End Stage Renal Disease (ESRD)
End Stage Renal Disease (ESRD)
End Stage Renal Disease (ESRD)
Disease (ESRD)
Prepared by:
Abellana, Mary Catherine T.
Acapulco, Kyla Faye C.
Acaso, Ashley Sue P.
Acedillo Carmela Marie C.
Apa, Karen L.
Arias, Romero Y.
Balili, Jirah Grace C.
Banuag, Mary Jo A.
Bazar, Brixie Lyka C.
Anatomy and Physiology
Urinary System
OVERVIEW
Consist of:
● Glomerulus
● Bowman’s capsule
○ Podocytes
○ Filtration slits
Renal tubule
● About 3 cm long
● Different regions of the tubule have specific names
■ Proximal convoluted tubule (PCT)
■ Loop of Henle
■ Distal convoluted tubule (DCT)
● Cortical nephrons
○ Located within the cortex
● Juxtamedullary nephron
○ Situated close to the cortex-
medulla junction and the
nephron loops dip deep into the
medulla.
● Collecting ducts
○ Deliver urine to the renal pyramid then
to the calyces and renal pelvis.
Each and every nephron is associated with two
capillary bed
1. Glomerulus
-low pressure
- porous vessels
Your kidneys filter wastes and excess fluids from your blood, which are then excreted
in your urine. When your kidneys lose their filtering abilities, dangerous levels of fluid,
electrolytes and wastes can build up in your body
With end-stage renal disease, you need dialysis or a kidney transplant to stay alive.
But you can also choose to opt for conservative care to manage your symptoms —
aiming for the best quality of life during your remaining time.
Risk Factors
Certain factors increase the risk that chronic kidney disease will progress more quickly to end-stage renal disease,
including:
Increased tubular
reabsorption
Increased O2
consumption
-Decreased nitric
oxide, increased Tissue -Tubulointerstitial injury
RAS hypoxia -Microvascular
-Insufficient HIF rarefaction
activation -Glomerlulosclerosis
-Decreased AMPK
CKD
s/sx start to
appear during this
stage
Drug study
indicated for chronic
renal insufficiency
with the following
conditions: Given
with high calorie, low
protein food <40 g
daily; Compensated
or decompensated
retention; Glomerular
filtration rate (GFR) of
5-50 mL/minute.
The primary mechanism
of action of febuxostat
evaluated in trials was
the inhibition of xanthine
oxidase, evidenced by
the increase in serum and
urine xanthine
concentrations, decrease
in serum and urine uric
acid levels, and lack of
significant reduction in
total purine synthesis.
Problem list
1. Excess fluid volume related to decreased urine output, dietary excesses, and retention of sodium and water.
2. Impaired Urinary Elimination related to failing glomerular filtration AEB Impaired excretion of nitrogenous
products secondary to Renal Failure
3. Acute pain related to the trauma that the kidney experience perceive by the body as a threat
Risk for systemic infection related to hemodialysis procedure as manifested by fatigue, weakness and low
hemoglobin and hematocrit Level
4. Imbalanced nutrition less than body requirements related to anorexia, nausea, vomiting, dietary restrictions,
and altered oral mucous membranes.
5. Risk for systemic infection related to hemodialysis procedure as manifested by fatigue, weakness and low
hemoglobin and hematocrit Level
NCP