Nephrology Made Simple : Metabolic Complications of Renal Failure:

Metabolic Complications of Renal Failure:

Lipid Abnormalities:

Renal failure leads to an increase in plasma cholesterol levels.

This leads to deposition of cholesterol in blood vessels and an increased incidence of cardiovascular complications and renal vascular disease.

This is usually present in patients with heavy proteinuria.

In patients without proteinuria,there is an increase in serum triglyecerides and abnormal apolipoprotein metabolism.

Acidosis:

This occurs in severe renal failure.

It results in bone disease,increased muscle metabolism and growth retardation in children.

In severe casese,it causes hyperventilation and also predisposes to hyperkalemia.

HYPERKALEMIA

This occurs in Chronic renal failure and has a number of causes

Causes of Hyperkalemia in Renal Failure :

1.Decreased secretion in collecting ducts :

Mostly due to medications :

Spironolactone

ACE inhibitors

Angiotensin 2 receptor blockers

Hyporeninaemic hypoaldosteronism

2.Decreased renal excretion :

Potassium sparing diuretics

Worsening renal failure

3.Shift of potassium from cells:

Acidosis

Muscle breakdown

Released from red blood cells after transfusion

4 Increased potassium intake :

Dietry intake

Potassium supplements : Oral or iv

Absorption from blood : Haematoma or GI bleed