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End stage of renal disease

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End-stage renal disease is a condition in which the kidneys no longer function normally and required excellent medical and nursing care for the managing this condition.

Published in: Health & Medicine
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End stage of renal disease

  1. 1.  Kidneys eliminate poisons from the body, andKidneys eliminate poisons from the body, and keep a normal balance of fluid and certainkeep a normal balance of fluid and certain minerals in the body. When the kidneys can nominerals in the body. When the kidneys can no longer perform this function, a person becomeslonger perform this function, a person becomes very ill and ultimately dies.very ill and ultimately dies.  In end-stage renal disease, the kidneysIn end-stage renal disease, the kidneys function at a fraction of their normal capacity.function at a fraction of their normal capacity. When this occurs, there are only two options:When this occurs, there are only two options: replace the job the kidneys are supposed to doreplace the job the kidneys are supposed to do by using a machine, instead (kidney dialysis)by using a machine, instead (kidney dialysis) or transplant a new, healthy kidney. A singleor transplant a new, healthy kidney. A single new kidney can do the work of the two kidneys.new kidney can do the work of the two kidneys.
  2. 2.  End-stage kidney disease means thatEnd-stage kidney disease means that the final stage of kidney disease, andthe final stage of kidney disease, and kidneys are not functioning well enoughkidneys are not functioning well enough to meet the needs of daily life.to meet the needs of daily life.  End-stage renal disease is a condition inEnd-stage renal disease is a condition in which the kidneys no longer functionwhich the kidneys no longer function normally.normally.
  3. 3.  DiabeticsDiabetics cannot break down glucosecannot break down glucose (sugar) correctly, and levels remain high(sugar) correctly, and levels remain high in the blood. High levels of glucose in thein the blood. High levels of glucose in the blood damage the glomeruli in theblood damage the glomeruli in the nephrons.nephrons.  HypertensionHypertension, the increased pressure, the increased pressure that is forced upon the small vessels inthat is forced upon the small vessels in the kidneys leads to damage that makesthe kidneys leads to damage that makes the vessels unable to perform theirthe vessels unable to perform their blood-filtering duties.blood-filtering duties.
  4. 4.  Autoimmune diseases like systemic lupusAutoimmune diseases like systemic lupus erythematosus (lupus)erythematosus (lupus)  Genetic disorders, such as polycystic kidneyGenetic disorders, such as polycystic kidney diseasedisease  Exposure to toxic drugs, including:Exposure to toxic drugs, including: certain antibioticscertain antibiotics chemotherapychemotherapy contrast dyescontrast dyes  pain relieverspain relievers
  5. 5.  a decrease in urine outputa decrease in urine output  inability to urinateinability to urinate  fatiguefatigue  general ill feelinggeneral ill feeling  headachesheadaches  unexplained weight lossunexplained weight loss  loss of appetiteloss of appetite  nausea and vomitingnausea and vomiting  dry skin and itchingdry skin and itching  changes in skin colorchanges in skin color  bone painbone pain  confusion and difficulty concentratingconfusion and difficulty concentrating
  6. 6. Other symptoms may include:Other symptoms may include:  bruising easily, along with frequent nosebleedsbruising easily, along with frequent nosebleeds  numbness in hands and feetnumbness in hands and feet  bad breathbad breath  excessive thirstexcessive thirst  frequent hiccupsfrequent hiccups  absence of menstrual cyclesabsence of menstrual cycles  sleeping problemssleeping problems  swelling (edema), especially in the legs and handsswelling (edema), especially in the legs and hands
  7. 7.  History takingHistory taking  Physical ExaminationPhysical Examination  Blood tests:Blood tests: Kidney function tests look for the level ofKidney function tests look for the level of waste products, such as creatinine and urea, in thewaste products, such as creatinine and urea, in the blood.blood.  Urine tests:Urine tests: Analyzing a sample of urine may revealAnalyzing a sample of urine may reveal abnormalities that point to chronic kidney failure and helpabnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.identify the cause of chronic kidney disease.  Imaging tests: UImaging tests: Ultrasound to assess kidneys' structureltrasound to assess kidneys' structure and size.and size.  Removing a sample of kidney tissue for testing:Removing a sample of kidney tissue for testing: AA kidney biopsy to remove a sample of kidney tissue.kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using aKidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through skin and intolong, thin needle that's inserted through skin and into kidney. The biopsy sample is sent to a lab for testing tokidney. The biopsy sample is sent to a lab for testing to help determine what's causing kidney problem.help determine what's causing kidney problem.
  8. 8. End-stage kidney disease has two treatments:End-stage kidney disease has two treatments: dialysis or kidney transplant.dialysis or kidney transplant. DialysisDialysis  There are two types of dialysis:There are two types of dialysis:  Hemodialysis:Hemodialysis: During hemodialysis, blood isDuring hemodialysis, blood is removed from a vein. It is run through filters toremoved from a vein. It is run through filters to remove waste products. The blood is thenremove waste products. The blood is then returned to the body. Hemodialysis usually isreturned to the body. Hemodialysis usually is done at a dialysis center. The treatments aredone at a dialysis center. The treatments are done three times a week, in three- to four-hourdone three times a week, in three- to four-hour sessions.sessions.
  9. 9. Peritoneal dialysis:Peritoneal dialysis: During peritonealDuring peritoneal dialysis, sterile fluid is infused into thedialysis, sterile fluid is infused into the abdomen. Waste products graduallyabdomen. Waste products gradually accumulate in the fluid, which is drainedaccumulate in the fluid, which is drained several hours later. Peritoneal dialysis isseveral hours later. Peritoneal dialysis is done at home. It takes longer thandone at home. It takes longer than hemodialysis and must be done four tohemodialysis and must be done four to five times a day. It can be automated tofive times a day. It can be automated to occur during sleep.occur during sleep.
  10. 10. Kidney transplantsKidney transplants  Kidney transplants allow people with severe kidneyKidney transplants allow people with severe kidney disease to avoid or discontinue dialysis. However, evendisease to avoid or discontinue dialysis. However, even a successful kidney transplant is not a cure.a successful kidney transplant is not a cure.  Anyone who receives a kidney transplant must takeAnyone who receives a kidney transplant must take immunosuppressive drugs for life, unless they receivedimmunosuppressive drugs for life, unless they received a kidney donated by their identical twin. These area kidney donated by their identical twin. These are drugs that prevent the body from rejecting the donateddrugs that prevent the body from rejecting the donated organ. In addition, a good genetic match is needed fororgan. In addition, a good genetic match is needed for a successful transplant. Most transplant candidatesa successful transplant. Most transplant candidates wait one to three years before they are matched to await one to three years before they are matched to a kidney from an unrelated donor.kidney from an unrelated donor.
  11. 11.  Other treatment TechniquesOther treatment Techniques  Diabetics and those with hypertension mustDiabetics and those with hypertension must control their conditions. Both conditions benefitcontrol their conditions. Both conditions benefit from drug therapy using angiotensin-convertingfrom drug therapy using angiotensin-converting enzyme (ACE) inhibitors or angiotensinenzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs).receptor blockers (ARBs).  A diet low in sodium, potassium, and otherA diet low in sodium, potassium, and other electrolytes may be needed, along with fluidelectrolytes may be needed, along with fluid restrictions. Caloric intake may need to berestrictions. Caloric intake may need to be increased, and protein consumption may needincreased, and protein consumption may need to decrease.to decrease.
  12. 12.  skin infections from itching and dry skinskin infections from itching and dry skin  hepatitis B, hepatitis C, and/or liverhepatitis B, hepatitis C, and/or liver failurefailure  heart and blood vessel problemsheart and blood vessel problems  fluid buildup around the lungsfluid buildup around the lungs  hyperparathyroidismhyperparathyroidism  increased risk of infectionsincreased risk of infections  malnutritionmalnutrition
  13. 13.  nerve damagenerve damage  joint, bone, and muscle painjoint, bone, and muscle pain  anemiaanemia  stomach and intestinal bleedingstomach and intestinal bleeding  brain dysfunction and dementiabrain dysfunction and dementia  abnormal electrolyte levelsabnormal electrolyte levels  blood glucose level changesblood glucose level changes  seizuresseizures  weakening of the bones, joint disorders, andweakening of the bones, joint disorders, and fracturesfractures
  14. 14.  AssessmentAssessment  Subjective DataSubjective Data  Objective DataObjective Data
  15. 15.  Excess fluid Volume related to compromisedExcess fluid Volume related to compromised regulatory mechanism.regulatory mechanism.  Decrease Cardiac Output related to fluidDecrease Cardiac Output related to fluid overload, fluid shifts, fluid deficit.overload, fluid shifts, fluid deficit.  Risk for Imbalanced Nutrition: Less than BodyRisk for Imbalanced Nutrition: Less than Body Requirements.Requirements.  Risk for Infection related to reverse renalRisk for Infection related to reverse renal function.function.  Knowledge deficit related to disease processKnowledge deficit related to disease process and treatment plan.and treatment plan.

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