| [ Summary ] |
The kidney is the target organ of hormones regulating fluid and electrolytes metabolism, so progressive renal failure causes various disturbances. When GFR is reduced to less than 25 ml/min, retention of fluids, sodium, and potassium, as well as metabolic asidosis occurs. Phosphate retention occurs in cases of moderate to severe renal failure. A rise in serum phosphate reduced the plasma ionized calcium, stimulating release of PTH. Phosphate retention is important in the prognosis of patients with pre-dialysis renal failure, because it is one of the major factors responsible for the development of renal osteodystrophy and ectopic calcification. Chronic metabolic acidosis associated with renal failure may also contribute to the production of metabolic bone disease. Restriction of water, salt and proteins prevents these disturbances. |