Chronic Renal Failure (CRF) or end stage renal disease is a chronic renal dysfunction is progressive and irreversible. Where the ability of the body fails to maintain metabolism and fluid and electrolyte balance, leading to uremia (the retention of urea and other nitrogen wastes in the blood) (KMB, Vol 2 p. 1448).
CAUSES OF CHRONIC RENAL
The cause of chronic renal failure are:
- High blood pressure (hypertension)
- Blockage of the urinary tract
- Abnormalities of the kidneys, such as kidney disease polikista
- Diabetes mellitus (diabetes)
- Autoimmune disorders, such as systemic lupus erythematosus.
Two theoretical approaches are usually proposed to explain the impairment of renal function in chronic renal failure:
1. Traditional viewpoint
Said that all units of the nephron have been stricken with the disease but in different stages, and specific parts of the nephron is associated with certain functions can be completely broken or changed its structure, such as organic lesions in the medulla will be damage the anatomic arrangement of the loop of Henle
2. Bricker hypothesis approach or the intact nephron hypothesis
Opinion that when nephron disease will be destroyed then the whole unit, but the remaining nephrons are still intact to keep working normally. Uremia will be occur if the number nephrons that have been so reduced so that fluid and electrolyte balance can not be maintained anymore.
Chronic Kidney Care
Dialysis can be performed to prevent complications of acute renal failure are serious, such as hyperkalemia, pericarditis and seizures. Pericarditis improve biochemical abnormalities; cause caiarn, protein and sodium can be consumed freely; eliminate bleeding tendency, and helps wound healing.
2. handling of hyperkalemia
Treatment of kidney by maintaining fluid and electrolyte balance is a major problem in acute renal failure; hyperkalemia is life-threatening condition that most of these disorders. Therefore, patients will be be monitored via series of examinations of hyperkalemia serum electrolyte levels (potassium values> 5.5 mEq / L; SI: 5.5 mmol / L), ECG changes (T wave peak height low or very high), and changes in clinical status. Pningkatan potassium levels can be reduced by administration of ion resin (sodium sulfonate polistriren [kayexalatel]), orally or by retention enema.
3. Maintaining fluid balance
Renal care by management of fluid balance is based on daily body weight, central venous pressure measurement, urine and serum concentration, fluid loss, blood pressure and clinical status of patients. input oral and parenteral and output of urine, gastric drainage, feces, wound drainage and perspiration is calculated and used as the basis for penggantia fluid therapy.(Sources: doktersehat.com)