There are many diseases that cause chronic renal disease each has its own pathophysiology. The disease tends to progress more rapidly in patients who excrete significant amounts of protein or have elevated blood pressure than those without these conditions Uremia develops and adversely affects every system in the body. As renal function declines, the end products of protein metabolism (normally excreted in urine) accumulate in the blood. Renal failure is a systemic disease and is a final common pathway of many different kidney and urinary tract diseases.The substances normally eliminated in the urine accumulate in the body fluids as a result of impaired renal excretion, affecting endocrine and metabolic functions as well as fluid, electrolyte, and acid-base disturbances.Renal failure results when the kidneys cannot remove the body’s metabolic wastes or perform their regulatory functions.The final stage of renal dysfunction, end-stage renal disease (ESRD), is demonstrated by a glomerular filtration rate (GFR) of 15%–20% of normal or less.This syndrome is generally progressive and produces major changes in all body systems.Causes include chronic infections ( glomerulonephritis, pyelonephritis), vascular diseases ( hypertension, nephrosclerosis), obstructive processes (renal calculi), collagen diseases (systemic lupus), nephrotoxic agents (drugs, such as aminoglycosides), and endocrine diseases ( diabetes, hyperparathyroidism).Chronic renal failure (CRF) is the end result of a gradual, progressive loss of kidney function.When the patient has sustained enough kidney damage to require renal replacement therapy on a permanent basis, the patient has moved into the fifth or final stage of CKD, also referred to as chronic renal failure. Learn about the nursing care management of patients with chronic renal failure in this nursing study guide.
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