Chronic kidney disease is the gradual loss of kidney function over time. It is divided into five stages based on glomerular filtration rate. Stage 5 is kidney failure where dialysis or transplantation is needed. Chronic kidney disease is usually caused by diabetes or high blood pressure and symptoms include fatigue, appetite loss, and swelling. It is detected through urine and blood tests which measure protein, creatinine, and waste levels to calculate GFR and monitor kidney function. As kidney function declines, electrolyte and mineral imbalances occur.
This document provides information on chronic kidney disease (CKD) and its treatment with dialysis. It discusses the physiological functions of the kidneys, causes of CKD including diabetes, stages of CKD and associated signs/symptoms. It also describes different treatment options for stage 5 CKD including kidney transplantation and dialysis (hemodialysis and peritoneal dialysis). The document outlines components of Mrs. Joaquin's medical nutrition therapy and assesses her weight and calculates her edema-free weight.
CHRONIC KIDNEY DISEASE- A CASE STUDY IN AYURVEDIC SETTING.VIKAS NARIYAAL
Chronic kidney diseases CKD encompasses a spectrum of different pathophysiologic proCesses associated with abnormal kidney function and a progressive decline in glomerular filtration rate (GFR)
Chronic kidney disease (CKD) consists of a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR).
"End Stage Renal Disease:Common Problems and Possible Solutions". A review of Diabetes and hypertension and how they contribute to complications in the ESRD patient. Renal Care Partners offers state of the art hemodialysis on the campus of Palm Garden of West Palm Beach.
This document summarizes medical nutrition therapy for chronic kidney disease and end-stage renal disease. It discusses the pathophysiology and stages of chronic kidney disease, complications that can arise at different levels of kidney function, and nutritional management strategies and guidelines for protein, fluid, electrolyte, and energy intake at various stages of kidney disease and on different types of dialysis.
Chronic Kidney Disease, a.k.a Chronic Kidney Failure, is a vast but serious topic that requires thorough study. This presentation entails the essentials - its stages, pathogenesis, risk factors, etiology, symptoms, diagnosis, treatment and prognosis.
Chronic kidney disease is a progressive loss of kidney function over months or years. It is defined as abnormalities in the kidney for 3 months with a glomerular filtration rate below 60. There are 5 stages based on GFR level with stage 5 being kidney failure requiring dialysis or transplant. Common causes are diabetes, hypertension, and glomerulonephritis. Symptoms vary but may include fatigue, skin changes, edema, and electrolyte imbalances. Diagnosis involves blood and urine tests to assess GFR and kidney damage markers. Treatment focuses on slowing progression through blood pressure control and managing complications.
This document provides information on chronic kidney disease (CKD) and its treatment with dialysis. It discusses the physiological functions of the kidneys, causes of CKD including diabetes, stages of CKD and associated signs/symptoms. It also describes different treatment options for stage 5 CKD including kidney transplantation and dialysis (hemodialysis and peritoneal dialysis). The document outlines components of Mrs. Joaquin's medical nutrition therapy and assesses her weight and calculates her edema-free weight.
CHRONIC KIDNEY DISEASE- A CASE STUDY IN AYURVEDIC SETTING.VIKAS NARIYAAL
Chronic kidney diseases CKD encompasses a spectrum of different pathophysiologic proCesses associated with abnormal kidney function and a progressive decline in glomerular filtration rate (GFR)
Chronic kidney disease (CKD) consists of a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR).
"End Stage Renal Disease:Common Problems and Possible Solutions". A review of Diabetes and hypertension and how they contribute to complications in the ESRD patient. Renal Care Partners offers state of the art hemodialysis on the campus of Palm Garden of West Palm Beach.
This document summarizes medical nutrition therapy for chronic kidney disease and end-stage renal disease. It discusses the pathophysiology and stages of chronic kidney disease, complications that can arise at different levels of kidney function, and nutritional management strategies and guidelines for protein, fluid, electrolyte, and energy intake at various stages of kidney disease and on different types of dialysis.
Chronic Kidney Disease, a.k.a Chronic Kidney Failure, is a vast but serious topic that requires thorough study. This presentation entails the essentials - its stages, pathogenesis, risk factors, etiology, symptoms, diagnosis, treatment and prognosis.
Chronic kidney disease is a progressive loss of kidney function over months or years. It is defined as abnormalities in the kidney for 3 months with a glomerular filtration rate below 60. There are 5 stages based on GFR level with stage 5 being kidney failure requiring dialysis or transplant. Common causes are diabetes, hypertension, and glomerulonephritis. Symptoms vary but may include fatigue, skin changes, edema, and electrolyte imbalances. Diagnosis involves blood and urine tests to assess GFR and kidney damage markers. Treatment focuses on slowing progression through blood pressure control and managing complications.
The document provides guidelines for the evaluation and management of chronic kidney disease (CKD) according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline. It defines CKD based on abnormalities in kidney structure/function persisting over 3 months and classified by cause, GFR, and albuminuria categories. It recommends evaluating GFR, albuminuria, and CKD chronicity and cause. It provides guidance on managing CKD progression and complications like anemia, bone disease, acidosis, cardiovascular risk, infections, and drug toxicity. It also covers referral to specialists and multidisciplinary care for advanced CKD patients.
The document discusses chronic kidney disease (CKD) in children. It defines CKD, describes the stages and progression of disease. Common causes in children include congenital abnormalities and inherited disorders. Clinical features range from asymptomatic to growth retardation, hypertension, anemia and bone disease. Investigations include blood and urine tests to assess kidney function and damage. Management involves fluid, electrolyte, nutritional, anemic and bone disease management tailored to the stage of CKD.
This document provides information on chronic kidney disease (CKD), including its definition, causes, stages, clinical assessment, complications, treatment, and management of associated conditions like hypertension and dyslipidemia. CKD is defined as kidney damage or decreased kidney function lasting 3 months or more. The three most common causes are diabetes, hypertension, and glomerular disease. CKD progresses through five stages depending on kidney damage severity and function level. Treatment focuses on slowing disease progression, managing complications, and reducing cardiovascular risk through blood pressure control, cholesterol lowering, and other measures.
This document discusses the screening, management, and treatment of chronic kidney disease. It notes that chronic kidney disease affects over 10% of US adults and risk increases with age. Diabetes and hypertension are the most common causes of end-stage renal disease. It recommends referring patients with decreased eGFR and increased albuminuria to a nephrologist. The management of complications such as hypertension, dyslipidemia, anemia, acidosis, and bone mineral disorders is also covered.
The document discusses chronic kidney disease (CKD). It defines CKD as kidney damage or decreased glomerular filtration rate (GFR) lasting at least 3 months. CKD is staged based on GFR levels and can progress to kidney failure requiring dialysis or transplant. The causes, risk factors, complications, diagnostic evaluation and management of CKD are described with a focus on pediatric patients.
Chronic kidney diseases and its causes and trends in global and Bangladesh p...BSMMU
This document discusses chronic kidney disease (CKD) trends and corrective actions needed, particularly in developing countries. It notes that CKD prevalence is increasing globally due to risk factors like diabetes and hypertension. In Bangladesh, CKD prevalence is estimated at 16-18% and is largely caused by diabetes (41%) and hypertension (33%). To address this growing problem, the document recommends primary prevention through screening, lifestyle changes, and controlling risk factors. It also stresses the need for secondary prevention, increasing access to renal replacement therapy, and national health planning through training, resources and partnerships.
The patient has chronic kidney disease and is on hemodialysis 3 times per week. He has secondary hyperparathyroidism due to low calcium levels from his kidney disease. This causes overproduction of parathyroid hormone which can lead to bone and cardiovascular problems if not managed. The patient is at risk due to his low calcium levels. His secondary hyperparathyroidism is managed through a low phosphorus diet, phosphate binders, vitamin D, and potentially parathyroidectomy for severe cases. Controlling serum phosphorus and parathyroid hormone levels is important to prevent complications.
Chronic kidney disease (CKD) and end-stage renal disease (ESRD) were defined. CKD is the gradual loss of kidney function over months to years, while ESRD is the most advanced stage where kidney function is generally less than 15%. The global prevalence of CKD is estimated at 13.4% and is a leading cause of death worldwide. Treatment for ESRD includes kidney transplantation, hemodialysis, and peritoneal dialysis. People with ESRD have a significantly higher risk of death from COVID-19 compared to those without kidney failure.
Chronic Kidney Disease (CKD) is defined as a progressive loss of kidney function over months or years. Patients with early stage CKD are generally asymptomatic, while later stages can cause nausea, vomiting, fatigue, and other symptoms. CKD is staged based on glomerular filtration rate, with stage 5 being severe kidney failure requiring dialysis or transplant. Risk factors include diabetes, high blood pressure, smoking, and family history. Screening helps detect CKD in at-risk groups. Treatment focuses on lifestyle changes, medications, and dialysis or transplant for kidney failure.
1) The document discusses the approach to chronic kidney disease (CKD). It defines CKD and outlines its stages based on glomerular filtration rate and albuminuria levels.
2) Risk factors for CKD mentioned include diabetes, hypertension, family history of kidney disease, use of certain medications, and prior acute kidney injury. The pathogenesis of CKD involves initial injury followed by adaptive hyperfiltration and long-term damage to remaining nephrons.
3) Evaluation of patients with suspected CKD involves obtaining a history, physical exam, lab tests including serum creatinine and urine analysis, and imaging like renal ultrasound. A kidney biopsy may be done if disease-specific therapy is still possible.
In this presentation we have described about chronic kidney disease in details.Anyone will be able to understand all the contents.In This presentation we have used easier language to make it more understandable.
Define Chronic Renal Failure.
Mention the main causes of Chronic Renal Failure.
Know the signs and symptoms of renal failure.
Know the treatment options of CRF
Know new definition of CKD
Chronic kidney disease occurs when the kidneys are damaged and cannot effectively remove waste from the blood. It is usually caused by conditions that damage the kidneys such as high blood pressure, diabetes, and heart disease. While CKD has no cure, early treatment can slow its progression and prevent kidney failure. The document provides details on stages of CKD and codes for classifying and documenting CKD and related conditions.
1. Chronic Kidney Disease (CKD) is defined as kidney damage or reduced kidney function lasting over 3 months as measured by GFR <60 mL/min/1.73m2 and/or albuminuria.
2. CKD is a major public health problem and leading cause of ESRD. Diabetes and hypertension are the leading causes of CKD.
3. The kidneys maintain homeostasis through filtration, reabsorption, secretion and other functions. Progressive loss of nephrons in CKD disrupts this balance and leads to physiological changes and clinical manifestations.
Acute liver failure describes severe liver dysfunction that occurs within 6 months of symptoms appearing. It can be caused by infections, drugs, autoimmune conditions, or inherited metabolic disorders. Clinically, it presents with jaundice, coagulopathy, and hepatic encephalopathy ranging from changes in consciousness to coma. Investigations show prolonged prothrombin time and elevated bilirubin. Treatment focuses on supportive care, identifying and treating precipitating causes, reducing gut-derived toxins like ammonia through dietary changes and medications like lactulose, and managing complications like hepatic encephalopathy and cerebral edema. The prognosis depends on the severity of encephalopathy and underlying cause.
This document presents a case study of a 50-year-old male patient with chronic kidney disease due to diabetic nephropathy. The patient has a 15-year history of type 2 diabetes and non-proliferative diabetic retinopathy. Diagnostic tests show elevated blood sugar, creatinine, and signs of kidney damage. The patient is assessed as having progressed chronic kidney disease due to diabetic nephropathy. His treatment plan includes insulin, medications to protect the kidneys and manage symptoms, and lifestyle changes to control his diabetes and slow disease progression.
Anemia is common in patients with diabetes mellitus and chronic kidney disease. Erythropoietin production by the kidneys regulates red blood cell production but is deficient in kidney disease, leading to anemia. Three case studies describe patients with diabetes and various degrees of anemia and kidney impairment. The document discusses the pathogenesis, evaluation, and management of anemia in diabetes, including the role of erythropoietin deficiency and treatment targets. It concludes regular anemia screening and early treatment can help prevent complications in diabetes patients.
Case Presentation on Multiple Organ Dysfunction Syndrome with Diabetic Nephropathy, Hypertension, Severe Metabolic Acidosis and Acute Respiratory Distress Syndrome
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function lasting over 3 months. CKD is evaluated based on glomerular filtration rate (GFR) and markers of kidney damage. Progression is defined as a sustained decline in GFR or a 25% drop from baseline. Management focuses on preventing progression through blood pressure control, ACE inhibitors/ARBs, glycemic control, salt restriction, and lifestyle changes like exercise and smoking cessation. Complications include anemia, bone disease, vitamin D deficiency, acidosis, cardiovascular disease, and increased risk of infection. Dialysis is initiated when symptoms develop or control of volume, pressure, or nutrition cannot be maintained.
The kidneys filter blood and produce urine to remove waste and regulate fluid balance. Renal function tests assess kidney health and include urine analysis and tests of glomerular filtration rate (GFR), renal plasma flow, and tubular function. GFR is measured using creatinine clearance, which involves collecting urine for 24 hours and testing creatinine levels in blood and urine. Lower GFR indicates worsening kidney function. Tubular function tests examine the kidneys' ability to concentrate and dilute urine and regulate acid-base balance. Together these tests provide information on both glomerular and tubular performance.
The document discusses the functions and tests of the kidney. It notes that the kidney excretes waste, maintains water and electrolyte balance, and produces hormones. It describes renal clearance tests to assess glomerular and tubular function, including creatinine clearance and urine concentration tests. Normal ranges are provided for various blood and urine parameters. Renal function tests evaluate glomerular filtration rate and tubular function.
The document provides guidelines for the evaluation and management of chronic kidney disease (CKD) according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline. It defines CKD based on abnormalities in kidney structure/function persisting over 3 months and classified by cause, GFR, and albuminuria categories. It recommends evaluating GFR, albuminuria, and CKD chronicity and cause. It provides guidance on managing CKD progression and complications like anemia, bone disease, acidosis, cardiovascular risk, infections, and drug toxicity. It also covers referral to specialists and multidisciplinary care for advanced CKD patients.
The document discusses chronic kidney disease (CKD) in children. It defines CKD, describes the stages and progression of disease. Common causes in children include congenital abnormalities and inherited disorders. Clinical features range from asymptomatic to growth retardation, hypertension, anemia and bone disease. Investigations include blood and urine tests to assess kidney function and damage. Management involves fluid, electrolyte, nutritional, anemic and bone disease management tailored to the stage of CKD.
This document provides information on chronic kidney disease (CKD), including its definition, causes, stages, clinical assessment, complications, treatment, and management of associated conditions like hypertension and dyslipidemia. CKD is defined as kidney damage or decreased kidney function lasting 3 months or more. The three most common causes are diabetes, hypertension, and glomerular disease. CKD progresses through five stages depending on kidney damage severity and function level. Treatment focuses on slowing disease progression, managing complications, and reducing cardiovascular risk through blood pressure control, cholesterol lowering, and other measures.
This document discusses the screening, management, and treatment of chronic kidney disease. It notes that chronic kidney disease affects over 10% of US adults and risk increases with age. Diabetes and hypertension are the most common causes of end-stage renal disease. It recommends referring patients with decreased eGFR and increased albuminuria to a nephrologist. The management of complications such as hypertension, dyslipidemia, anemia, acidosis, and bone mineral disorders is also covered.
The document discusses chronic kidney disease (CKD). It defines CKD as kidney damage or decreased glomerular filtration rate (GFR) lasting at least 3 months. CKD is staged based on GFR levels and can progress to kidney failure requiring dialysis or transplant. The causes, risk factors, complications, diagnostic evaluation and management of CKD are described with a focus on pediatric patients.
Chronic kidney diseases and its causes and trends in global and Bangladesh p...BSMMU
This document discusses chronic kidney disease (CKD) trends and corrective actions needed, particularly in developing countries. It notes that CKD prevalence is increasing globally due to risk factors like diabetes and hypertension. In Bangladesh, CKD prevalence is estimated at 16-18% and is largely caused by diabetes (41%) and hypertension (33%). To address this growing problem, the document recommends primary prevention through screening, lifestyle changes, and controlling risk factors. It also stresses the need for secondary prevention, increasing access to renal replacement therapy, and national health planning through training, resources and partnerships.
The patient has chronic kidney disease and is on hemodialysis 3 times per week. He has secondary hyperparathyroidism due to low calcium levels from his kidney disease. This causes overproduction of parathyroid hormone which can lead to bone and cardiovascular problems if not managed. The patient is at risk due to his low calcium levels. His secondary hyperparathyroidism is managed through a low phosphorus diet, phosphate binders, vitamin D, and potentially parathyroidectomy for severe cases. Controlling serum phosphorus and parathyroid hormone levels is important to prevent complications.
Chronic kidney disease (CKD) and end-stage renal disease (ESRD) were defined. CKD is the gradual loss of kidney function over months to years, while ESRD is the most advanced stage where kidney function is generally less than 15%. The global prevalence of CKD is estimated at 13.4% and is a leading cause of death worldwide. Treatment for ESRD includes kidney transplantation, hemodialysis, and peritoneal dialysis. People with ESRD have a significantly higher risk of death from COVID-19 compared to those without kidney failure.
Chronic Kidney Disease (CKD) is defined as a progressive loss of kidney function over months or years. Patients with early stage CKD are generally asymptomatic, while later stages can cause nausea, vomiting, fatigue, and other symptoms. CKD is staged based on glomerular filtration rate, with stage 5 being severe kidney failure requiring dialysis or transplant. Risk factors include diabetes, high blood pressure, smoking, and family history. Screening helps detect CKD in at-risk groups. Treatment focuses on lifestyle changes, medications, and dialysis or transplant for kidney failure.
1) The document discusses the approach to chronic kidney disease (CKD). It defines CKD and outlines its stages based on glomerular filtration rate and albuminuria levels.
2) Risk factors for CKD mentioned include diabetes, hypertension, family history of kidney disease, use of certain medications, and prior acute kidney injury. The pathogenesis of CKD involves initial injury followed by adaptive hyperfiltration and long-term damage to remaining nephrons.
3) Evaluation of patients with suspected CKD involves obtaining a history, physical exam, lab tests including serum creatinine and urine analysis, and imaging like renal ultrasound. A kidney biopsy may be done if disease-specific therapy is still possible.
In this presentation we have described about chronic kidney disease in details.Anyone will be able to understand all the contents.In This presentation we have used easier language to make it more understandable.
Define Chronic Renal Failure.
Mention the main causes of Chronic Renal Failure.
Know the signs and symptoms of renal failure.
Know the treatment options of CRF
Know new definition of CKD
Chronic kidney disease occurs when the kidneys are damaged and cannot effectively remove waste from the blood. It is usually caused by conditions that damage the kidneys such as high blood pressure, diabetes, and heart disease. While CKD has no cure, early treatment can slow its progression and prevent kidney failure. The document provides details on stages of CKD and codes for classifying and documenting CKD and related conditions.
1. Chronic Kidney Disease (CKD) is defined as kidney damage or reduced kidney function lasting over 3 months as measured by GFR <60 mL/min/1.73m2 and/or albuminuria.
2. CKD is a major public health problem and leading cause of ESRD. Diabetes and hypertension are the leading causes of CKD.
3. The kidneys maintain homeostasis through filtration, reabsorption, secretion and other functions. Progressive loss of nephrons in CKD disrupts this balance and leads to physiological changes and clinical manifestations.
Acute liver failure describes severe liver dysfunction that occurs within 6 months of symptoms appearing. It can be caused by infections, drugs, autoimmune conditions, or inherited metabolic disorders. Clinically, it presents with jaundice, coagulopathy, and hepatic encephalopathy ranging from changes in consciousness to coma. Investigations show prolonged prothrombin time and elevated bilirubin. Treatment focuses on supportive care, identifying and treating precipitating causes, reducing gut-derived toxins like ammonia through dietary changes and medications like lactulose, and managing complications like hepatic encephalopathy and cerebral edema. The prognosis depends on the severity of encephalopathy and underlying cause.
This document presents a case study of a 50-year-old male patient with chronic kidney disease due to diabetic nephropathy. The patient has a 15-year history of type 2 diabetes and non-proliferative diabetic retinopathy. Diagnostic tests show elevated blood sugar, creatinine, and signs of kidney damage. The patient is assessed as having progressed chronic kidney disease due to diabetic nephropathy. His treatment plan includes insulin, medications to protect the kidneys and manage symptoms, and lifestyle changes to control his diabetes and slow disease progression.
Anemia is common in patients with diabetes mellitus and chronic kidney disease. Erythropoietin production by the kidneys regulates red blood cell production but is deficient in kidney disease, leading to anemia. Three case studies describe patients with diabetes and various degrees of anemia and kidney impairment. The document discusses the pathogenesis, evaluation, and management of anemia in diabetes, including the role of erythropoietin deficiency and treatment targets. It concludes regular anemia screening and early treatment can help prevent complications in diabetes patients.
Case Presentation on Multiple Organ Dysfunction Syndrome with Diabetic Nephropathy, Hypertension, Severe Metabolic Acidosis and Acute Respiratory Distress Syndrome
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function lasting over 3 months. CKD is evaluated based on glomerular filtration rate (GFR) and markers of kidney damage. Progression is defined as a sustained decline in GFR or a 25% drop from baseline. Management focuses on preventing progression through blood pressure control, ACE inhibitors/ARBs, glycemic control, salt restriction, and lifestyle changes like exercise and smoking cessation. Complications include anemia, bone disease, vitamin D deficiency, acidosis, cardiovascular disease, and increased risk of infection. Dialysis is initiated when symptoms develop or control of volume, pressure, or nutrition cannot be maintained.
The kidneys filter blood and produce urine to remove waste and regulate fluid balance. Renal function tests assess kidney health and include urine analysis and tests of glomerular filtration rate (GFR), renal plasma flow, and tubular function. GFR is measured using creatinine clearance, which involves collecting urine for 24 hours and testing creatinine levels in blood and urine. Lower GFR indicates worsening kidney function. Tubular function tests examine the kidneys' ability to concentrate and dilute urine and regulate acid-base balance. Together these tests provide information on both glomerular and tubular performance.
The document discusses the functions and tests of the kidney. It notes that the kidney excretes waste, maintains water and electrolyte balance, and produces hormones. It describes renal clearance tests to assess glomerular and tubular function, including creatinine clearance and urine concentration tests. Normal ranges are provided for various blood and urine parameters. Renal function tests evaluate glomerular filtration rate and tubular function.
This document discusses renal function tests (RFTs). It begins by describing the functions of the kidney including formation of urine, excretion of waste products, and regulation of water, electrolytes and acid-base balance.
It then explains that RFTs are used to assess renal damage, monitor progression of renal disease, and adjust dosing of nephrotoxic drugs. RFTs provide information on renal blood flow, glomerular filtration rate, tubular function, and urine output. Tests include urine analysis, measurements of glomerular function like creatinine clearance, and tests of tubular function like concentration and dilution tests. The document describes several RFTs in detail.
Renal function tests assess kidney function and detect impairment. They include tests of glomerular filtration rate (GFR) using creatinine, urea and inulin clearance. GFR is calculated using creatinine levels and equations factoring age, weight and sex. Other tests evaluate tubular function through urine concentration, osmolality, and checking for proteins, glucose and amino acids in urine. Together these tests provide valuable information about both glomerular and tubular integrity and kidney health.
This document discusses renal function tests and their importance in assessing kidney function and detecting impairment. It describes various tests including urine analysis, blood tests of creatinine and urea, and glomerular function tests. Common indications for evaluating renal function are listed, such as older age, diabetes, and hypertension. The document also outlines approaches to interpreting test results and diagnosing different kidney conditions like acute injury, nephritic syndrome, and nephrotic syndrome.
The document discusses kidney function tests. It describes the purpose of urine examination to diagnose kidney disorders and other diseases affecting kidney function. It covers macroscopic examination of urine including color, odor, pH, specific gravity and volume. Microscopic examination looks at cells, crystals, casts and microorganisms. Chemical examination tests for proteins, sugars, ketones, bile salts and blood. Clearance tests and urine concentration tests assess renal tubular function. Different types of kidney stones are also discussed.
The document summarizes the case of a 60-year-old male admitted with generalized swelling of the body for 20 days. Investigations revealed IgA monoclonal gammopathy and renal biopsy showed features of amyloidosis. The patient was diagnosed with primary amyloidosis (AL type) associated with hepatitis B infection. Treatment with diuretics and antibiotics improved his symptoms and kidney function recovered.
This document discusses renal function tests. It begins by outlining the objectives of renal function tests which are to detect possible renal damage, assess severity, observe progress of renal disease, and monitor safe drug use. It then discusses causes of kidney disorders which can be pre-renal, renal, or post-renal. The main tests of renal function described are urine examination, tests of excretory function like creatinine clearance, and estimating blood urea nitrogen and serum creatinine levels. The document provides details on how to perform and interpret these tests.
Renal Diagnostic Tests OR InvestigationsChandima007
The document discusses various renal diagnostic tests including laboratory studies, radiology/imaging tests, and other procedures. Laboratory tests of renal function include tests of concentration, creatinine clearance, serum creatinine, blood urea nitrogen, protein, microalbumin levels, and urine casts. Imaging tests include x-rays of the kidneys/ureters/bladder, intravenous pyelograms, renal angiograms, renal scans, ultrasounds, CT scans, and MRIs. Other procedures mentioned are cystoscopy, prostate-specific antigen testing, and needle biopsy of the kidney. Precautions and nursing considerations are provided for many of the tests.
This presentation outlines an Extended Project Qualification (EPQ) on an unspecified topic. It includes sections for the title of the EPQ project, an outline of the topic, a discussion of research conducted including primary and secondary sources, an analysis of research findings, strengths and weaknesses of the project, what was learned from completing the EPQ, and final thoughts. The presentation provides the framework to discuss all aspects of an EPQ from topic outline to research to evaluation.
This document summarizes renal function tests and urine analysis. It describes the anatomy and function of the nephron, steps in urine formation, and normal ranges for physical and chemical urine tests including volume, color, odor, specific gravity, pH, creatinine, BUN, electrolytes, glucose, protein, and ketones. It discusses clinical implications of abnormal test values and interfering factors. Macroscopic urine examination for casts and cells is also covered, in addition to exogenous markers of glomerular filtration rate like inulin and iothalamate clearance tests.
1. A 10 year old boy presented with facial swelling, foot swelling, and abdominal distension. His history revealed a fever 6 weeks prior.
2. The probable diagnosis is nephritic syndrome.
3. Recommended tests include a urine analysis to check for proteinuria and microscopic hematuria, and a serum albumin test to evaluate nephrotic range proteinuria.
This document discusses various renal function tests used to evaluate different aspects of kidney function. It describes tests of glomerular filtration rate (GFR) including clearance tests using substances like creatinine, inulin, and radioactive tracers. It also discusses tubular function tests like urine concentration tests, osmolarity measurements, and tests of the kidney's response to vasopressin. Formulas for calculating clearance, osmolarity, and free water clearance are provided. The significance of GFR measurements and estimated GFR formulas like Cockcroft-Gault and MDRD are summarized.
The kidneys contain approximately 1 million nephrons each. Nephrons are the functional units of the kidney and consist of glomeruli and tubules. Nephron formation is complete by birth but maturation continues into childhood. A decreased number of nephrons can lead to renal disease later in life. Evaluation of renal function includes urine analysis, measurement of glomerular filtration rate (GFR) using creatinine clearance or formulas, and tests of urinary concentration and acidification abilities.
This document discusses the key functions and mechanisms of the kidneys. The kidneys are responsible for regulating water, electrolyte and acid-base balance, and excreting metabolic waste products like urea and creatinine. They also retain substances vital to the body like glucose and amino acids. The kidneys function as endocrine organs by producing hormones like erythropoietin and calcitriol. The nephron is the functional unit of the kidney, and glomerular filtration and tubular reabsorption are the key processes in urine formation. Various tests are used to assess kidney function, including clearance tests using creatinine and urea, as well as examining the blood, urine and using thresholds.
This document discusses renal function tests and their importance in assessing kidney function. It covers urine analysis including physical, chemical and microscopic examination. It also discusses various blood tests like serum creatinine, blood urea, uric acid and electrolytes to evaluate glomerular function. Tests of tubular function examined include urine concentration, vasopressin and water load tests. The significance of renal function tests in acute kidney injury is also highlighted. An addendum discusses cystatin C as a novel marker for non-invasive estimation of glomerular filtration rate and early renal impairment.
The document discusses various laboratory investigations that may be advised by dentists. It describes tests related to hematology, biochemistry including renal function tests, liver function tests, lipid analysis, and electrolyte analysis. It provides reference ranges for common tests and discusses conditions that could cause increases or decreases in certain markers. The tests can help dentists screen for systemic conditions, establish diagnoses, and guide treatment and management of patients.
This document discusses chronic kidney disease (CKD), including its definition, stages, causes, complications, screening, diagnosis, treatment, and management. CKD is defined as irreversible kidney damage or reduced glomerular filtration rate lasting over 3 months. The leading causes are diabetes and hypertension. As CKD progresses, complications arise affecting multiple body systems. Treatment aims to slow progression, manage complications, and prepare for kidney replacement if needed.
Chronic kidney disease (CKD) is a condition where the kidneys lose their ability to remove waste and excess fluid from the blood, causing these substances to build up in the body. The most common causes of CKD are diabetes and high blood pressure. CKD can progress to complete kidney failure where dialysis or transplantation is required for survival. The main treatment goal is to prevent CKD progression by diagnosing it early and controlling the underlying cause.
Renal or kidney failure occurs when the excretory function of the kidney fails, detected by a decrease in glomerular filtration rate and increased waste products in the blood. Renal failure is categorized as acute kidney injury (AKI), which is rapidly progressive and potentially reversible with treatment, or chronic kidney disease (CKD), which progresses slowly over months to years and is not reversible. Symptoms of renal failure include edema, vomiting, breathing difficulty, neurological issues, and others, depending on the type and severity of failure. Diagnosis involves blood and urine tests to evaluate kidney function, while treatment ranges from symptom management to dialysis and transplant for end-stage disease.
A 30-year old female patient was admitted with symptoms of shortness of breath, pedal edema, facial puffiness, and periorbital swelling. She has a history of acute kidney infection. Laboratory tests revealed decreased calcium and albumin levels, increased phosphorus, and a glomerular filtration rate of 18 ml/min, consistent with chronic kidney disease. Her treatment plan includes medications to reduce swelling, acidosis, and blood pressure, as well as mineral and vitamin supplements. She was counseled on lifestyle changes like a salt-restricted diet and exercise to help manage her condition.
Acute kidney injury (AKI), also known as acute renal failure, is a sudden episode of kidney failure or damage that occurs over hours or days. It causes a build up of waste in the blood and issues maintaining fluid balance. AKI is common in hospital patients, especially older adults, and can affect other organs. The causes of AKI include low blood pressure, bleeding, infection, heart issues, liver failure, medications, and toxins. Treatment focuses on resolving the underlying cause and preventing complications through IV fluids, diuretics, calcium, and dialysis.
Renal failure and its homeopathy treatment in Chembur, Mumbai, India Shewta shetty
"Treatment & remedies for renal failure and its homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."/>
Acute kidney failure occurs when the kidneys suddenly lose their ability to filter wastes and excess fluids from the blood. Common causes include acute tubular necrosis, dehydration, medications, and infections. Risk factors include existing kidney disease, diabetes, high blood pressure, and surgery. Symptoms range from swelling and fatigue to changes in mental status. Treatment focuses on restoring kidney function through diet, medications, and possibly dialysis. Complications can include chronic kidney failure or end-stage renal disease if not properly treated.
Chronic kidney failure is the progressive loss of kidney function over months or years. It is characterized by a buildup of waste products due to decreased filtration by the kidneys. The National Kidney Foundation stages chronic kidney disease based on glomerular filtration rate. Stage 1 involves normal kidney function while stage 5 is end-stage renal disease requiring dialysis or transplantation. Treatment options depend on the stage and may include lifestyle changes, medication, dialysis, and transplantation.
Renal failure occurs when the kidneys can no longer remove waste and regulate fluids and electrolytes in the body. Chronic kidney disease develops gradually over months to years and initially presents no symptoms. As kidney function declines, waste builds up in the blood and the kidneys lose their ability to concentrate urine and regulate fluids, electrolytes, and acid-base balance. Treatment focuses on managing complications through medications, diet, dialysis, and potentially a kidney transplant. The goals are to maintain kidney function and homeostasis for as long as possible.
Renal failure is a medical condition at which the kidneys are functioning at less than 15% of the normal.
Two main classifications
Acute renal failure or Acute kidney injury (AKI)
Chronic renal failure or Chronic kidney disease (CKD)
Unraveling the Enigma of Proteinuria A Deep Dive into Its Connection with Kid...jsomal
The human body is an intricate web of interconnected systems, each playing a vital role in maintaining overall health. Among these, the kidneys stand out as unsung heroes, diligently filtering waste and excess fluids to ensure a delicate balance within. However, when the kidneys encounter challenges, it can manifest in various ways, with proteinuria being a significant red flag. In this comprehensive exploration, we will unravel the complexities of proteinuria and its intricate relationship with kidney disease.
What is Proteinuria?
Proteinuria, a term that may sound intimidating at first, is simply the presence of an abnormal amount of protein in the urine. The kidneys act as meticulous gatekeepers, allowing essential substances to stay in the bloodstream while efficiently filtering out waste products. When this selective process goes awry, proteins, particularly albumin, may leak into the urine. This phenomenon is not a standalone condition; rather, it serves as a crucial indicator of underlying kidney issues.
The Role of Kidneys in Filtration
To appreciate proteinuria, one must understand the kidney’s primary function—filtration. The nephrons, the functional units of the kidneys, intricately filter blood, ensuring that essential components like red blood cells and proteins remain in circulation while waste products are excreted as urine. The glomerulus, a network of tiny blood vessels within the nephron, plays a pivotal role in this filtration process. Any disruption to this finely tuned system can lead to the escape of proteins into the urine, setting the stage for proteinuria.
Chronic Kidney Disease Management and caresachintutor
Chronic kidney disease (CKD) is defined as the presence of kidney damage or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 mt2, persisting for 3 months or more, irrespective of the cause.
The document discusses renal (kidney) failure, which can be acute, chronic, or acute-on-chronic. Acute renal failure develops rapidly and requires identifying and treating the underlying cause. Chronic kidney disease develops slowly over time from conditions like diabetes or hypertension and leads to kidney damage. Symptoms of kidney failure include fatigue, nausea, and fluid retention as waste builds up in the bloodstream. The causes, stages, diagnosis, and historical terminology of renal failure are also outlined.
This document discusses chronic kidney disease, which slowly damages the kidneys over months or years. The main causes are diabetes and high blood pressure. As the kidneys become less functional, waste builds up in the blood and the patient may experience symptoms like fatigue, nausea, and swelling. Tests can detect kidney damage and declining function. In the final stages, called end-stage renal disease, dialysis or transplant is needed to clean the blood. Home treatments focus on controlling blood pressure and blood sugar, healthy eating and exercise, and avoiding smoking.
The kidneys are located retroperitoneally and filter waste from the blood to form urine. Kidney failure occurs when the kidneys cannot adequately remove waste or regulate fluids and electrolytes. Acute kidney injury is a sudden decrease in function while chronic kidney disease is long-term damage. Causes include decreased blood flow, direct damage, and obstruction. Treatment focuses on treating reversible causes and managing complications like anemia and bone disease. Dialysis or transplantation may be needed for late-stage disease.
This document discusses chronic renal failure (CRF). CRF is the end result of progressive kidney damage and loss of function over 3 months or more. It is diagnosed through screening high risk individuals and blood tests showing elevated creatinine levels. CRF is classified into four stages based on loss of glomerular filtration rate. Common causes include diabetes, hypertension, glomerular disease, cystic kidney diseases, and exposure to toxins. Symptoms may include anemia, vomiting, and edema. Treatment focuses on fluid management, dietary restrictions, dialysis, and transplantation. Aminoglycoside antibiotics can cause nephrotoxicity and toxicity is more likely with renal insufficiency or chronic use.
Glomerular diseases can be classified as either primary (intrinsic renal pathology) or secondary (to a systemic disease). They present clinically with nephritic syndrome (hematuria, hypertension, azotemia) or nephrotic syndrome (proteinuria, edema, hypoalbuminemia, hyperlipidemia). The pathophysiology depends on which part of the glomerular structure is affected - podocyte damage leads to nephrotic syndrome with proteinuria alone, while damage to endothelial cells, GBM or mesangial cells causes nephritic syndrome with hematuria and proteinuria. Common primary glomerular diseases include minimal change disease, focal segmental glomerulosclerosis, membranous glomerulone
Everything You Need to Know about Chronic Kidney DiseaseEPIC Health
Chronic kidney disease is a slow and progressive condition where the kidneys are damaged and cannot filter waste from the blood properly. It has five stages with decreasing kidney function. The most common causes are uncontrolled diabetes and high blood pressure, which damage the filtering units of the kidneys over time. Chronic kidney disease often has no symptoms in early stages, so regular screening tests are needed to detect any kidney damage. Treatment focuses on controlling risk factors and slowing disease progression. Maintaining healthy habits like a low-salt diet, exercise, and monitoring blood sugar and pressure can help prevent chronic kidney disease.
End-stage renal disease (ESRD) occurs when the kidneys can no longer function well enough to sustain life and meet bodily needs. The kidneys normally remove waste, excess fluid, and toxins from the body while regulating electrolyte and mineral balance. ESRD is typically caused by diabetes, hypertension, and autoimmune diseases which damage the kidneys over time. It can lead to a buildup of waste products and fluid in the body that requires dialysis or kidney transplantation for management.
The document provides information about kidney structure and function, as well as kidney diseases. It discusses that the kidneys contain nephrons and filter blood to remove waste and regulate fluid levels. It describes acute kidney injury (AKI) as a sudden decline in kidney function, and chronic kidney disease (CKD) as long-term decreased function. For kidney failure, dialysis or transplantation is needed to replace lost kidney function.
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Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
This presentation gives information on the pharmacology of Prostaglandins, Thromboxanes and Leukotrienes i.e. Eicosanoids. Eicosanoids are signaling molecules derived from polyunsaturated fatty acids like arachidonic acid. They are involved in complex control over inflammation, immunity, and the central nervous system. Eicosanoids are synthesized through the enzymatic oxidation of fatty acids by cyclooxygenase and lipoxygenase enzymes. They have short half-lives and act locally through autocrine and paracrine signaling.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
1. Introduction
Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss
of renal function over a period of months or years. The symptoms of worsening kidney
function are unspecific, and might include feeling generally unwell and experiencing a
reduced appetite. Chronic kidney disease occurs when one suffers from gradual and
usually permanent loss of kidney function over time. This happens gradually, usually
months to years. Chronic kidney disease is divided into five stages of increasing severity
(see Table 1 below). The term "renal" refers to the kidney, so another name for kidney
failure is "renal failure." Mild kidney disease is often called renal insufficiency.
With loss of kidney function, there is an accumulation of water; waste; and toxic
substances, in the body, that are normally excreted by the kidney. Loss of kidney
function also causes other problems such as anemia, high blood pressure, acidosis
(excessive acidity of body fluids), disorders of cholesterol and fatty acids, and bone
disease.
Stage 5 chronic kidney disease is also referred to as kidney failure, end-stage kidney
disease, or end-stage renal disease, wherein there is total or near-total loss of kidney
function. There is dangerous accumulation of water, waste, and toxic substances, and
most individuals in this stage of kidney disease need dialysis or transplantation to stay
alive.
Unlike chronic kidney disease, acute kidney failure develops rapidly, over days or weeks.
• Acute kidney failure usually develops in response to a disorder that directly
affects the kidney, its blood supply, or urine flow from it.
• Acute kidney failure is often reversible, with complete recovery of kidney
function.
• Some patients are left with residual damage and can have a progressive decline
in kidney function in the future.
• Others may develop irreversible kidney failure after an acute injury and remain
dialysis-dependent.
Table 1. Stages of Chronic Kidney Disease
GFR*
Stage Description
mL/min/1.73m2
2. Slight kidney damage with normal or
1 More than 90
increased filtration
2 Mild decrease in kidney function 60-89
Moderate decrease in kidney
3 30-59
function
4 Severe decrease in kidney function 15-29
Less than 15 (or
5 Kidney failure
dialysis)
*GFR is glomerular filtration rate, a measure of the kidney's function.
Signs and Symptoms
The early symptoms of chronic kidney disease often occur with other illnesses, as well.
These symptoms may be the only signs of kidney disease until the condition is more
advanced.
Symptoms may include:
• General ill feeling and fatigue
• Generalized itching (pruritus) and dry skin
• Headaches
• Weight loss without trying to lose weight
• Appetite loss
• Nausea
Other symptoms that may develop, especially when kidney function has worsened:
• Abnormally dark or light skin
• Bone pain
• Brain and nervous system symptoms
o Drowsiness and confusion
o Problems concentrating or thinking
o Numbness in the hands, feet, or other areas
o Muscle twitching or cramps
• Breath odor
• Easy bruising, bleeding, or blood in the stool
• Excessive thirst
• Frequent hiccups
3. • Low level of sexual interest and impotence
• Menstrual periods stop (amenorrhea)
• Sleep problems, such as insomnia, restless leg syndrome, and obstructive sleep
apnea
• Swelling of the feet and hands (edema)
• Vomiting, typically in the morning
Risk Factor
Although chronic kidney disease sometimes results from primary diseases of the kidneys
themselves, the major causes are diabetes and high blood pressure.
• Type 1 and type 2 diabetes mellitus cause a condition called diabetic
nephropathy, which is the leading cause of kidney disease in the United States.
• High blood pressure (hypertension), if not controlled, can damage the kidneys
over time.
• Glomerulonephritis is the inflammation and damage of the filtration system of
the kidneys, which can cause kidney failure. Postinfectious conditions and lupus
are among the many causes of glomerulonephritis.
• Polycystic kidney disease is an example of a hereditary cause of chronic kidney
disease wherein both kidneys have multiple cysts.
• Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil)
regularly over long durations of time can cause analgesic nephropathy, another
cause of kidney disease. Certain other medications can also damage the kidneys.
• Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys
causes a condition called ischemic nephropathy, which is another cause of
progressive kidney damage.
• Obstruction of the flow of urine by stones, an enlarged prostate, strictures
(narrowings), or cancers may also cause kidney disease.
• Other causes of chronic kidney disease include HIV infection, sickle cell disease,
heroin abuse, amyloidosis, kidney stones, chronic kidney infections, and certain
cancers.
Pathophysiology
4. There are many diseases that cause CKD, each has its own pathophysiology. However,
there are common mechanisms for disease progression. Pathologic features include
fibrosis, loss of renal cells and infiltration of renal tissue by monocytes and
macrophages. Proteinuria, hypoxia and excessive angiotensen II production all
contribute to pathophysiology. In an attempt to maintain GFR, the glomerulus
hyperfiltrates; this results in endothelial injury. Proteinuria results from increased
glomerular permeability and increased capillary pressure. Hypoxia also contributes to
disease progression. Angiotensin II increases glomerular hypertension, which further
damages the kidney.
Laboratory exams
Chronic kidney disease usually causes no symptoms in its early stages. Only lab tests can
detect any developing problems. Anyone at increased risk for chronic kidney disease
should be routinely tested for development of this disease.
• Urine, blood, and imaging tests (X-rays) are used to detect kidney disease, as well
as to follow its progress.
• All of these tests have limitations. They are often used together to develop a
picture of the nature and extent of the kidney disease.
• In general, this testing can be performed on an outpatient basis.
Urine Tests
Urinalysis: Analysis of the urine affords enormous insight into the function of the
kidneys. The first step in urinalysis is doing a dipstick test. The dipstick has reagents that
check the urine for the presence of various normal and abnormal constituents including
protein. Then, the urine is examined under a microscope to look for red and white blood
cells, and the presence of casts and crystals (solids).
Only minimal quantities of albumin (protein) are present in urine normally. A positive
result on a dipstick test for protein is abnormal. More sensitive than a dipstick test for
protein is a laboratory estimation of the urine albumin (protein) and creatinine in the
urine. The ratio of albumin (protein) and creatinine in the urine provides a good
estimate of albumin (protein) excretion per day.
Twenty-four hour urine tests: This test requires you to collect all of your urine for 24
consecutive hours. The urine may be analyzed for protein and waste products (urea
5. nitrogen, and creatinine). The presence of protein in the urine indicates kidney damage.
The amount of creatinine and urea excreted in the urine can be used to calculate the
level of kidney function and the glomerular filtration rate (GFR).
Glomerular filtration rate (GFR): The GFR is a standard means of expressing overall
kidney function. As kidney disease progresses, GFR falls. The normal GFR is about
100-140 mL/min in men and 85-115 mL/min in women. It decreases in most people with
age. The GFR may be calculated from the amount of waste products in the 24-hour
urine or by using special markers administered intravenously. An estimation of the GFR
(eGFR) can be calculated from the patient's routine blood tests. Patients are divided into
five stages of chronic kidney disease based on their.
Blood Tests
Creatinine and urea (BUN) in the blood: Blood urea nitrogen and serum creatinine are
the most commonly used blood tests to screen for, and monitor renal disease.
Creatinine is a product of normal muscle breakdown. Urea is the waste product of
breakdown of protein. The level of these substances rises in the blood as kidney
function worsens.
Estimated GFR (eGFR): The laboratory or your physician may calculate an estimated GFR
using the information from your blood work. It is important to be aware of your
estimated GFR and stage of chronic kidney disease. Your physician uses your stage of
kidney disease to recommend additional testing and suggestions on management.
Electrolyte levels and acid-base balance: Kidney dysfunction causes imbalances in
electrolytes, especially potassium, phosphorus, and calcium. High potassium
(hyperkalemia) is a particular concern. The acid-base balance of the blood is usually
disrupted as well.
Decreased production of the active form of vitamin D can cause low levels of calcium in
the blood. Inability to excrete phosphorus by failing kidneys causes its levels in the
blood to rise. Testicular or ovarian hormone levels may also be abnormal.
Blood cell counts: Because kidney disease disrupts blood cell production and shortens
the survival of red cells, the red blood cell count and hemoglobin may be low (anemia).
Some patients may also have iron deficiency due to blood loss in their gastrointestinal
system. Other nutritional deficiencies may also impair the production of red cells.
6. Other tests
Ultrasound: Ultrasound is often used in the diagnosis of kidney disease. An ultrasound is
a noninvasive type of imaging test. In general, kidneys are shrunken in size in chronic
kidney disease, although they may be normal or even large in size in cases caused by
adult polycystic kidney disease, diabetic nephropathy, and amyloidosis. Ultrasound may
also be used to diagnose the presence of urinary obstruction, kidney stones and also to
assess the blood flow into the kidneys.
Biopsy: A sample of the kidney tissue (biopsy) is sometimes required in cases in which
the cause of the kidney disease is unclear. Usually, a biopsy can be collected with local
anesthesia by introducing a needle through the skin into the kidney. This is usually done
as an outpatient procedure, though some institutions may require an overnight hospital
stay.
Management
a.) Medical / Surgical management
There is no cure for chronic kidney disease. The four goals of therapy are to:
1. slow the progression of disease;
2. treat underlying causes and contributing factors;
3. treat complications of disease; and
4. Replace lost kidney function.
Strategies for slowing progression and treating conditions underlying chronic kidney
disease include the following:
• Control of blood glucose: Maintaining good control of diabetes is critical. People
with diabetes who do not control their blood glucose have a much higher risk of
all complications of diabetes, including chronic kidney disease.
• Control of high blood pressure: This also slows progression of chronic kidney
disease. It is recommended to keep your blood pressure below 130/80 mm Hg if
you have kidney disease. It is often useful to monitor blood pressure at home.
7. Blood pressure medications known as angiotensin converting enzyme (ACE)
inhibitors or angiotensin receptor blockers (ARB) have special benefit in
protecting the kidneys.
• Diet: Diet control is essential to slowing progression of chronic kidney disease
and should be done in close consultation with your health care practitioner and a
dietitian
b) Nursing management:
The nurse should monitor the vital signs and the client diet. We should monitor
the non-verbal ques and the objectives. The patient should have adequate rest and also
providing individualized physical therapy that can be continued by the client when
discharge.
References:
http://www.emedicinehealth.com/chronic_kidney_disease/article_em.htm#Chronic%20Kidney
%20Disease%20Overview
http://www.emedicinehealth.com/chronic_kidney_disease/page2_em.htm#Chronic%20Kidney
%20Disease%20Causes
http://www.emedicinehealth.com/chronic_kidney_disease/page8_em.htm#Medical
%20Treatment
http://adam.about.com/encyclopedia/infectiousdiseases/Chronic-renal-failure.htm
http://en.wikipedia.org/wiki/Chronic_kidney_disease#Causes
www.raymondcheong.com/.../NA%2001%20-%20Renal%20Pathophysiology.doc
BOOK: Medical- Surgical Nursing Volume 1 by Joyce M. Black page 796
Perpetual Help College of Manila
8. College of Nursing
Case Literature
(Chronic Kidney Disease)
Gat Andres Bonifacio Memorial Medical
Center
MEDICAL WARD
Submitted by:
Sy, Genevieve Kay F.
A4F
Submitted to:
Mr. Joselito Salvador RN