Pathophysiology
Chronic Kidney Disease: Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN, this is why most cases involve DM. The lack of tissue perfusion leads the kidneys to fail in properly filtering out waste and excreting. In ESRD most patients become anuric. The clinical manifestations of CKD affect the entire body system, called uremia. This is caused by the build up and retention of waste products such as; urea, creatinine, phenol, hormones, electrolytes, and water. This can cause hypervolemia, peripheral edema, hyperphosphatemia, hyperkalemia, hypocalcemia, metabolic acidosis, anemia, and peripheral neuropathy. As the BUN increases, nausea, vomiting, lethargy, fatigue, headaches, and impaired thought process result. This toxic build up causes many complication system wide. This patient presents with slow motor and thought processes, lethargy, weakness, fatigue, HTN, CHF, anemia, hyperlipidemia, RA, pancreas disorder, fluid overload causing crackles in lungs, diminished breath sounds, chest pain, ↑K+, ↑BUN/Creatinine, GFR of 13, EF 35%. The predisposition for this disease is his HTN and DM. Diagnostic procedures include: Labs- BUN/Creatinine, GFR, ABG, UA, CBC, X-ray, nephrotomography/scans, and EEG, and kidney