Chronic Kidney Disease Introduction
Chronic Kidney Disease Introduction
Medical care planning for patients with Chronic Kidney Disease
Introduction
Chronic Kidney is a disorder that disturbs the correct working of the kidney, which is increasingly becoming a challenge to the health care sector. Just like any other chronic disease, CKD comes with the responsibility of ensuring that a patient gets maximum medical treatment facilities and attention as much as possible. “The definition and classification of chronic kidney disease (CKD) have evolved, but current international guidelines define this condition as decreased kidney function as shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m2 or markers of kidney damage, or both, of at least three months duration, regardless of the underlying cause”, Morton & Masson, 2017.
Morbidity and comorbidity of chronic Kidney disease
Weak/low results are closely associated with CKD; this is because of the burdens that are so high when it comes to comorbidity. Many pieces of research have indicated that CKD relates to diabetes and hypertension conditions. Intense conditions of chronic kidney disease also lead to heart complications. There is little information on the mental difficulties that come with CKD.
“Chronic kidney disease (CKD) can be associated with adverse clinical outcomes, poor quality of life, and high health-care costs; clinicians need to understand that these observations result from a high burden of comorbidity among CKD patients”, (Manns &Hemmelgarn 2010). Key morbidities of CKD, therefore, include pulmonary complications, diabetes, hypertension, and atrial fibrillation. CKD, to a very high degree, leads to characteristics such as myocardial infarction, dementia, hypothyroidism, depression, and stroke. All comorbidities remain classified as concordant others that closely relate with CKD but ranked as discordant include; asthma, constipation, lymphoma dementia, etc.
Impacts of chronic kidney disease
Various medical reports by the health care agencies and organizations, including the World Health Organization show that CKD is a growing complication that has become a big concern of the public health care sector not just in the United States but around the globe. An estimation of over 26 million people is affected by CKD in the country. Annual reports have shown that this number is likely to increase if serious investments are in the health care sector. Hypertension and diabetes are proven, leading causes of kidney complications. To an individual, CKD can lead to other primary complications such as nephropathy, lupus, and continuity of kidney failure. The country invests billions of money annually, something that is becoming hard to sustain because of the annual increase in population and the number of those affected by CKD.
As of 2006, over $23 billion was spent on CKD and other related chronic complications, and this is a clear indication that with CKD comes a substantial financial burden not only to the affected person and his/her but the society at large. Although CKD complications cannot be changed, its progression rate may be measured. For this rate to be measured successfully, a lot of emphases must be put on developing outstanding strategies that will make it easy when it comes to the identification of people who have high chances of being affected by CKD for early screening to be done.
Key goals and objectives for chronic kidney diseases
According to Healthy People 2020, CKD, together with ESRD (End-Stage Renal Disease are among the most critical challenges facing the public health care sector. It is also a vital source of the low quality of life and suffering to the affected people, the family, and society in general. A lot of premature death cases are rising from CKD and high prices within the economy both within the public and the private sector. The most crucial aim that Healthy people seeks to achieve is reducing the rise of recent cases as far as CKD is concerned, and this is the inclusion of all the other difficulties that come hand in hand with CKD, lowering death rates, disability cases related to CKD, and the enormous economic expanses.
The objectives include, “reducing the proportion of the U.S population with CKD, increasing the percentage of people with CKD that know they have impaired renal function, increasing the actual percentage of hospital patients that have incurred kidney injuries that have a follow-up evaluation of renal in within six months of post-discharge, Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical evaluation, Increase the proportion of persons with chronic kidney disease who receive medical evaluation with serum creatinine, lipids, and micro albuminuria, Increase the proportion of persons with type 1 or type 2 diabetes and chronic kidney disease who receive medical evaluation with serum creatinine, micro albuminuria, A1c, lipids, and eye examinations, Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBS) and Improve cardiovascular care in persons with chronic kidney disease”, (Healthy People 2020).
Care plan for C.K.D patients
1. Monitoring the most important factors which are essential in maintaining consistent blood pressure. This monitoring is an excellent way through which the kidneys get protected from more damages.
2. Monitoring and managing the blood sugar level is vital in reducing the stress that the kidneys may face
3. Assessing the cardio-pulmonary systems, “Fluid retention from improper glomerular filtration may collect in the myocardium resulting in pressure on the heart and the lungs. Listen for friction rub and pulmonary crackles or congestion”, NSRNG 2019.
4. Monitoring laboratory and diagnostic evaluations. “Purification Degree (GFR) <60 indicates kidney disease, <15 indicates kidney failure, CT / Ultrasound Kidney biopsy (if necessary), Chest x-ray – if indicated GFR- is a blood test that can show the degree of kidney function available. It is a calculation of creatinine levels, race, age, and gender. CT / Ultrasound- this imaging may be helpful to view the kidneys to determine if there are tumours or other unusual characteristics of the organs”. Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. 2016
5. Evaluating the mental state of the patients.
6. Monitoring I & O is carried out by monitoring the functioning of the kidney, calculating the level of fluid retention, the patient’s weight daily at the proper planned time.
7. Inserting an indwelling catheter appropriately, this is a better way of monitoring the fluids balance plus urine features.
8. Palpating the patient’s abdomen, this is a better way of assessing the level of fluid retention.
9. Another meaningful way is Focusing on nutrition guidelines. “The kidneys are compromised and unable to remove the waste produced by processing proteins (BUN). Choose foods low in saturated and Tran’s fat to prevent and lower fat deposits in the blood vessels. Choose lower potassium foods to avoid hyperkalemia caused by excess potassium retention”. Hall, M. E., do Carmo, J. M., da Silva, A. A., Juncos, L. A., Wang, Z., & Hall, J. E. 2014.
References
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. The Lancet, 389(10075), 1238-1252.
Chawla, L. S., Eggers, P. W., Star, R. A., & Kimmel, P. L. (2014). Acute kidney injury and chronic kidney disease as interconnected syndromes. New England Journal of Medicine, 371(1), 58-66.
Collins, A. J., Foley, R. N., Gilbertson, D. T., & Chen, S. C. (2015). The United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney international supplements, 5(1), 2-7.
Hall, M. E., do Carmo, J. M., da Silva, A. A., Juncos, L. A., Wang, Z., & Hall, J. E. (2014). Obesity, hypertension, and chronic kidney disease. International journal of nephrology and renovascular disease, 7, 75.
Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. (2016). The global prevalence of chronic kidney disease–a systematic review and meta-analysis. PloS one, 11(7), e0158765.
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