The stage of chronic renal failure in which creatinine clearance is reduced to about 5 ml / minute. Needs therapy of renal function in order to avoid life threatening fluid overload, hyperkalemia and other complications of uremia.
RATIONALE The end stage renal failure can come as a result of many other diseases, such as diabetes, hypertension, glomerulonephritis, vasculitis, multiple myeloma, analgesic abuse, any of the causes of acute renal failure (eg . shock, dehydration, metapofraktiki renal disease, exposure to nephrotoxin as aminoglycosides, lead the radiopaque substances). In the US, approximately 300,000 people received treatment for ESRD.
Symptoms Patients may complain of fatigue (eg as a result of anemia), difficulty concentrating, irritability, personality changes, drowsiness, nausea, vomiting, anorexia, edema, dyspnea (when fluid retention leading to pulmonary edema) the reduced diuresis.
Some patients may become strongly uremic lethargic the coma, while others develop uremic pericarditis. Generally, the early symptoms of renal failure are nonspecific.
TREATMENT: The clearance (artificial kidney dialysis with peritoneal dialysis) the kidney transplant used to restore Stis renal function in patients with end stage renal failure. Other treatments include the administration of water-soluble vitamins, drugs that bind phosphate, erythropoietin, and bicarbonate buffer. The nutritional treatment comprising meals by limiting the amount of fluid, sodium, potassium and protein, prevents complications such as fluid retention and hyperkalemia. Strict control of blood pressure and blood glucose in patients with hypertension and diabetes respectively prolong kidney function and prevent deterioration.
CARE PATIENT: Patients with ESRD should avoid medicines that may harm the kidney (such as nonsteroidal anti-inflammatory drugs), the drugs can accumulate to toxic concentrations result in renal failure (medications that normally excreted by the kidney, such as aspirin, magnesium as metformin).