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Non-modiable

risk factors:
-Hereditary (gene9cally Modiable risk factors:
determined abnormali9es in -Diabetes mellitus
kidney development or -Hypertension
integrity, immune complex -Diet
-Smoking
deposi9on and inamma9on
in certain types of -Use of analgesics
glomerulonephri9s) -Toxin inges9on (toxin exposure in
-Age greater than 60 years old certain diseases of the renal tubules and
-Gender inters99um
-Race

Reduc9on in renal mass

Increased intrarenal ac9vity of Hypertension PE:


the renin-angiotensin axis BP:
200/80mmHg

Increased pressure

Decreased GFR Ini9al adap9ve hyperltra9on S9mula9on of TGF-B Disrup9on of


sodium/potassium
balance

Impaired elimina9on of Increased glomerular Maladap9ve hypertrophy


nitrogenous wastes permeability and sclerosis
Increased
intravascular volume
Reduced excre9on
Uremia of phosphate Increased ltra9on of PE:
Inability to concentrate urine
proteins and Grade II bipedal
Fluid extravasa9on
macromolecules edema

Further loss of HPI:


Increased dyspnea Edema Dehydra9on
synthesis of PTH nephron func9on
PE: bilateral
and parathyroid rales
growth mass Conges9ve heart
Loss of nonexcretory renal failuire
func9on

Secondary Decreased renal


hyperparathyroidism perfusion

Diminished calcitriol Failure to produce Impaired insulin Decreased ammonia Increased Immune Distrubances in
produc9on erythropoe9n ac9on produc9on produc9on of lipids impairment reporduc9on

Decreased ionized Anemia High blood glucose Metabolic Advanced Delayed wound Infec9on Decreased libido
calcium levels/errac9c blood acidosis atherosclerosis healing and infer9lity
glucose levels
PE:
Pale palpebral
Hypocalcemia
conjunc9vae

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