Renal Failure Stages The intensity of renal failure is determined by Glomerular Filtration Rate (GFR).

Normal Glomerular Filtration Rate in healthy people is approximately 90mL per minute or more and this value also refers to stage 1 of the disease. The value of Glomerular Filtration Rate reduces in each of the following stages of the disease. In stage 2 it ranges from 60 to 89 mL /min. In stage 3 GFR ranges from 30 to 59 mL/min. In stage 4, 15 to 29 mL /min and finally, in stage 5 it is way below 15 mL/min. The terminal stage requires dialysis.

Stage 1 of Renal Failure

This stage of the disease features with small changes in kidney function. They are actually an introduction to the disease. The abnormalities of the kidney tissue can be only confirmed by pathohistological examination of the biopted kidney. The treatment of this stage is excellent and there are numerous medications which can enhance the function of the kidneys. The patient needs to take care of the blood pressure and is due to report any change which may point to progression of the disease Stage 2 of Renal Failure GFR is moderately reduced and the doctor requires additional blood and urine tests as well as imaging studies which will identify further damage of the kidneys.

Stage 3 of Renal Failure

This stage can be additionally divided into 2 sub-stages, 3A and 3B, according to the value of GFR. 3B stage is more severe and the patient is further examined and treated in order to prevent further reduction in function of the kidneys.

Stage 4 of Renal Failure

This stage features with rather low level of GFR which indicates the onset of terminal kidney failure. Improper function of kidneys starts to affect other organs in the body and the patient's health in general deteriorates. The patients in the stage 4 require dialysis.

Stage 5 of Renal Failure

In this stage the function of the kidneys is completely ruined. The only option for patients in this stage is either dialysis or kidney transplantation.

SODIUM BICARBONATE:
NaHCO3 is administered as an IV bolus or by IV infusion. The standard dosage is 1 mg/kg of body weight as the initial dose followed by 0.5 mg/kg every 10 minutes for the duration of the cardiac arrest. A 50milliliter bolus of NaHCO3 will raise the serum pH approximately 0.1 of a pH unit. If the pH is 7.0, it requires four 50 mEq ampules of HCO3 to correct the pH to 7.40.

The 2010 Guidelines promote high quality CPR and defibrillation to facilitate rapid ROSC as the method of restoring acid-base balance.

Nephrotic syndrome: 1. Massive proteinuria 2. Hypoalbuminemia 3. Edema 4. Hyperlipidemia/hyperlipiduria Nephritic syndrome: 1. Hematuria 2. Oliguria 3. Azotemia 4. Hypertension

Nephritic syndromes

RBC casts, hematuria mild to moderate proteinuria retention of salt, oliguria periorbital puffiness, hypertension

Nephrotic syndromes

fatty casts, oval fatbodies proteinuria > 3.5g/dl/day generalized pitting edema ascites

Examples

Examples MCD - M.C. in children FSGS - M.C. in AIDS MGN - M.C. in adults, HBV association MPGN - type I - HCV association diabetic glomerulosclerosis - begins with microalbuminuria amyloidosis

RPGN: Good pasture's syndrome, ... IgAGN (Berger's disease) - M.C. GN

type IV diffuse proliferative GN in SLE PSGN Alport syndrome - hereditary n. deafness