Chronic kidney disease damages nephrons and impairs filtration. The lecture breaks down five mechanisms: nephron damage, lost filtration capacity, compensatory increases in GFR, activation of the renin-angiotensin-aldosterone pathway that worsens renal blood flow, and complications like proteinuria, anemia, and electrolyte imbalances.
In this video, I'm giving you an easy step by step breakdown of the pathophysiology of chronic kidney disease. This one is one of those med surg topics that you must know about in nursing school because it will definitely show up on your exams and possibly then on the nclex. Now make sure that you subscribe and click the notification bell. Because friend, this is the easiest way to learn in nursing school. You do not want to miss out on anything that I have for you. Trust me. Let's dive in. So chronic kidney disease in a nutshell just means that the kidneys are permanently damaged and now they can't do their job as well. Now, the kidneys are in charge of so many things in the body, like filtering the blood, removing waste products, keeping a good balance of fluid and electrolytes. So if the kidneys are damaged, it can lead to some serious, serious, serious problems. Chronic kidney disease can be caused by things like hypertension, infection, diabetes or immune disorders. What happens is over time, as the kidney disease gets worse, it can lead to end stage renal disease or renal failure where the kidneys really cannot filter blood at all. So friend, let's put this pathophysiology into simple steps for you to follow. Now, I love breaking these really tough nursing school concepts into easy steps because it really helps you to learn it so so much faster, which is what we're all about. So here's what's going on during chronic kidney disease. Now, the first step is that there is a trigger that damages the nephrons. So the nephrons are that functional part of the kidney. They do all the work to filter the blood. So when the nephrons are damaged, it is bad news. And this leads us to step number two, which is the damaged nephrons now can't filter blood as well. So in step number one, there was a trigger that caused the damage to those nephrons. And now in step number number two, the nephrons cannot filter blood like they should. Now, thankfully, because the body is pretty amazing, the healthy nephrons that are not damaged try to compensate for those damaged nephrons. So they see those damaged ones and they try to help out by increasing the amount of blood that they can filter. Now this is called the glomerular filtration rate, or gfr. The GFR is the amount of blood the glomeruli, which are inside the nephrons, filter per one minute. So the healthy nephrons then increase their productivity. They filter more and more blood to try to compensate so that is now step number three of this process. Now, as time goes on, more and more nephrons will become damaged. This will then limit the blood flow to the kidneys. And the kidneys will trigger a compensatory response to this lack of blood flow. Now, this response is called the RAA pathway. This is step number four. With the RAA pathway, the kidneys release an enzyme called renin. This release of renin then sets off a series of events that ultimately increase the blood pressure in the body. It's trying to increase the blood flow to the kidneys by increasing the blood pressure. Now, if you want a deep dive into the RAA system or RA pathway, we have a whole video for you on that to check out. Now, here's where things get pretty sticky. Normally, that increase in blood pressure helps get more blood to the kidneys. But during chronic kidney disease, it actually can decrease blood flow to the kidneys depending on what caused it in the first place. So, for example, if the original cause of the chronic kidney disease was something like hypertension and all of that, renin just now raised the blood pressure even more. Well, now those arteries that go to the kidneys are even smaller, which will then decrease the blood flow to the kidneys even more. And finally, step number five is where we start to see the complications of this, the major signs and symptoms of chronic kidney disease. Now, the key complications that you need to know about for nursing school are proteins spilling out into the urine. This is called proteinuria. You'll also see decreased glomerular filtration rate, or gfr, which we just talked about. Increased creatinine and urea levels, anemia and fluid and electrolyte imbalances. Now, if you are a nursing SOS member, make sure to log into your dashboard, find the signs and symptoms video in the chronic kidney disease series. Now, in that video, I do a deep dive into why each of these signs and symptoms happens. So be sure to check that out because you absolutely have to know that for nursing school. So that, my friend, is the pathophysiology of ckd. The nephrons are damaged. They aren't able to filter as much blood. Now causing that RA pathway to spring into action. Now, complications will arise like protein in the urine, decreased glomerular filtration rate, increased urea and creatinine levels, and those fluid and electrolyte imbalances. Now, if this video was super helpful for you and you love step by step breakdowns like this, please let me know that you want more of it by leaving a comment below, hitting the like button and sharing it with a friend. And if you didn't like this video, well, definitely don't leave a comment, and definitely do not subscribe to this channel. But if you love me and you love what we do here, what are you waiting for, friend? Hit that subscribe button, click the notification bell, and let's rock nursing school together, and I will catch you in the next video.
