Michael Emory

            MTCC PNE / NUR 101

                                                 Chronic Kidney Disease (CKD)                    

Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss in renal function over a period of months or years. The early symptoms of worsening kidney function vary and often go un-noticed. Chronic kidney disease (CKD) causes destruction of the kidneys. It is progressive and irreversible. (Brunner).

Your kidneys are an essential part of your body’s ability to function. They have a number of functions: they help maintain the balance of minerals and electrolytes such as calcium, sodium, and potassium, they play an essential role in the production of red blood cells, they maintain the delicate acid-base balance of the blood, and they excrete water soluble wastes from the body. Each kidney contains about one million tiny filtering units called nephrons. (Shier, 12th Edition) Any disease that injures or scars these filtering units can cause kidney disease. (White etal., 2011)

Diabetes and high blood pressure can both damage the nephrons. (Brunner) High blood pressure can also damage the blood vessels of the kidneys, heart, and brain. This is key, because, in general, blood vessel diseases are dangerous to the kidneys. The kidneys are vascular—meaning they contain lots of blood vessels. (Brunner) The risk of CKD increases over the age of 65 and chances seem to increase if there is a family history of renal disease. It is more likely to occur in African-Americans, American Indians, and Asian Americans. Other risk factors for CKD include: cigarette smoking, obesity, high cholesterol, diabetes, and autoimmune disease. (White etal., 2011)

CKD does not cause noticeable symptoms until about 90 percent of the kidney has been destroyed. Once the kidney is severely damaged, symptoms of CKD could include: swelling around the eyes (per orbital edema), swelling of the legs (pedal edema], fatigue, shortness of breath, nausea vomiting, especially in the morning and after eating. (Brunner). BUN can be elevated when the kidney starts to fail. Normally, the kidney clears products of protein breakdown from the blood. However, after kidney damage,

byproducts build up. Urea is one byproduct of protein breakdown. Urea is what gives urine its odor. (Brunner).

The diagnosis of CKD begins with a medical history. A family history of kidney failure can raise suspicions. So can a history of high blood pressure or diabetes. However, other tests are needed to confirm a CKD diagnosis.  A complete blood count (CBC) can show anemia. Kidneys produce erythropoietin. This is the hormone that stimulates the bone marrow to produce red blood cells. When the kidney is severely damaged, the ability to produce erythropoietin decreases. This causes the decline in red blood cells known as anemia. (Brunner).

Procedures that can be done to help with the diagnosis include a Renal Flow and Scan.  This is an imaging study of kidney function A Renal Ultrasound This noninvasive test measures the kidneys and prostate. It gives information about whether an obstruction is present.  Additional tests for CKD include: biopsy of the kidney, bone density test, abdominal computed tomography (CT) scan abdominal magnetic resonance imaging (MRI).  (Brunner).

CKD is chronic and irreversible. Treatment focuses on improving the underlying disease.

Treatment can also prevent and manage complications of CKD, such as: fluid overload, congestive heart failure, anemia, and weight loss and electrolyte imbalance. Control of underlying problems, such as hypertension and diabetes, can slow the rate of kidney damage. Chronic kidney disease frequently progresses to complete kidney failure. When this happens either dialysis or a kidney transplant is necessary for continued survival.  There are steps a person can take to properly manage chronic kidney disease and prevent the process from progressing.   One very important issue is controlling blood sugar. And keeping your blood pressure well controlled is probably two of the single best ways to manage chronic kidney disease So, Making exercise and healthy eating will help to regulate blood pressure and blood sugar which in turn helps to manage chronic kidney disease. (Brunner) (White etal., 2011) (Shier, 12th Edition)

                                                            

References

Brunner, L. S., Suddarth, D. S., & Smeltzer, S. C. (2008). Brunner & Suddarth's textbook of medical-surgical nursing (7th ed.). Philadelphia, New York: Lippincott Williams & Wilkins.

 "Hole's Human Anatomy & Physiology (Shier), 12th Edition." Your Page Title. N.p., n.d. Web. 14 Nov. 2013. .

White, Lois, Gena Duncan, and Wendy Baumle. Foundations of Nursing. Clifton Park, NY: Delmar/ Cengage Learning, 2