Glomerular Filtration Rate and Chronic Kidney Disease Management

The National Kidney Foundation information is provided in a question and answer format with one or two sentence simple answers provided. The Merck Manual site utilizes headers with information ranging between one to three paragraphs. Links available on the National Kidney Foundation Website keep the reader on the site and frequently take them back to the donation page. The Website provides a section for “Professional” users, however, the majority of the area is again written for the general public. One area reviewed provides an “Education and Research” option that takes the professional reader to more technical writing sources contained within the National Kidney Foundation Website. The Merck Manual links allow the reader to visit other Websites for additional subject information. The National Kidney Foundation Website offers additional educational opportunities via Webinars and seminars. No such offerings were noted on the Merck Manual site.

Chronic kidney disease (CKD) is a worldwide problem that is currently three times higher for African Americans, Hispanics, Pacific Islanders, American Indians and seniors (The National Kidney Foundation, 2013). CKD occurs when the kidneys are damaged by a pathogen or injury and they can no longer adequately maintain proper levels of regulated chemicals in the bloodstream. There are many risk associated with CKD. According to the National Kidney Foundation, two of the major risks are Chronic Renal Failure (CRF) and Cardiovascular Disease. Currently twenty million American adults have CKD and millions of others are at increased risk. Age has no barrier on getting CKD. People with pre-existing health issues, and a part of certain population

Chronic kidney disease (CKD) is a common disorder and occurs in the elderly population. In younger patients, it

Using an existing National VA AKI-CKD study cohort extracted from the VA CDW containing electronic medical records, I will identify those in the cohort diagnosed with AKI using KDIGO along with associated International Classification of Diseases, Ninth Revision (ICD-9) diagnostic codes for AKI or acute renal failure as inclusion criteria in my study population (Kidney Disease Improving Global Outcomes (KDIGO), 2012). I will exclude those who do not fit the set cohort criteria.

Chronic Kidney Disease (CKD) is a disease that is described as a loss of kidney function gradually over time. As kidney function decreases, the waste collection in the body’s blood becomes high and makes the individual feel sick. This disease can lead to other complications in the body such as anemia, poor nutritional health, high blood pressure, and nerve damage. These complications will begin to progress and show as CKD progresses to advanced stages. Early detection of this disease is essential when it comes to treatment. If CKD is diagnosed early enough the disease progression can be slowed down and managed. This disease will eventually lead to failure of the kidneys

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,

Mark is a four year old male who has been diagnosed with chronic renal failure. Mark has two older brothers, John and Max. His mom, Carol, is a teacher at the local elementary school. His dad, Mike, is a community police officer. Mark goes to preschool from 0800-1200 four days a week. They live in a rural community in small four bedroom house with their dog, Bruno. Everyone in the community seems close and supportive. Both Mark’s older brothers caught strep throat at school and then Mark caught it. The strep wasn’t treated for two weeks as his mother thought his symptoms were allergies. Mark was in the clinic with his mom with symptoms of decreased urine output, rusty colored urine, and swelling of the abdomen. The doctor diagnosed him

The comparison was between survival rates of the patients with raised and normal concentrations of troponin. Cox proportional hazard was used to determine the relative risk of death both adjusted and unadjusted and 95% confidence intervals. Kaplan- Meir method was used to compute survival curves. After that summarisation if clinical data was done 733 patients. It was founded that majority of patients had increased troponin t as compared to troponin i irrespective of the cut-off criteria used. Again regardless of the cut-off criteria used one, two and three-year combined mortality rates were higher in patients with raised troponin t compared patients having normal levels. Unadjusted for other risk factors for mortality, Regardless of the duration of follow-up, an increase of 2-5 times in risk of death was noted with raised troponin t and 2 times with raised troponin i. Age, history of CAD, time since dialysis were identified as independent risk factors according to the data. Whereas sex, diabetes, and history of myocardial infarction were not found to be predictive independently. It was also found out that there are increase mortality rates with mild, moderate and larger increases in troponin t. Based on pre-dialysis troponin t and troponin i concentrations this was the first study to determine short and long-term survival in ESRD patients. This also found causes for more elevations of troponin t as compared to troponin i. Three different

The three key components of evaluation and management are history, physical exam, and medical decision-making. History is broke down into four blocks chief complaint, history of present illness, review of systems, and past medical, family, and social history. There are four levels of history problem focused, expanded problem focused, detailed, and comprehensive. Physical exam included the body and the organ system which is broke down into four blocks problem focused, expanded problem focused, detailed, and comprehensive. Medical decision making is the decision making that improves the patients’ health includes four blocks straightforward, low complexity, moderate complexity, and high complexity. New patient has to meet 3 out of 3 key components

The most commonly evaluated clinical parameter measured in the ESRD population is the delivered dose of dialysis is by Kt/V. In this case, majority of the diabetic and non-diabetic population has an adequate dialysis based on their Kt/v (sp). But still many factors are needed to be considered. We should identify the possible causes for those patients who did not meet their required clearance. Check the patient’s vascular access. A Good vascular access provides adequate dialysis. Observe proper cannulation technique and rotate sites to prevent damage of the access. Proper priming should be observed to utilize the surface area of the dialyzer. Clotting of blood due to inadequate heparinization does not produce adequate clearance. The nurse should administer heparin per facility protocol or as ordered by the doctor. Monitor patient’s Kt/V through online clearance monitoring (OCM) to immediately evaluate the current urea clearance of the patient and to provide a prompt intervention and investigation as necessary.

Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,

There is a need for greater awareness of the importance of early intervention. Nephrology nurses have assumed increased clinical responsibilities within today's practice setting, and their role in managing CKD patients may increase in the future. Nephrology nurses can have a major impact on the clinical outcomes of CKD patients, primarily through patient education and improved patient compliance. Nephrology nurses who do not oversee the direct medical management of CKD patients may still play vital roles in identifying anemic patients, promoting compliance, educating patients and health care personnel, and administering therapies. These functions are essential because several barriers exist to optimal anemia management in the CKD patient. For instance, patients and care providers may not understand the importance of anemia management and may question whether it is worth bringing CKD patients into the office weekly for injections. Nephrology nurses can communicate the importance of anemia management over the long term and assure patients about the safety and efficacy of the available

CathyAnn, great post. You have made a great point about renal impairment and being precautious when prescribing medication to elderly with CKD. Renal impairment can happen for numerous different reasons, a few of the reasons that renal impairment can happen are diabetic nephropathy, lupus, and aging (Burchum & Rosenthal, 2016 & Rull, 2016). With aging it is normal to have a decline in renal function. For this patient particularly, it would be important to make sure that if there is any medication that the nurse practitioner would be prescribing that would need to have renal dose adjustment it would be important to do testing to see what kind of adjustments needed to be made.

Chronic kidney disease (CKD) is becoming a major public health problem worldwide. As per WHO Global burden of disease project, diseases of the kidney and urinary tract contribute to the global burden with approximately 850,000 deaths every year, and 115,010,107 disability adjusted life years. CKD is the 12th leading cause of death and 17th cause of disability. [1]

stages, symptoms and risk factors. It also examines the process of kidney transplantation to treat