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    • 1. Common Kidney Diseases Ma. Tosca Cybil A. Torres, RN
    • 2. Common Kidney Diseases Polycystic Kidney Disease Hypertensive Nephrosclerosis Glomerulonephritis / Glomerulosclerosis Urinary Tract Infection (UTI) Kidney Stones Diabetic Kidney Disease Analgesic nephropathy
    • 3. Polycystic Kidney Disease
      • Genetically acquired
      • 2 forms - dominant and recessive
      • In the dominant PKD form, one parent has the disease and passes it to the child. The chance of passing the gene to the offspring is 50%.
      • Cysts are abnormal pouches containing fluid. Eventually the cysts replace normal kidney tissue -> suffers ESRD
    • 4. Polycystic Kidney Disease
      • Signs and Symptoms
      • Dull pain at the side of the abdomen and back
      • Blood in the urine
      • Frequent urine tract infection
      • High blood pressure (often before cysts appear)
      • Upper abdominal discomfort (liver and pancreatic cysts)
    • 5. Polycystic Kidney Disease
      • Treatment
      • Blood pressure - controlled and treated
      • Kidney failure - supportive therapy until end-stage is reached when dialysis or transplantation is then required
      • Urine tract infection - treatment with antibiotics
      • Pain - analgesics are used. Alternatively, surgery to shrink or resect the cysts.
    • 6. Hypertensive Nephrosclerosis
      • Poorly controlled high blood pressure (hypertension) can lead to kidney failure
        • Thickening of blood vessels
    • 7. Hypertensive Nephrosclerosis
      • Signs and Symptoms
      • Headache
      • Giddiness (sometimes related to posture)
      • Neck discomfort
      • Easily tired
      • Nauseous and/or vomiting
      • Protein in urine
    • 8. Hypertensive Nephrosclerosis
      • Treatment
      • Medications to control blood pressure (anti-hypertensive)
      • Lowering of dietary salt (2g/day)
      • Exercise regularly
    • 9. Glomerulonephritis / Glomerulosclerosis
      • Glomerulonephritis - An inflammatory condition that affects predominantly the glomeruli.
      • Causes
        • IgA nephropathy
        • Streptococcus bacteria
        • Autoimmune
      • Glomerulosclerosis - scarring of the glomeruli
    • 10. Glomerulonephritis / Glomerulosclerosis
      • Signs and Symptoms
      • Blood or protein in urine
      • Frothy urine (signifying protein in urine)
      • Dark or pink-coloured urine
      • Leg swelling
      • Systemic disease like diabetes or autoimmune disease will have systemic manifestations, e.g. weight loss, arthritis, or skin rash
    • 11. Glomerulonephritis / Glomerulosclerosis
      • Treatment
      • Specific
      • Suppression of inflammation may be achieved by certain medications (eg steroids).
      • General
      • Medications to decrease excretion of urinary protein
      • Control of blood pressure
      • Dietary modifications
    • 12. Urinary Tract Infection (UTI)
      • Disease of the urinary tract
        • Infection occurs when microorganisms attach themselves to the urethra and begins to multiply.
      • May lead to infection of the kidneys (pyelonephritis) and cause permanent kidney damage, if left untreated.
      • Women are especially prone to get urinary tract infection.
    • 13. Urinary Tract Infection (UTI)
      • Conditions that increases risk of UTI
        • Diabetes
        • Situations where a urine catheter is needed
        • Abnormalities of the urinary tract
        • Obstructed urine flow (large prostate or stone)
        • Being pregnant
    • 14. Urinary Tract Infection (UTI)
      • Signs and Symptoms
      • Painful urination (burning sensation)
      • Hot and foul smelling urine
      • Blood in urine
      • Fever (sometimes with chills)
      • Painful lower abdomen
      • Increased urgency/frequency of wanting to pass urine
      • Nausea and/or vomiting
    • 15. Urinary Tract Infection (UTI)
      • Treatment
      • Appropriate antibiotics
      • Drink plenty of water
    • 16. Kidney Stones
      • Start as salt/chemical crystals that precipitate out from urine
      • Occurs when substance in urine that prevents crystalisation are ineffective
    • 17. Kidney Stones
      • Various forms of kidney stones - the most common is calcium in combination with either phosphate or oxalate
      • More common in
        • Males
        • 20-40 yo
    • 18. Kidney Stones
      • Signs and Symptoms
      • Extreme pain at the site where the stone is causing the irritation
      • Blood in the urine (abrasion along the urinary tract as the stone travels)
      • Painful and/or difficult urination
      • Unable to pass urine if the stone is large enough to obstruct the outlet completely
    • 19. Kidney Stones
      • Treatment
      • With plenty of water, most stones can pass through if small
      • Pain-killers (as prescribed by the doctor)
      • Some medications may help 'breakdown' larger stone
      • Shockwave therapy (F-SWL) to break the stone
      • Surgical intervention - cystoscopy or open surgery
    • 20. Diabetic Kidney Disease
      • Common in chronic and poorly controlled diabetics
      • Diabetes damages blood vessels in the kidneys
      • Occurs in both types of diabetes
      • Occurrence of high blood pressure in diabetics is a strong predictor for diabetic nephropathy
      • Most common cause of ESRD in many developed countries
    • 21. Diabetic Kidney Disease
      • Signs and Symptoms
      • Frothy urine (signifying protein in urine)
      • Leg swelling (worse after walking/standing)
      • High blood pressure
      • Itching
      • Nausea and/or vomiting
      • Losing weight
      • Lethargy
      • Increased need to urinate at night
    • 22. Diabetic Kidney Disease
      • Treatment
      • Good control of diabetes
      • Good control of blood pressure (aiming for < 130/85 or lower in younger patients)
      • Medications to decrease protein excretion and preserve the function of kidneys
      • Lower protein diet
      • Treat any urine tract infection (which is common in diabetics)
    • 23. Analgesic Nephropathy
      • Chronic kidney disease that occurs when there is a long period of painkiller/s ingestion (usually years)
      • Associated with conditions which require constant need for painkiller medications
      • May lead to ESRD
    • 24. Analgesic Nephropathy
      • Signs and Symptoms
      • Blood in the urine
      • Protein in the urine
      • Signs and symptoms related to kidney failure such as nausea, vomiting, lethargy, swelling, and poor appetite.
    • 25. Analgesic Nephropathy
      • Treatment
      • Avoid long-term consumption of analgesics
      • Those already with kidney disease of other kinds should certainly refrain from harmful analgesics as much as possible.
    • 26. In the wards…
      • Look out for…
        • Vital signs
          • BP
          • Temp
          • HR
        • Catheterisation?
        • Dialysis
          • When?
          • Eventful?
        • Other electrolyte values
          • Na
          • K
          • Creatinine
          • Urea
          • Etc
        • Blood count
          • Hb