(Renal Insufficiency)
function of kidney
(concept of renal insufficiency) renal insufficiency)
glomeruar filtration rate, GFR :125ml/min
GFR
GFR
~ ~ ~
H 2 O H 2 O H 2 O
1.0 2.0 3.0 4.0
Acute Renal Failure ARF
IRI
GFR
(Oliguric Phase)
> 1.020 < 20 mmol/l > 500 mmol/l < 1.015 > 40 mmol/l < 400 mmol/l (+) RBC(+) WBC(+)
water intoxication azotemia
4. ARF
diuretic stage
(recovery stage)
(Chronic Renal Failure)
Intact nephron hypothesis) GFR Number of Intact nephrons
Trade-off hypothesis)
Glomerular Hyperfiltration Hypothesis
Renal Tubulointerstitial Damage
(nocturia)
(polyuria)
(oliguria)
1.008-1.012 1.003-1.035) 266-300mmol L 360-1450mmol/L
Azotemia Blood urea nitrogen, BUN GFR 40% BUN GFR 20% BUN 71.4mM creatinine clearance rate, CCr
GFR PTH
VitD
3 renal osteodystrophy
PTH
renal hypertension)
renal anemia
hemorrhage
uremia
1 25- OH 2 D 3