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Pathophysiology Of Chronic Renal Failure

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Kidneys can be prevented from any damage, provided one is careful to prevent all those diseases, at least the common ones, which harm the kidneys. Since CRF usually occurs as a result of undetected/uncontrolled diabetes, high blood pressure, GN, UTI, especially the cases where there is an obstruction in the urinary tract, due to enlarged prostate, urinary stones, etc., all these predisposing factors/diseases have to be avoided/ prevented right from the beginning/ early age, so as to achieve total protection against damage to the kidneys. Therefore, it would be advisable to look up the preventive measures of each of the above diseases.



Needless to say, that total prevention, through early detection and proper control of the above-mentioned diseases, is the most important key to keep the kidneys safe, for all practical purposes.

Prevention of drug-induced renal/kidney failure: Besides the above, an indiscriminate use of drugs is a serious cause for CRF. If all the above measures are taken care of, and equal attention has not been paid to drug abuse, CRF is bound to hit the person. In other words, no stone should be left unturned for the prevention of CRF.

All drugs should be used cautiously and under strict medical advice. Any of the drugs can cause renal failure. When drugs are administered into the body, they are excreted by the kidneys, directly, or as their end-products. Since the kidneys bear the brunt of handling the various drugs/chemicals, they are likely to be damaged by the various drugs, which are toxic to the kidneys, leading to drug-induced renal damage.

Various antibiotics, like ciprofloxacin, lomefloxacin, gentamicin, etc., pain-killers (analgesics), diuretics, radiographic dyes (used in various radiological tests like intravenous pyelography) are some of the examples that may prove to be toxic for the kidneys (nephrotoxic) and cause renal failure.

It is seen that people take drugs, especially pain-killers, tranquillizers, and even antibiotics, indiscriminately on their own, not once or twice but frequently, and even for long periods. It is not advisable, and today, even the food composition or intake is properly monitored. Further, the administration of drugs is an 'iatrogenic' phenomenon, i.e. the disease is induced by the patient, due to sheer ignorance. Hence it should be avoided by all concerned. One only needs to be aware about this and be careful in the use of drugs. If one is already taking these, one must stop all such drugs, and take medical advice for one's ailment and get the drugs prescribed, if they are at all required.

Hence, to prevent drug-induced CRF, the following steps should be taken:

(i) Use only the prescribed drugs, and only for the duration necessary for the treatment of the disease.

(ii) Use drugs with caution, especially in the case of patients who are prone to CRF, e.g. all cases of glomerulonephritis(GN), hypertension, diabetes, etc.

(iii) Besides the above, administration of radiographic dyes, which are used in certain radiological tests like intravenous pyelography, should also be discouraged, and other alternative tests should be done so that their use is avoided. If required essentially, all precautions must be taken, like the intake of fluids before and after the administration of the dye. Only the least toxic dyes, in their minimum dosage, should be used. Estimation of blood urea and serum creatinine must be done before the administration of the required dye. If these tests show higher levels of blood urea and serum creatinine, the dye should be avoided, as it may cause damage to the kidneys.

(iv) While on drugs, take adequate fluids, so that their excretion may become easy through the kidneys.
Pathophysiology Of Chronic Renal Failure
Kidneys can be prevented from any damage, provided one is careful to prevent all those diseases, at least the common ones, which harm the kidneys. Since CRF usually occurs as a result of undetected/uncontrolled diabetes, high blood pressure, GN, UTI, especially the cases where there is an obstruction in the urinary tract, due to enlarged prostate, urinary stones, etc., all these predisposing factors/diseases have to be avoided/ prevented right from the beginning/ early age, so as to achieve total protection against damage to the kidneys. Therefore, it would be advisable to look up the preventive measures of each of the above diseases.

Needless to say, that total prevention, through early detection and proper control of the above-mentioned diseases, is the most important key to keep the kidneys safe, for all practical purposes.

Prevention of drug-induced renal/kidney failure: Besides the above, an indiscriminate use of drugs is a serious cause for CRF. If all the above measures are taken care of, and equal attention has not been paid to drug abuse, CRF is bound to hit the person. In other words, no stone should be left unturned for the prevention of CRF.

All drugs should be used cautiously and under strict medical advice. Any of the drugs can cause renal failure. When drugs are administered into the body, they are excreted by the kidneys, directly, or as their end-products. Since the kidneys bear the brunt of handling the various drugs/chemicals, they are likely to be damaged by the various drugs, which are toxic to the kidneys, leading to drug-induced renal damage.

Various antibiotics, like ciprofloxacin, lomefloxacin, gentamicin, etc., pain-killers (analgesics), diuretics, radiographic dyes (used in various radiological tests like intravenous pyelography) are some of the examples that may prove to be toxic for the kidneys (nephrotoxic) and cause renal failure.

It is seen that people take drugs, especially pain-killers, tranquillizers, and even antibiotics, indiscriminately on their own, not once or twice but frequently, and even for long periods. It is not advisable, and today, even the food composition or intake is properly monitored. Further, the administration of drugs is an 'iatrogenic' phenomenon, i.e. the disease is induced by the patient, due to sheer ignorance. Hence it should be avoided by all concerned. One only needs to be aware about this and be careful in the use of drugs. If one is already taking these, one must stop all such drugs, and take medical advice for one's ailment and get the drugs prescribed, if they are at all required.

Hence, to prevent drug-induced CRF, the following steps should be taken:

(i) Use only the prescribed drugs, and only for the duration necessary for the treatment of the disease.

(ii) Use drugs with caution, especially in the case of patients who are prone to CRF, e.g. all cases of glomerulonephritis(GN), hypertension, diabetes, etc.

(iii) Besides the above, administration of radiographic dyes, which are used in certain radiological tests like intravenous pyelography, should also be discouraged, and other alternative tests should be done so that their use is avoided. If required essentially, all precautions must be taken, like the intake of fluids before and after the administration of the dye. Only the least toxic dyes, in their minimum dosage, should be used. Estimation of blood urea and serum creatinine must be done before the administration of the required dye. If these tests show higher levels of blood urea and serum creatinine, the dye should be avoided, as it may cause damage to the kidneys.

(iv) While on drugs, take adequate fluids, so that their excretion may become easy through the kidneys.
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