陆福明尿毒症课件.pptVIP

Chronic Renal Insufficiency Lu Fuming Division of Nephrology,Huashan Hospital,Fudan University Chronic Renal Insufficiency Pathogen and pathogenesis Manifestation Laboratory examination Diagnosis and differential diagnosis Treatment Etiology primary glomerular diseases hypertensive nephrosclerosis diabetic nephropathy chronic pyelonephritis multicystic kidney systemic lupus nephritis Pathogenesis Mechanism associated with exacerbation of renal function Mechanism associated with uremic symptom Mechanism Associated With Exacerbation of Renal Function Hyperfiltration theory Effect of proteinuria Trade-off hypothesis in acidosis Disturbance of lipid metabolism Tubulointerstitial injury Renal hypoxia Mechanism Associated With Uremic Symptom Uremic toxins malnutrition trade-off hypothesis Endocrine dysfunction Manifestation of the Uremic Syndrome Gastrointestinal Cardiovascular Hematologic Pulmonary Gastrointestinal Manifestation Anorexia progressing to nausea and vomiting Stomatitis and gingivitis Parotitis Peptic ulcer diathesis Gastritis , duodenitis and enterocolitis Pancreatitis Ascites Cardiovascular Manifestation Accelerated atherosclerosis Cardiomyopathy pericarditis Hematologic Manifestation Anemia Altered neutrophilic chemotaxis Depressed lymphocyte function Platelet dysfunction Pulmonary Manifestation Atypical pulmonary edema Pneumonitis Fibrinous pleuritis Neurologic Manifestation Central Daytime drowsiness,a tendency to sleep,coma Decreased attentiveness Seizures Disorientation and confusion Peripheral Restless leg syndrome Sensorimotor peripheral neuropathy Increased muscle fatigability and muscle cramps Dermatologic Manifestation Pruritus Dystrophic calcification Changes in skin pigmentation Renal Osteodystrophy high bone turnover disease low bone turnover disease Mixed bone disease Endocrinologic Manifestation Secondary hyperparathyroidism Insulin resistance Type IV hyperlipidemia Altered peripheral thyroxine metabolism Testicular atrophy O