Paper Example on Pathophysiology: Chronic Renal Failure

Introduction

The kidney plays a significant role in the removing of waste from the body and the production of hormones towards regulating several body processes. Hence it is one of the most critical organs in the body whose failure can lead to a myriad of complications. There are so many other functions that are controlled by what is taking place in the kidney. Therefore any problems with the organ need to be handled critically with the urgency of restoring the normal functioning of the body. This paper will look at the pathophysiology associated with chronic renal failure, its symptoms, diagnosis and together with its treatment and management.

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Chronic kidney disease (CKD) or chronic renal failure (CRF) is a disease of the kidney associated with its reduced efficacy or inability to handle its processes over time. It is not some disease that happens suddenly, but it takes time as it continues malfunctioning gradually. According to McCance and Huether (2010), the kidney is made up of two main parts, the glomerulus, and the tubules. The glomeruli are in their millions and are tiny blood vessel through which blood is pumped. There is increased pressure in the vessels that pushes some of the fluids and substances out into the tubules. There is further processing in the tubules where some of the substances needed by the body will be retained, and toxins and other substances comprising urea and creatine are disposed of (Jacobson, 1991). With CKD there is a breakdown of this filtration process ending up having parts that do not work as expected. Some of this waste will end up in the body and traces of protein in the urine interfering with the body chemical balance.

Some clinical manifestations will be typical for the patients suffering from CKD. These symptoms are usually the result of the buildup of urea resulting in uremia. Gloe (2016) agrees that symptoms range from mild ones like fatigue, shortness of breath, lack of appetite and nausea and vomiting. The patient has puffy eyes and limbs, high blood pressure, thirst and weight loss. In addition, there is also a tendency to have itchy skin, cramping and twitching muscles and a skin that is getting a tint of yellowish-brown. Blood will exhibit advanced manifestation in the urine, which is also likely to be cloudy or tea-colored with increased urination. The patient is also expected to start getting mental slowing and seizures in addition to the clouding of consciousness.

Some differential diagnoses are required so as not to confuse CKD with forms of illnesses. It is common for there to be difficulty in differentiating AKI (Acute Kidney Injury) and CKD because they share several symptoms (Nishi et al., 2013). Additional tests can assist in this task for the sake of knowing the line of treatment to follow. When the patient exhibits anorexia, pruritis, fatigue, weight loss and nocturia, there will be a high possibility to suggest CKD. Jacobson (1991) agrees that the physicians can rely on the history of the patients and their examinations to provide clues. A renal ultrasound is the one that will be used to provide information that will suggest whether it is AKI or CKD. Renal abnormalities such as chronic glomerulonephritis and adult polycystic for small kidney and large cystic kidneys respectively will point to CKD.

Some tests confirm whether the patient has CKD which will follow after an initial diagnosis pointing to the same. Among some of the things that the doctor will be interested in is the family history, diagnosis of high blood pressure and medication that may affect the kidney functionality. Perkins et al. (2016) argue that additional tests are the ones that confirm the suspicions of the medical personnel. Blood tests are used to detect the presence of waste products like creatinine and urea which will imply that the kidney may not be working as required. A urine test is essential to detect any abnormalities that may suggest kidney failure or causes of the kidney malfunctions (Gloe, 2016). Imaging tests will reveal the structure and size of the kidney from ultrasound results. A kidney biopsy is used to extract a sample of the kidney for further analysis in a laboratory to determine the cause and problem with the organ.

Different forms of treatment may be preferred depending on the nature of the kidney problem and its causative agents. Some of the chronic kidney diseases cannot be cured, but they can be managed to prolong the individual's life. The physician may have a choice of slowing or controlling the complication by dealing with the agents causing it (McCance & Huether, 2010). There is the option of addressing the difficulties arising out of the disease which is a standard line of treatment. In this case, there will be the utilization of medications for high blood pressure, the ones for lowering cholesterol levels and those treating anemia. Furthermore, there is medication for relieving the swelling of limbs, protecting one's bones and reducing protein diet and hence controlling the amount of waste that will end up in the blood. The end-stage kidney disease can be managed through dialysis and kidney transplant (Nishi et al., 2013). In dialysis waste products are removed from the blood artificially. The damaged kidney may be removed through a surgical process and have it replaced with one that has been donated by a living donor or deceased persons.

It has been observed that chronic renal failure is on the rise due to several causes. Some symptoms were used to arouse suspicion on its possibility and that it shares several signs for the ones with injured kidneys. For confirmation of CKD diagnosis, some further tests are conducted from where specific treatment or management may commence depending on the extent of the problem. It is good to know that there is undergoing research to discover future potential therapies.

References

Gloe, D. (2016). Medication Therapy Adjustments in Patients with Chronic Renal Failure. MEDSURG Nursing, 25(5), 325-328.

Jacobson, H. (1991). Chronic renal failure: Pathophysiology. Lancet, 338 (8764), 419.

McCance, K. L., & Huether, S. E. (2010). Pathophysiology: The biologic basis for disease in adults and children. St. Louis: Mosby.

Nishi, H., Shibagaki, Y., Kido, R., Tamura, S., Nangaku, M., Sugawara, Y., & Fujita, T. (2013). Chronic renal outcome after living donor liver transplantation. Clinical Transplantation, 27(1), 90-97. doi:10.1111/ctr.12013

Perkins, R. M., Chang, A. R., Wood, K. E., Coresh, J., Matsushita, K., & Grams, M. (2016). Incident chronic kidney disease: trends in management and outcomes. Clinical Kidney Journal, 9(3), 432-437. doi:10.1093/ckj/sfw044