Kidney Failure Diagnosis and Treatment - Essay Example

CHRONIC KIDNEY DISEASE Kidney Failure Diagnosis and Treatment (Affiliations) Describe Clinical Presentation of chronic kidney disease. Chronic kidney disease, mostly commonly referred to as CKD is a prolonged and irreversible kidney damage that occurs or propagates in five stages. These stages are differentiated on the basis of glomerular filtration rate GFR The presence of kidney damage indicators in the form of abnormalities in the blood, urine or imaging tests for a duration greater than or equal to three months or a glomerular filtration rate GFR less than sixty milli liters per minute per 1.73 meter cubic for greater than or equal to three months. These symptoms are considered while diagnosing CKD regardless of evident kidney damage. (McClellan et al, 2006). It is differentiated from end-stage renal disease by GFR less than 12 milli liters per minute with the uremic syndrome. The five stages of CKD involve: Stage 1disease: identified by a normal glomerular filtration rate of greater than ninety milli liters per minute per 1.73 meter square and persistent albuminuria (large amount of albumin in the urine, a common type of proteinuria) Stage 2 disease: identified by a GFR between sixty to eighty-nine milli liters per minute per 1.73 meter square and persistent albuminuria. Stage 3 disease is identified by a GFR between thirty and fifty-nine milli liters per minute per 1.73 meter square. Stage 4 disease is identified by a GFR between fifteen and twenty-nine milliliters per minute per 1.73 meter square. Stage 5 disease is identified by a GFR of less than fifteen milliliters per minute per 1.73 meter square or end- stage renal disease (Rao, 2009). Explain how you might diagnose a patient with chronic kidney disease including the role that patient’s history, physical exams and diagnostic play in diagnosis. One of the following symptoms plays an important role in the first perception of disease these include; Incessant vomiting, Encephalopathy, Overload of fluids in the lungs that cannot be removed by diuretics, metabolic acidosis, electrolyte abnormalities hyperkalemia, uremic pericarditis, Uremic neuropathy, Severe malnutrition, loss of energy, appetite or weight and anemia unresponsive to epoetin alfa and iron therapy. The history of the patient along with past disease afflictions plays an important role in diagnosis. In this case common causes include Diabetes mellitus, Hypertension, Chronic glomerular nephritis or polycystic kidney disease. Diseases like polycystic kidney disease and type I diabetes mellitus have a genetic disposition and are noted as precursors of chronic kidney disease. In physical exams usually do not play a substantial role in diagnosing the disease but age has a minor role, since this disease can occur at any age. Symptoms such as increased skin pigmentation, hypertension, peripheral oedema, peripheral vascular disease, pleural effusions, peripheral neuropathy and restless legs syndrome if indicated in physical examination may be useful indicators to diagnose the disease as its early symptoms however it may only reveal minor onsets of disease and may be symptoms to more than one kind of disease. (Levin. Nahas, 2009) Explain implications of potential treatment options for this disease including prescribed drugs. Usually patients seeking medical treatment from a physician who is not a nephrologist need to be aware of the possible implications of various drug prescriptions. These drugs cannot minimize the damage but can provide some relief; by curing the symptoms. Such patients are usually suffering from high blood pressure; medication like diuretics, vasodilators etcetera is given to control it. Then some medication is given during dialysis like Vitamin D to keep the bones strong. Possible side effects include low blood salt concentration, high circulating calcium, dehydration, oedema, slow heat rate, problematic breathing in case of asthma patients, dizziness and erectile dysfunction. Other than drug prescription two types of dialysis are used. Dialysis is basically a process which cleans the blood either outside, utilizing mechanical kidney dialyzer, or inside the peritoneum cavity, peritoneal dialysis. A) Haemodialysis: it employs outside the body mechanism to remove nitrogenoutos wastes like creatinine, urea and water from the blood. It utilizes the basic principle (National Kidney Federation, 2000). B) Peritoneal dialysis : The basic principle is the same in fact both of these are a type of dialysis for functioning as artificial kidneys in patients suffering from renal failure or uremia .This procedure differs from haemodialysis in employing the human’s peritoneum cavity, this type of dialysis occurs in the human body without artificial kidney Side effects include blood borne infectious disease contagion of unsterilized equipment .Anaphylactic shock in case of unfavorable between apparatus .Thrombus formation .Air embolism, When an air bubble may entre the veins causing nervous breakdown and death .Unfavorable removal of useful nutrients and complications arising from fistula .Therefore precaution should be taken that a healthy environment along with professional staff is employed for efficient procedure. This procedure is executed two to three times per week. Describe how the patient factors might impact the diagnosis and treatment of patients with chronic kidney disease. A number of patient factors play a major role in proving to be a hurdle for proper treatment and diagnosis. Lack of awareness and ignorance on part of the patient and his family not only delays the process but may deviate it altogether in the wrong direction. These days’ people are less aware of the modern techniques and are largely biased towards modernization. They are completely oblivious to their effectiveness and power of remedy. Thus delayed treatment cause fatality and decreases the chances of survival; kidneys suffering from end- stage renal failure require a perfect purification of blood as elevation in circulating levels of nitrogenous compounds in blood causes toxicity and eventually death. Many people are attracted towards cheap treatments other than alopathy, the most common attraction being homeopathy. Treatment with herbs and herb- derived substances are believed to cure illness; this is a completely wrong and fatal perception. Moreover late consultation at the stage of acute complexity of symptoms often becomes incurable. Another important factor is wrong preference of medical department and complete dependence on general physician without feeling the need to go to a specialist. Not following instructions and believing in myths and taboos is also a prevalent notion. Last but no the least socio- economic factors play a pivotal role in alluring the patient towards all the wrong treatment. Lack of financial assistance or a backup plan also leads to a large number of deaths. References McClellan, W. M., Schoolwerth, A. C., &Gehr, T. (2006). Clinical management of chronic kidney disease. Caddo, OK: Professional Communications. Meguid El Nahas, Adeera Levin. (2009). Chronic Kidney Disease: A practical Guide to Understanding and Management. Oxford Clinical Nephrology. Oxford University Press. National Kidney Federation.(2000). Introduction to haemodialysis.Worksop: National Kidney Federation. Rao, M. K. (2009). Chronic kidney disease: National clinical guideline for early identification and management in adults in primary and secondary care. Kidney International, 75(6), 571. Read More