosphorus in the blood body will pull calcium from the bones to match the amount of phosphorus in the blood it cause bones to become weak and brittle.

ITCHING---

Uraemic pruritus is also called Kidney associater pruritis.It refers to excessive urea in the blood.It occurs when both kidneys stop functioning.It is a common with end stage renal disease patients.It caused due to dry skin,reduction of sweating,abnormal metabolism of calcium and phosphorus,accumulation of toxins and systemic inflammation.

INCREASED BUN/CR---

Blood urea nitrogen (BUN) is an normal waste product in blood that comes from the breakdown of protein from the food that we consume and from body metabolisn.Normally it is removed from blood by the kidneys but when kidneys function slows down the level of BUN rises.

Raisee creatinine level occurs due to kidney disease.It occurs due to poor clearance of creatinine by the kidneys.

DECREASED ALBUMIN---

Hyperalbuminemia is common in patients with end stage renal disease (ESRD).It is caused by a combination of a reduced synthesis and inceeased degradation of albumin.The altered level caused by a systemic inflammatory disease.Albumin provided the body with the protein needed to maintain growth and repair tissues.Problems with kidneys cause them to release large amounts of protein into the urine.This can take albumin from the blood and leads to hypoalbuminemia.