Postrenal kidney failure is often seen due to prostatic hypertrophy or urinary tract obstruction. Table 13-1 Kidney disease in the elderly   Primary Secondary Hereditary/congenital Glomerular disease Membranous nephropathy Minimal change nephrotic syndrome

Focal segmental glomerulosclerosis IgA nephropathy Hypertensive nephropathy (nephrosclerosis) Diabetic nephropathy Microscopic PN (ANCA-associated vasculitis) Renal GDC-0941 in vivo amyloidosis Hepatitis C-associated nephropathy   Tubulo-interstitial and urinary tract disease Chronic interstitial nephritis Myeloma kidney Gouty kidney Ischemic nephropathy Drug-induced nephropathy Prostate hypertrophy (post-renal renal failure) Polycystic kidney disease Urinary stone Malignancies in the urinary tract”
“Either excessive intake or over restriction of water is harmful. Salt intake selleck compound is preferably restricted to less than 6 g/day. Obesity is recommended to be controlled with BMI being less than 25 kg/m 2 . Smoking

cessation is essential for suppression of CKD progression as well as CVD development. Restriction of protein intake to 0.6–0.8 g/kg/day exerts favorable effects in CKD stages 3–5. It is better for calorie intake to be 30–35 kcal/kg/day, although 25 kcal/kg/day can be applied 4SC-202 nmr in obese diabetics. Proper consumption of alcohol as ethanol is less than 20–30 mL/day in men (corresponding to 180 ml Japanese sake ), and less than 10–20 mL/day in women. Note: “kg body weight” indicates “kg” in the standard body weight, but not in the Montelukast Sodium current real body weight. standard body weight (kg) = [height (m)] 2  × 22 The diet therapy Morbid states requiring diet therapy and its contents are summarized in Table 17-1. The nephrologists participate

in determination of diet therapy for CKD in stages 3–5. Table 17-1 Pathophysiology of kidney disease and diet regimen Pathophysiology Diet therapy Effect Hyperfiltration Salt restriction (<6 g/day) Protein restriction (0.6–0.8 g/kg/day) Decrease in proteinuria, retard GFR decline ECFV excess Salt restriction (<6 g/day)   Decrease in edema Hypertension Salt restriction (<6 g/day)   Lower blood pressure, retard GFR decline Azotemia Protein restriction (0.6–0.8 g/kg/day)   Lower BUN, ameliorate uremic symptoms Hyperkalemia Potassium restriction (<1,500 mg/day)   Lower serum potassium Hyperphosphatemia Protein restriction (0.6–0.8 g/kg/day) Phosphate restriction (mg) (protein, g × 15) Lower serum phosphate, retard vascular calcification Metabolic acidosis Protein restriction (0.6–0.8 g/kg/day)   Ameliorate metabolic acidosis Standard weight (kg) = [Height (m)]2 × 22 ECFV extracellular fluid volume Water Generally water restriction is not required, but in advanced CKD stage, water restriction might be instituted. Salt CKD patients are vulnerable to hypertension.