) Chronic Renal Failure. (CRF

Dr. Rehab Jassim Muhammad
Eirteham Saeed Raheem
Department of chemistry, College of Education for Pure Sciences, University of Karbala, Iraq.

Chronic kidney disease is a common health problem all over the world, especially in patients with diabetic kidney disease and chronic glomerulonephritis [1].
The disease was classified as the twelfth cause of death and the seventeenth cause of disability, as chronic renal failure contributed to the death of approximately (85,000) people [2].
Chronic renal failure is defined as a clinical condition characterized by the irreversible loss of kidney function and dysfunction in the functional units of the kidneys (nephrons) resulting from the inability of the kidneys to perform their vital functions [3].
In patients with chronic renal failure, kidney function decreases to less than (25%) of its normal level, causing the accumulation of waste (fluids and toxins) in the various tissues of the body, and the kidneys lose part of their physiological activity and their ability to filter and filter the blood[ 4].
Chronic renal failure affects all age groups, but it focuses on ages between (30-64) years due to the low glomerular filtration rate (GFR) [5]
Among the most common causes of this disease are metabolic syndrome, high blood pressure, obesity and other diseases. The disease can also occur as a result of long-term acute renal failure or due to prolonged obstruction of the urinary tract [6].
Chronic renal failure passes through five stages, and the stage the patient suffers from is determined according to the percentage of kidney damage and the glomerular filtration rate, which is a measure of the level of kidney function [7].
The disease causes many complications and symptoms that appear on the patient, Including (high blood pressure, hyperkalemia, calcium deficiency, increased phosphorus levels) and others [8].
But the most important complications of chronic kidney failure disease is anemia.
Anemia is one of the most important complications of chronic renal failure, especially for dialysis patients, as it is a common cause and risk factor for early death.
The cause of anemia and a lack of white blood cells in patients is the result of a defect In the production of the hormone erythropoietin, or a deficiency of folic acid and the element of iron and the Increase in the breaking of red blood cells and hyperglycemia In the blood or It is due to other factors, including the accumulation of waste and toxic substances that the kidneys cannot excrete outside the body [9. 10].
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2. Liyanage, T., Ninomiya, T., Jha, V., Neal, B., Patrice, H. M., Okpechi, I., Zhao, M. H., Lv, J., Garg, A. X., Knight, J., Rodgers, A., Gallagher, M., Kotwal, S., Cass, A., & Perkovic, V. (2015). Worldwide access to treatment for end-stage kidney disease: A systematic review. The Lancet, 385 (9981).
3. Meyer, T.W. and Hastetler, T. (2007). Medical progress uremia. Engl. J. Med., 357(13): 1316 – 1325.
4. Alghythan, A.k.and Alsaeed, A.H. (2012) . Hematolgical changes before after hemodialysis. sci.res. Essays,7(4):490-497..
5. West, H. (2007). Rhabdomyolysis associated with compartment syndrome resulting in acute renal failure. European Journal of Emergency Medicine, 14 (6).
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7. Mulloy LL, Talavera F, Verrelli M (September 16, 2018). Batuman V (ed.).”Chronic Kidney Disease”. Medscape
8. Al-Abchi, S.Z. Mustafa, L.A. Hassan, D.S.k and Al-Hadidi A.(2012) .Study of some biochemical changes in serum of patients with chronicrenal failure .Iraqi National J.chem., 46:270-280
9. Siamopoulos ,K.C. and Kalaitzidis ,R.G.(2010). Metabolic kidney Disease. European Nephrology ,4:8-13.
10. Cavanaugh, K. L. , Wingard, R. L. ,Hakim, R. M. , Elasy, T. A. &lkizler, T. A. (2009). Patient dialysis Knowledge is associated with permanent arteriovenous access use in Chronic hemodialysis. Clinical Journal of the American Society of Nephrology, 4(5),950 ـ 956.