Abstract
This chapter will discuss the therapeutic approach in patients with chronic renal insufficiency (serum creatinine concentration ~2–10mg/dl, GFR ~10–50% of normal), not yet requiring dialysis treatment. A number of conservative measures are indicated to maintain the patients in a state of well-being. To understand the rationale for these interventions it should be realized that chronically diseased kidneys often have a limited capacity to appropriately regulate body fluids and electrolytes (1), and this may be uncovered during stress (excessive potassium load, excessive fluid intake, or dehydration, etc.). In these circumstances, inadequate renal adaptation to the needs of the body may result in pernicious hyperkalemia, pulmonary edema, hyponatremia, or volume depletion. Furthermore, the long-term consequences of several abnormalities, such as malnutrition and disturbed calcium metabolism, require an early correction to prevent later complications at the time of dialysis. We shall discuss the prophylaxis of acute and chronic sequelae of chronic renal insufficiency, measures to slow the progression of functional renal deterioration, as well as the psychological handling of these patients.
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© 1991 Kluwer Academic Publishers
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Ritz, E.F. (1991). Renal Insufficiency. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0689-4_42
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DOI: https://doi.org/10.1007/978-1-4613-0689-4_42
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-8027-9
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