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