Chronic Renal Disease – Coursework Example
Chronic Renal Disease of Chronic Renal Disease Chronic renal disease (CRD) refers to a condition characterized by a gradual loss in the renal function over months or years. The indications that the kidney is increasingly being impaired include general feelings of being unwell and lack of appetite. Diagnosis of chronic renal disease is by screening those vulnerable or suspected to be at risk of developing kidney problems (Johnson, 2011). CRD could also result in conditions such as cardiovascular disease, high blood pressure, diabetes, anemia, or pericarditis. Initially CRD does not have clear and specific symptoms and can only be detected by the rise in the secretion of serum creatinine or protein in the urine and a decrease in kidney function. The main symptoms of chronic renal disease that accompany decreased kidney function are increased blood pressure, hypertension, congestive heart failure, azotemia, uremia, malaise, and cardiac arrhythmias (Tonelli, Wiebe, & Culleton, 2006). The other symptoms are mild edema, pulmonary edema, hyperphosphatemiae to reduced phosphate excretion, and metabolic acidosis.
The causes of CRD include hypertension, glomerulonephritis, and diabetes mellitus. CRD is classified differently depending on the section of the anatomy affected. For instance, renal artery stenosis and ischemic nephropathy are vascular while glomerular chronic renal diseases include focal diabetic nephropathy, lupus nephritis, and segmental glomerulosclerosis and IgA affected. Regarding diagnosis of chronic renal disease, the causal disease is always already known. To differentiate chronic renal failure and acute renal failure (ARF), which is treatable, an abdominal ultrasound is always conducted to measure the size of the kidney since kidneys affected by CRD are comparatively smaller than normal kidneys. The measurement of the level of serum creatinine over months or years is the other method of diagnosing and differentiating chronic renal disease from the ARF. CRD occurs in four stages. In the first stage, the kidney has slightly diminished function marked by abnormalities in blood or urine. In the second stage, there is a mild reduction in Glomerular Filtrate Rate (GFR: 60–89 mL/min/1.73 m2) accompanied by kidney damage. The third stage is marked by a GFR of 30–59 mL/min/1.73 m2 while the fourth stage has a severe reduction in GFR (15–29 mL/min/1.73 m2) (National Kidney Foundation, 2002). By the fifth stage, it is already established that one has a kidney failure. Chronic renal disease is managed by controlling the risk factors, therapies to slow or halt the progression of the disease to later stages, controlling blood pressure, and treating the causative/original disease (National Kidney Foundation, 2002).
Johnson, D. (2011). Chapter 4: CKD screening and management: Overview. In Daugirdas, John (Ed.), Handbook of chronic kidney disease management (pp. 32-43). Lippincott Williams and Wilkins.
National Kidney Foundation (2002). K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, Classification and Stratification. Retrieved from http://www.kidney.org/professionals/kdoqi/guidelines_ckd/toc.htm
Tonelli, M., Wiebe, N., & Culleton, B. (2006). Chronic kidney disease and mortality risk: A systematic review. Journal of American Society of Nephrology, 17(7), 2034.