慢性肾功能不全英文.pptVIP

Chronic Renal Failure(CRF) Wang Weiming Department of Nephrology, Ruijin Hospital Shanghai Jiao Tong University Reasons for a National Kidney Disease Education Program Kidney failure is a public health problem Economical, effective testing and therapy exist Testing and therapy are inadequately applied Kidney Failure Compared to Cancer Deaths in the U.S. in 2000(in Thousands) The Kidney The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, converting Vit D into its active form, and stimulating RBC production by synthesizing erythropoietin. Definition final stage of numorous renal diseases resulting from progressive loss of glomerular, tubular and endocrine function in both kidneys. This leads to disturbed excretion of end products of metabolism disturbed elimination of electrolytes and water disturbed secretion of hormones(eg. Erythropoietin, renin, prostaglandins, active form of vitamin D) Incidence of CRF Britain 70-80/per million China 100/per million USA 60-70/per million CRF Stage 1: the normal stage of renal function GFR70 ml/min, BUN6.5 mmol/L, Scr110 umol/L Stage 2:imcompensation stage of renal GFR 50-70 ml/min, 6.5 BUN 9 mmol/L, 110 Scr 178 umol/L no any signs and symptoms except for the underlying disorders CRF Stage 3: azotemic stage GFR50 ml/min,BUN9 mmol/L Scr178 umol/L there may be slight fatigue,anorexia and anemia Stage 4: uremic stage GFR25 ml/min,BUN20 mmol/L Scr445 umol/L a constellation of uremic syndrome may appear in this stage 慢性肾衰分期比较 GFR (ml/min) CRF CKD 肾功能正常期 70 ?90 肾功能不全代偿期 50 ~ 70 60