• Renal
• Effects of renal failure
• CV
• IHD
  HT
  CCF
  pericarditis
• Respiratory
• Pulmonary oedema
  Pneumonia
• Haematological
• Coagulaopathy
  Platelet dysfunction
  Iron deficiency anaemia
  Reduced epo production
• Endocrine
• Diabetes
  Parathyroid dysfunction
• Gastrointestinal
• Peptic ulceration
  GORD
• Immune
• Impaired immunity
• Nervous
• Motor and sensory neuropathy,
  Myopathy
• Classification
• Pre-renal
• Hypovolaemia
  Inadequate renal blood flow
  Low cardiac output state
• Renal
• ATN
  GN
• Post-renal
• Mechanical obstruction
• CRF Definitions
• Normal GFR = 120ml/min
  CRF if 10% of normal or 20ml/min
  ESRD if < 5% normal or 10ml/min
• GFR < 60ml/min for 3 months
• CKD stages
  1. GFR >90ml/min with abnormalities in blood, urine or imaging to support diagnosis
  2. GFR 60-89ml/min with abnormalities in blood, urine or imaging to support diagnosis
  3. Moderate reduction in GFR 30-59ml/min
  4. Severe reduction in GFR 15-29ml/min
  5. Kidney failure GFR <15ml/min or dialysis
• RIFLE
• R - Risk: <0.5ml/kg/hr for 6 hrs (>25% ↓in GFR)
• I - Injury: <0.5ml/kg/hr for 12 hrs (>50% ↓in GRF)
• F - Failure: <0.3ml/kg/hr for 24 hrs (>75% ↓in GFR)
• L - Loss: Loss in function for > 4/52
• E - ESRF: >3/12 loss