Hemodialysis using biocompatible noncellulose membranes has been shown to improve survival. Renal insufficiency, characterized by elevated BUN and greatly diminished capacity for dealing with water solute fluctuations, but otherwise can maintain homeostasis. Common causes include diabetes, hypertension, glomerulonephritis, polycystic kidney disease, obstructive uropathy, amyloidosis, etc. Unfortunately deterioration may continue even after initial insult resolves, perhaps because of a change in intrarenal hemodynamics. Early manifestations may include only nocturia because of inability to concentrate urine.
Hypertension is common.
Fluid and electrolyte imbalances result in varying signs and symptoms. Loss of erythropoietin and vitamin D function results in anemia and osteodystrophy. Generally reflected in an elevated BUN and creatinine. A 24-hour urine study will show a decreased creatinine clearance. Acidosis is usually present and so too a normochromic-normocytic anemia.