End stage renal failure

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End stage renal failure

  1. 1. Randi M. Haupert
  2. 2.  End stage renal disease (ESRD) occurs when the kidneys are functioning at a level of 10 percent or less.  ESRD is a permanent condition that occurs at the final stage of chronic kidney disease (CKD).  CKD is divided into 5 stages: Stage 5 is the last stage  GFR (glomerular filtration rate) is less than 60 ml/min for more than 3 months  20 million Americans have diagnosed CKD and 20 million more are at an increased risk  Patient is unable to continue living without dialysis or a kidney transplant.
  3. 3.  Controls blood pressure  Controls fluid balance  Maintain homeostasis:  Regulates blood pressure and electrolytes, maintenance of acid-base balance  Production of hormones  Calcitriol, renin, erythropoietin  Production of red blood cells  Reabsorption of water, glucose, and amino acids  Removes waste from blood  Removes waste via urine  Excretes waste such as urea and ammonium
  4. 4.  Most common  Diabetes Mellitus (46%)  High blood pressure (27.2%)  Other Causes  Congenital abnormalities  Reactions to medications  Injuries  Trauma to kidneys  Major loss of blood
  5. 5.  Excessive thirst  Fatigue  Drowsiness  Confusion  Headaches  Difficulty concentrating  Weight loss/Loss of appetite  Muscle twitching  Bruise easily  Edema in hands and feet  Numbness in extremities  Nose bleeds  Bone pain  Nausea/Vomiting
  6. 6.  Dialysis or kidney transplant are the only treatments for ESRD  Dialysis  Too much waste in the body  2 Types  Hemodialysis – Blood circulates through a machine  Enters and exits the body through a “gortex graft” or “cimino fistula”  Peritoneal dialysis – Places fluid in stomach to remove waste via catheter  Lab test results  Severity of symptoms  Patient readiness  Medications  ACE inhibitors  Angiotensin receptor blocker  High blood pressure medication
  7. 7.  Changes in diet  Low – protein diet  Limit:  Fluids  Salt  Potassium  Phosphorous  Electrolytes  Other treatments  Anemia  Increase iron intake  Phosphate binders  Prohibit elevation of phosphorous levels  Increase calcium and vitamin D
  8. 8.  Creatinine (10-12 cc/minute level)  BUN (Blood urea nitrogen)  Potassium  Sodium  Albumin  Phosphorous  Calcium  Cholesterol  Magnesium  Complete blood count (CBC)  Electrolytes * Labs must be drawn regularly if patient is prescribed dialysis
  9. 9.  45% of ESRD are diabetic and inactive  Low functioning capacity  Average peak oxygen consumption is 20 ml∙kg-¹∙min-¹  Very light intensity  Increased leg fatigue
  10. 10.  Goal of exercise: Improve or maintain exercise capacity  Challenged by daily tasks of living  Resistance and aerobic exercise training to increase  Improves blood pressure control
  11. 11.  Reduced peak cardiac output  Reduced oxygen-carrying capacity due to anemia  Muscle fatigue  Unable to recover from exercise as quickly
  12. 12.  End stage kidney disease. (2009, August 12). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000500.  End stage renal disease (esrd). (2008, February 11). Retrieved from http://www.kidneyfund.org/kidney-health/kidney- failure/end-stage-renal-disease.html.  Krasnoff, J., & Painter, P. (2009). Acsm;s exercise management for persons with chronic diseases and disabilities. Champaign, IL: Human Kinetics.  Lippincott, Williams, & Wilkins. (2010). Acsm's guidelines for exercise testing and prescription. Baltimore, MD: Wolters Kluwer Health.  Shiel, W. (2006, July 19). Dialysis. Retrieved from http://www.medicinenet.com/dialysis/article.htm.

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