Chronic Kidney Disease

Main Risk Factors?

Diabetes

Hypertension

Heart disease

Glomerulonephritis

Age(over60)

Anatomical abnormalities or inherited condition

Polycystic kidney disease

Ethnicity

African American

Hispanic

Native American

Symphoms

Change of Urination

foamy,bubbly

more or less of frequency

greater or less amount of urine

darker or paler of color of urine

bloody urine

difficulty urination

Fluid Retention (Extra fluid in the body)

Swelling (legs, ankles, feet face or hands)

Shortness of Breath(pulmonary edema)

Anemia

Less EPO(erythropoietin)

EPO tells the body to make RBC which carries oxygen

feeling cold

Fatigue

weakness

brain not getting enough O2

Memory problem

Trouble concentration

Dizzines

Uremia

Rash/ severe itchiness

Difficulty sleeping might need med and moisturizer

Metalic taste, Ammonia breath

Nausea/ Vomiting

What is CKD? Permanent Progressive damage to the kidney

Main Helathy Kidney Roles

Regulation of fluid volume

Regulation of BP

Blood PH balance

By Regulating
H+ and Hco3-

Elimination of metabolic waste

Urea

Creatinine

Drug(water soluble)

Toxin

Electrolyte balance

Ca2+,Na+ K+ Cl- Mg2+

H+/Hco3-

Metabolic process

gluconeogenesis

glycogenesis

glycogenolysis

Vit D synthesis

control of Ca2+ in blood

Endocrine

Renin for RASS(maintain BP)

Erythropoietin

production of RBC

5 Stages of CKD in GFR(ml/min/1.73m2)

Stage 1

Normal Kidney >90

Stage 2

Mild Damage 60~89

Stage 3

Moderate Damage 30~59

Stage 4

Severe Damage 15~29

Stage 5

Kidney Failure <15

Diagnosis

GFR

Common blood test to see how well the kidney are filtering

Urine Albumine

Checks for a protein that passes into urine when the kidneys are damaged

Serum Creatinine

Creatinine is waste product that is produced from the normal wear and tear on muscles in the body. If the kidney function drops, creatine level increases.(Normal range :0.74~1.35mg/dl for men, 0.59~1.04mg/dl for women)

BUN(Blood Urea Nitrogen)

BUN comes from the breakdown of protein in the foods people eat.(normal range :7~2mg/dl)

kidney scan

check size of kidney

kidney biopsy

check cell damage

Chest X ray

to check pulmonary edema

Management of CKD^

Medication

BP control

ACE inhibitor

Angiotensin II receptor blockers

Diuretics and low slat diet

Glucose control

insulin

Metformin

glinides

to lower Cholesterol level to reduce the risk of heart disease

Startins

to treat Anemia

erythropoiesis

Iron supplement

to relieve swelling

Diuretics

to protect bones

Calcium and Vit D Supplements

phosphate binder

Diet

low protein

A registered dietician can suggest ways to lower protein intake while still eating a healthy diet.^

Low slat

Low K+

Low P-

life ryle

exercise

Physical activity also help controlling hypertension,diabetes, heart disease.

smoking cessation

Avoid NSAIDs and Aminoglycoside antibiotics

limit alcohol and coffee

Medical treatment for ESRD

Dialysis : artificially removes waste products and extra fluid from blood when kidneys can no longer do this

Hemodialysis

A machine filters waste an d ecess fluids from the body

peritoneal dialysis

A thin tube inserted into the abdomen fills the abodomen cavity with a dialysis solution that absorbs waste and excess fluids. After a time, the dialysis solution drains from the body, carrying the waste with it.^

Kidney Transplant

Surgically placing a healthy kidney form a donor into a recipient's body

After a transplant, need to take medications for the rest of recipient's life to keep the body from rejecting the new organ.