progressive, irreversible loss of kidney function - RENAL GLOMERULAR AND TUBULOINTERSTITIAL
FIBROSIS INCREASES WITH AGE LEADING TO CKD - presents with a decompensation of the pts preexisting
medical problems. - HTN AND DM ARE HIGH RISK FACTORS FOR CKD
RAAS (renin-angiotensin-aldosterone system)
Renin is released by kidneys in response to decreased blood volume; causes angiotensinogen to split &
produce angiotensin I; lungs convert angiotensin I to angiotensin II; angiotensin II stimulates adrenal
gland to release aldosterone & causes an increase in peripheral vasoconstriction
Medications to avoid in CKD
-NSAIDs- block the synthesis of the renal prostaglandins that promote vasodilation, and this can worsen
renal hypoperfusion
-DEMEROL: Metabolized to normeperidine in the liver, which kidneys excrete
-AMINOGLYCOSIDES, PENICILLIN, AND TETRACYCLINES: Nephrotoxic
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