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Chronic Kidney Disease

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Running Head: CHRONIC KIDNEY DISEASE

Understanding Chronic Kidney Disease

Kim Prior

Rock Valley College

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Understanding Chronic Kidney Disease Chronic kidney disease is a growing problem with increasing numbers of patients being diagnosed and those beginning dialysis or the transplant process. “Currently, 26 million Americans have CKD…and 111,000 patients were newly diagnosed with end-stage renal disease in 1 year” (Castner, 2010, p. 26). Chronic kidney disease develops over years and can be considered a silent disease because many patients with this disease are diagnosed while being tested for another condition. Signs and symptoms of the disease are dependent on the cause, stage, and other medical conditions the patient has that may complicate the kidney disease. The first step is to identify patients with increased risk factors and early signs and symptoms of kidney disease. Risk factors include a family history, diabetes, smoking, obesity, hypertension, exposure to harmful substances that may injure the kidneys, and cardiac conditions such as heart failure or acute myocardial infarction (Castner, 2010). Patients that have these risk factors should be evaluated frequently by their physician as well as educated about lifestyle changes to decrease their risk (weight loss, exercise, smoking cessation, blood sugar control, blood pressure monitoring, and a healthy diet. Early signs and symptoms include fatigue, cold intolerance, metallic taste, irregular pulse, a change in urine output, increased bleeding, and edema (Castner, 2010). The signs and symptoms may be generalized, but combined with the risk factors kidney disease should not be overlooked. There are many diagnostic tests for kidney disease. A urine dipstick shows protein (proteinuria) as this indicates damage to the glomeruli which act as filters. Normally protein is kept in the blood by the glomeruli, but as they become damaged they cannot keep the protein from passing into the urine. Specific gravity of the urine is an indicator of how well the kidneys concentrate urine. As the kidneys become more damaged the ability decreases showing a low specific gravity. Blood tests show increased levels of BUN and creatinine. An abnormal
Kidney disease 3 blood count indicates anemia due to decreased production of erythropoietin (Castner, 2010). A CT scan or MRI can evaluate the anatomy and function of the kidneys to help determine the cause and stage of the disease. A renal biopsy may also be performed. These diagnostic tests determine the progression of the disease. There are five stages of chronic kidney disease. The treatment plan depends on the stage of the disease. If it is diagnosed in stage one, the patient and physician can work to treat the contributing factors and slow the progression of the disease. By the fifth stage the patient is on dialysis, needs a transplant, or in the most severe cases is in hospice care (Castner, 2010). Educating the patient is a very important part of the nursing role. The patient with chronic kidney disease needs to be educated on the disease process, how to slow the progression of the disease, medications, diet restrictions, dialysis and how to care for the dialysis access site, and the importance of regular visits with their physician. The more a patient knows, the more he/she can be proactive in the treatment plan. Kidney disease is manageable if diagnosed early and the patient needs to understand that it is not a death sentence! I was so excited with I came across this article because it is exactly what we are studying in class. Although it is a more general article, it simplifies the subject so I can understand the basics of chronic kidney disease. My best friend’s mom was on dialysis the last year of her life and I wish I had known more about what was going on. It is amazing to me how important the kidneys are in all aspects of the human body. The information in this article will help me to understand blood tests and the results that we draw routinely in our office. I didn’t think I would like renal, but now that I’m understanding it more, I find it very interesting. I may actually consider being a dialysis nurse. It amazes me that we can take a person’s blood out of their body, clean it, and put it back in!!

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References
Castner, D. (2010). Understaning the Stages of Chronic Kidney Disease. Nursing 2010, 40(5), 25-31.

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