Chronic Renal Failure (CRF)

It is the progressive, irreversible deterioration of renal function that results from a wide variety of diseases. Diabetes mellitus is the leading cause of end-stage renal disease (ESRD) followed closely by systemic hypertension. A decrease in nephrons function occurs and can lead to a typical clinical pattern. Patients with chronic renal disease can still excrete solute and water loads without altering their diet, even when the GFR has been significantly decreased. CRF only becomes laboratory evident when less than 40% of the nephrons are functioning. Patients with chronic renal failure may remain relatively asymptomatic until renal function is less than 10% of normal (Table 7.1).

Table 7.1 Characteristics of Chronic Renal Disease & Normal Values of Renal Function Test

Characteristics of Chronic Renal Disease Renal Function Test Normal Values
  • Anemia
  • Decreased platelet adhesiveness
  • Hyperkalemia
  • Unpredictable intravascular fluid volume
  • Metabolic acidosis
  • Systemic hypertension
  • Pericardial effusion
  • Decreased sympathetic nervous system activity
  • Blood urea nitrogen 8-20 mg/dL
  • Serum creatinine 0.6-1.3mg/dL
  • Creatinine clearance 120 mL/min
  • Urine specific gravity 1.003-1.030
  • Urine osmolality 350-500 mOsm
  • Urine sodium 20-40 mEq
Last modified: Sunday, 20 November 2016, 5:38 PM