文档介绍：Chapter 16
Renal insufficiency
Renal insufficiency
内容
(contents)
尿毒症(Uremia)
功能代谢改变
急性肾功能衰竭(ARF)
慢性肾功能衰竭(CRF)
病因
发病机制
功能代谢改变
概述(introduction)
概念
基本发病环节
Physiological Function of the Kidneys
:排出代谢产物、药物和毒物;
:调节水、电解质和酸碱平衡以及维持血压;
:产生肾素、epo、1,25-(OH)2VD3和前列腺素,灭活甲状旁腺激素和胃泌素
泌尿功能
Renal insufficiency
Peritubular capillary
Renal tubule
H2O
H2O
H2O
Urine
肾小球滤过
Glomerular filtration
肾小管重吸收
Tubular reabsorption
肾小管分泌
Tubular secretion
Flow of filtrate
Renal corpuscle
尿液排泄
Urinary excretion
Renal insufficiency
ESRD Rates Continue to Rise
introduction
Incidence of Kidney Failure (per million population, 1990)
USRDS, 2000
introduction
Incidence of Kidney Failure (per million population, 2000)
USRDS, 2000
introduction
Kidney pared to Cancer Deaths in the . in 2000
Seer, 2004
Lung Cancer
Kidney
Failure
Colorectal
Cancer
Breast
Cancer
Prostate
Cancer
57
100
41
30
160
introduction
Costs of Kidney Failure are High (in $billions for 2002)
Kidney Failure
Care
Total NIH
Budget
Kidney Failure Accounts for 6% of Medicare Payments
Lost e for Patients is $2-4 Billion/Yr
USRDS, 2004
introduction
CKD Predicts CVD
Go, et al., 2004
introduction
0
5
10
15
20
25
30
35
40
≥
60
45-59
30-44
15-29
< 15