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REN
AL
PASKA
RENAL
DIAGNOSIS
Manifestasi
Komplikasi
LOSS Gagal ginjal akut menetap. Hilangnya fungsi ginjal > 4 minggu.
Hyperfiltration
hydrostatic proteinuria
pressure
Decreased Damage
glomeruli
glomerular filtration
rate
Changes in messangium and
epithelial cells
Manifestation Mechanisms
Accumulation of nitrogeneous Decline in glomerular filtration
waste products (azotemia) rate
Calcium supplementation
If Ca remains low after correction of serum phosphorous
Dose 500-2000 mg/day
Vitamin D therapy
If persistent hypocalcemia despite reductin of serum
phosphour level <6 mg and supplement of Ca
Renal osteodystrophy
Dose dihydroxyvitamin-D (rocatrol) 0.05-0.2 mg/day
Management
Anemia
Non farmacologic
Restriction of salt intake
Farmacologic
Diuretices
ACE inhibitor
Hypertensive emergencies
Nifedipine
Intravenous agents (clonidine)
Management
Dietary intake
If GFR <50%
Optimal caloric intake
Carbohydrate
Fat
Restriction of protein
High biologic value
Eggs, milk, meat, fish
Restriction of phosphorous
Milk
Phosphate binders
Restriction of salt intake
Supplementation of water-soluble vitamen (dialyzable)
Management
Water and electrolyte imbalance
Hypervolemia
Water restriction (ESRD)
Hyponatremia
Hyperkalemia
Metabolic acidosis
End-stage renal diseases
Dialysis
Hemodialysis
Hemofiltration
Peritoneal dialysis
Continuous ambulatory peritoneal dialysis (CAPD)
Continuous cyclic peritoneal dialysis