|
Harrison's Principles of Internal Medicine, 17e
| Part Twelve: Disorders of the Kidney and Urinary Tract > |
Chapter 274. Chronic Kidney Disease
Sections: Chronic Kidney Disease: Introduction, Clinical and Laboratory Manifestations of Chronic Kidney Disease and Uremia, Evaluation and Management of Patients with CKD, Further Readings.
Topics Discussed: kidney failure, chronic.
Excerpt:
"Chronic kidney disease (CKD) encompasses a spectrum of different
pathophysiologic processes associated with abnormal kidney function,
and a progressive decline in glomerular filtration rate (GFR). Table 274-1 provides a widely accepted classification,
based on recent guidelines of the National Kidney Foundation [Kidney
Dialysis Outcomes Quality Initiative (KDOQI)], in which
stages of CKD are defined according to the estimated GFR.The pathophysiology of CKD involves two broad sets of mechanisms
of damage: (1) initiating mechanisms specific to the underlying
etiology (e.g., immune complexes and mediators of inflammation in
certain types of glomerulonephritis, or toxin exposure in certain
diseases of the renal tubules and interstitium); and (2) a set of
progressive mechanisms, involving hyperfiltration and hypertrophy
of the remaining viable nephrons, that are a common consequence
following long-term reduction of renal mass, irrespective of underlying
etiology (Chap. 272). The responses to reduction
in nephron number are mediated by vasoactive hormones, cytokines, and
growth factors. Eventually, these short-term adaptations of hypertrophy
and hyperfiltration become maladaptive as the increased pressure
and..."
The content above is only an excerpt.
For full access, log into an existing user account below, purchase an annual subscription, or purchase a short-term subscription to the complete website.
|
|
|
|
|