WEEK TWELVE Flashcards
Risk factors of chronic kidney disease?
Family history/genetics increasing age previous kidney disease tobacco smoking physical inactivity poor nutrition cardiovascular disease diabetes systemic kidney inflammation low birth weight high blood pressure obesity males
General symptoms of CKD
Fatigue is the biggest physical issue with CKD.
Medication side effects
Nutritional deficiencies
Physiological alterations such as obstructive sleep apnoea
Abnormal urea and haemoglobin levels
Sleep dysfunction and factors associated with haemodialysis treatment
Depression
Sign of CKD worsening?
The S&S of uremic syndrome are: Nausea and vomiting Change in mental sates Abnormal bleeding from minor injuries Irregular heartbeats due to increased fluid upon the heart SOB due to fluid build-up in the lungs Itching Fatigue
Impact of disease on quality of life?
Depression Denial Helplessness Loss of control Anxiety Fear of death Guilt Anger Employment status Financial status
Assessment of symptoms?
Food and fluid consumption.
Skin problems, headache, joint enlargement or bone pain
History of fractures and menopausal status
Current medication
Do a physical examination: skin, itchiness, joints for calcium deposits, eyes for redness or inflammation
Watch for confusion, safety within environment
Medication used?
ACEI or/and ARB Diuretics Beta-blockers Calcium channel blockers Monitor glucose, albumin, lipids, Vitamin D, calcium, phosphate and parathyroid hormone, B12, iron, and folate levels
Management of CKD?
Dehydration Fasting Radio-opaque contrast Gentamycin/ Vancomycin Metformin Ibuprofen ACEI and ARB combinations are not recommended
Examples of Kidney replacement therapies
Haemodialysis/ Peritoneal dialysis/ Kidney transplantation
Use of kidney replacement therapies?
Remove end products of protein metabolism
Maintain safe serum electrolyte levels
Corrects acidosis
Removes excess fluid
Benefits of home dialysis
Improvement in QOL with family
Autonomy, flexibility
Remote location – stay at home
HHD – more likely to stay employed, less hospitalization, less complication than satellite or hospital based treatment
Can increase or extend their hours for treatment
Less expensive, reduced admissions and complications
Cheaper then satellite HD
Barriers to home dialysis?
Clinical factors System-based factors Patient factors Transplant Technque failures with PD Infections Carer or patient fatigue Non-dialysis related factors
Side effects of dialysis?
PD dialysis: Hernia Bloating & weight gain Low blood pressure Muscle cramps Blood clots Itchy or dry skin Infection
Kidney transplataion advantages
Advantages
Lowered long-term mortality risk
Increased quality of life
Lowered costs.
Kidney transplantation disadvantages?
Side effects associated with anti-rejection medications
Issues of chronic rejection
loss of donor organ
Need to return to dialysis
Complications post kidney transplant
Hyperacute Rejection – immediately after surgery
Acute rejection – one week to one year
Chronic rejection – occurs slowly, without obvious symptoms.
Infection
