(精编)【高血压英文教学精品课件】 Chronic Renal Failure.pptVIP

Cardiovascular and pulmonary disease hypertension （高血压） congestive heart failure（充血性心衰） pericarditis atherosclerosis respiratory system symptoms Hemotologic anemia （贫血）(GFR 30-40 ml/min) EPO,inhibitor factor,shorten of RBC life span, short of materials, loss bleeding diathesis （出血倾向） gastrointestinal, vaginal, pericardial, intracranial leukocyte （白细胞）abnormalities Neurologic manifestations central nervous symptom uremic encephalopathy （尿毒症脑病） (fatigue疲劳,sleep disturbance, headache, muscular irritability,lethargy嗜睡, seizure, coma) peripheral nervous restless leg syndrome（不安腿综合症）,paresthesias感觉异常, motor weakness, paralysis瘫痪 autonomic neuropathy Dermatologic manifestations（皮肤表现） pallor苍白, hyperpigmentation, pruritus Renal osteodystrophy（肾性骨营养不良） high-bone turnover dis: osteitis fibrosa cystica, osteoporosis, osteosclerosis low-bone turnover dis: osteomalacia骨软化, osteopenia骨量减少 mixed Endocrine abnormalities Infection cellular immune function is depressed Metabolic disturbance carbohydrate （碳水化合物）metabolism glucose tolerance （葡萄糖耐量） is reduced insulin（胰岛素）resistance hyperlipidemia: triglyceride（甘油三酯） Fluid, electrolyte（电解质） and acid-base disturbance sodium （钠）and water potassium（钾） metabolic acidosis（代谢性酸中毒） abnormalities of calcium, phosphate （钙、磷） and vitamin D metabolism Diagnosis Differential diagnosis History Physical examination Lab (urinalalysis,renal function, biochemical analysis of blood) X-ray,ultrasound, radiorenogram Stage sCr (?mol/L) Ccr (ml/min) Clinical presentations Compensation stage of CRI 133 50 No any signs and symptoms Azotemic stage 445 50-25 Mild anemia, fatigue and anorexia Renal failure stage 445 25-10 Obvious GI symptoms,anemia, metabolic acidosis End stage 800 10 A constellation of uremic syndrome may appear. Classification of the severity of renal failure Treatment Primary disease and revers