Chronic Kidney Disease
Causes
Risk Factors
Manifestations
Labs/Diagnostics
Collaborative Treatment
Complications
Poverty
Dyslipidemia
Obesity
Exposure to nephrotoxins
HTN
Chronic UTIs
Diabetes
Premature birth
Age
Acute kidney injury
Polycystic kidney disease
Many other diseases that predispose a person to renal disease
Pruritus
Paresthesia's, neuropathy
Nausea, vomiting, anorexia
Pale, yellowish grey skin tone
Fatigue
Dry skin, poor turgor
Edema
Bruises
Poor concentration, slower mentation
Osteodystrophy, osteoporosis
Mostly asymptomatic until advanced- early symptoms may include painful urination, foamy urine, pink or dark urine, increased need to urinate, puffy eyes, swelling, and increased thirst
GFR- best indicator
Creatinine- gradual increase to 15-30 mg/dL
BUN- gradual increase to 10-20 times the creatinine finding
CBC- decreased hemoglobin and hematocrit from anemia
Cystoscopy
Kidney biopsy
Radiologic procedures to detect disease processes, obstruction, and arterial defects (ultrasound, tomography, MRI)
Urine studies- proteinuria, hematuria, fixed specific gravity, oliguria
Metabolic acidosis
Electrolyte disturbances- hyponatremia, hypernatremia, hyperkalemia, hypocalcemia, hyperphosphatemia
African Americans, Hispanics, and Native Americans
Nephrology services to manage dialysis
Kidney transplant
Nutritional services to manage the nutritional needs
Electrolyte imbalances
Dysrhythmias
Fluid overload
HTN
Metabolic acidosis
Secondary infection
Uremia
Exercise
Smoking cessation
Beware of NSAIDs
Management of chronic conditions- Diabetes, HTN, hyperlipidemia
Maintain adequate hydration
Low sodium diet
Progressive and irreversible
Pathophysiology depends on the underlying disease
Diabetes- increased osmotic pressure due to hyperglycemia
Reduced blood flow to the nephrons of the kidneys
Resulting in= loss of nephrons, hypertrophy and high workload on remaining nephrons, predisposition to sclerosis, reduced kidney function, and additional nephron loss
Pre renal- blood flow to the kidney compromised
Intra renal- kidney tissue damage
Post renal- bladder or prostate problem