Definition

Normal Glomerulus filtration rate = 125ml/1.73m². *The lost nephrons are not replaced.

• Stage 1: slightly higher GFR, slight decline in renal function(10-20%)
• Stage 2: 20-50% decreased in GFR
• Stage 3: >50-75% decrease in filtration rate, disease progresses easily
• Stage 4: 75-90%
• Stage 5: renal failure(End Stage Renal Disease:ESRD), GFR < 15mL/min

Etiology

• Diabetes mellitus(44%)
• Hypertension(28%)
• Chronic Glomerulonephritis(16%):SLE, Infection, Autoimmune

Pathophysiology and complications

• Various diseases affect different parts in nephron(the glomerulus, tubule, vasculature) then the increased load on the other parts makes it all failed eventually.
  • eg. Hypertension attacks vasculature first, Glomerulonephritis attacks glomeruli first.
  • the nephrons that are lost are not replaced
• Normal funtion is maintained until more than 50% of nephrons are damaged (CKD stage 3)
• In early renal disease, sodium pumps decrease its function, and sodium loss occur which result in excessive amount of dilute urine and polyuria.
• In advanced renal disease(ESRD), patient can develop uremia which is a fatal condition. Kidneys are unable to concentrate, which cause dropping in urine output, fluid overload, which result in hypertension, insulin resistance, severe electrolyte balance(sodium depletion, hyperkalemia), cardiac diseases
  • Build up of non-protein nitrogen compound in blood is measured with BUN(blood urea nitrogen)

Note: ผ่านมา 20 วัน กลับมาอ่านยังต่อติดได้ เพราะ ออกกำลังกาย และ จดสรุปแบบ active recall