chronic renalfilure for foreign student 病理生理学双语课件.ppt

* Company Logo (3) Other alteration 1) renal hypertension： ① About 30% of ESRD is related to hypertension ②Targeted mean pressure 92-98mmHg in patients ③ mechanism: *retention of H2O Na+; *RAAS ↑; *vasodilative substances ↓: PGA2 , kinin Metabolism Function * Company Logo 2) renal anemia： Due to reduced erythropoietin production by kidney Occurs when creatinine rises to 2.5-3mg/dL or exceed it. Metabolism Function * Company Logo 3) bleeding tendency： Platelet dysfunction - usually with prolonged bleeding times. 4) immunity dysfunction 5) Renal osteodystrophy Metabolism Function P3+ excretion failure, serum P3+↑ acidosis Bone salt dissolve CRF Sensitivity of target cell to PTH↓ Bone Ca2+ ↓ Intestine absorb Ca2+ ↓ Hypocalcemia PTH inhibitor ↓ Bone calcium deposit failure Mechanism of renal osteodystrophy Renal osteodystrophy 1,25(OH)2D3 PTH ↑ Metabolism Function * Company Logo ARF CRF History Kidney function normal History of BUN and Cr ↑ Kidney size shrink, excluding diabetic, polycystic kidney, etc Normal Bone X-ray No evidence of RO evidence of RO Anemia Rare, unless caused by hemorrhage common Comparison of AFR and CRF RO: renal osteodystrophy Metabolism Function * Company Logo (1) concept： a clinical and biochemical syndrome occurs in ARF or CFR showing a series of toxicity symptoms due to metabolic products, endogenic toxins and the disturbance of homeostasis. 7. Uremia * Company Logo (2) Function and metabolic changes 1) NS ① uremic encephalopathy: coma, paralysis ② peripheral neuropathy: unusual feeling, nerve paralysis, etc. 2) Digestion system: It is the earliest and prominent symptoms in uremic patient: no appetite, vomit, etc. Uremia * Company Logo 3) Cardiovascular system: congestive heart failure, arrhythmia, uremic pericarditis. 4) Other changes: itchy s