Chronic kidney disease (CKD) is a type of kidney disease in which there is gradual loss of kidney function over a period of months to years. Initially there are generally no symptoms; later, symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications include an increased risk of heart disease, high blood pressure, bone disease, and anemia Get breaking news and the latest headlines on business, entertainment, politics, world news, tech, sports, videos and much more from AOL Disclaimer: If you need a custom written term, thesis or research paper as well as an essay or dissertation sample, choosing Solution Essays - a relatively cheap custom writing service - is a great option. Get any needed writing assistance at a price that every average student can afford
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Chronic kidney disease CKD is a type of kidney disease in which there is gradual loss of kidney function over a period of months to years. Causes of chronic kidney disease include diabeteshigh blood pressureglomerulonephritisand polycystic kidney disease. Screening at-risk people is recommended. Chronic kidney disease affected million people globally in million females and million males, a wise mans dissertation. CKD is initially without symptoms, and is usually detected on routine screening blood work by either an increase in serum creatinineor protein in the urine.
As the kidney function decreases:. The three most common causes of CKD in order of frequency as of are diabetes mellitushypertensionand glomerulonephritis. If the cause is unknown, it is called idiopathic. Diagnosis of CKD is largely based on historyexamination and urine dipstick combined with the measurement of the serum creatinine level see above.
It is important to differentiate CKD from acute kidney injury AKI because AKI can be reversible, a wise mans dissertation. One diagnostic clue that helps differentiate CKD from AKI is a gradual rise in serum creatinine over several months or years as opposed to a sudden increase in the serum creatinine several days to weeks. In many people with CKD, previous kidney disease or other underlying diseases are already known.
A significant number present with CKD of unknown cause. Screening those who have neither symptoms nor risk factors for CKD is not recommended. Screening should include calculation of the estimated GFR eGFR from the serum creatinine level, and measurement a wise mans dissertation urine albumin-to-creatinine ratio ACR in a first-morning urine specimen this reflects the amount of a protein called albumin in the urineas well as a urine dipstick screen for hematuria.
it is a reciprocal relationship:the higher the creatinine, the lower the GFR. It reflects one aspect of kidney function: how efficiently the glomeruli - the filtering units - work. The units of creatinine vary from country to country. This can be done by combining the GFR level with the clinical assessment of the person, including fluid status, and measuring the levels of hemoglobin, potassium, phosphate and parathyroid hormone PTH. Kidney ultrasonography is useful for diagnostic and prognostic purposes in chronic kidney disease.
Whether the underlying pathologic change is glomerular sclerosis, a wise mans dissertation, tubular atrophy, interstitial fibrosis or inflammation, the result is often increased echogenicity a wise mans dissertation the cortex. The echogenicity of the kidney should be related to the echogenicity of either the liver or the spleen Figure 22 and Figure Moreover, decreased kidney size and cortical thinning are also often seen and especially when disease progresses Figure 24 and Figure However, kidney size correlates to height, and short persons tend to have small kidneys; thus, kidney size as the only parameter is not reliable.
Chronic renal disease caused by glomerulonephritis with increased echogenicity and reduced cortical thickness.
Nephrotic syndrome. Hyperechoic kidney without demarcation of cortex and medulla. Chronic pyelonephritis with reduced kidney size and focal cortical thinning. End-stage chronic kidney disease with increased echogenicity, homogenous architecture without visible differentiation between parenchyma and renal sinus and reduced kidney size.
Additional tests may include nuclear medicine MAG3 scan to confirm blood flow and establish the differential function between the two kidneys. Dimercaptosuccinic acid DMSA scans are also used in kidney imaging; a wise mans dissertation both MAG3 and DMSA being used chelated with the radioactive a wise mans dissertation technetium Protein in the urine is regarded as an independent marker for worsening of kidney function and cardiovascular disease.
Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if protein loss is significant. The term "non-dialysis-dependent chronic kidney disease" NDD-CKD is a designation used to encompass the status of those persons with an established CKD who do not yet require the life-supporting treatments for kidney failure known as kidney replacement therapy RRT, including maintenance dialysis or kidney transplantation.
The condition of individuals with CKD, who require either of the two types of kidney replacement therapy dialysis or transplantis referred to as the end-stage kidney disease ESKD.
Hence, the start of the ESKD is practically the irreversible conclusion of the NDD-CKD. Even though the NDD-CKD status refers to the status of persons with earlier stages of CKD a wise mans dissertation 1 to a wise mans dissertationpeople with advanced stage of CKD stage 5who have not yet started kidney replacement therapy, are also referred to as NDD-CKD.
Apart from controlling other risk factors, the goal of therapy is to slow down or halt the progression of CKD. Angiotensin converting enzyme inhibitors ACEIs or angiotensin II receptor antagonists ARBs are recommended as first-line agents since they have been found to slow the decline of kidney function, relative to a more rapid decline in those not on one of these agents.
Obesity may have a negative impact in A wise mans dissertation, increasing the risk of disease progression to ESKD or kidney failure compared to controls with healthy weight, [62] and when in advanced stages also may hinder people's eligibility to kidney transplantation. The review concluded that lifestyle interventions may provide some health benefits, namely improving body weight, low density lipoprotein LDL cholesterol and diastolic blood pressure DBPwhen compared to usual care or controls.
Whether these benefits extend to help reducing cardiovascular events, kidney function and risk of death is uncertain. These conclusions were based on very low quality of evidence, so future robust studies are needed. Thus, it is recommended that weight management interventions should be individualised, according to a thorough patients' assessment regarding clinical condition, motivations and preferences, a wise mans dissertation. People with CKD suffer from sleep disorders, thus not being able to get quality sleep.
Despite all the available options studied so far, evidence shows that none of them is effective in the treatment of sleep disorders. There is currently limited evidence suggesting that eHealth interventions may improve dietary sodium intake and fluid management for people with chronic kidney disease CKD.
So, more large and higher quality research studies are needed to understand the impact of eHealth on the health of people with CKD. Guidelines for referral to a nephrologist vary between countries. It may also be useful at an earlier stage e. Other benefits of early nephrology referral include proper education regarding options for kidney replacement therapy as a wise mans dissertation as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those people with chronic kidney disease opting for future hemodialysis.
At stage 5 CKD, kidney replacement therapy is usually required, in the form of either dialysis or a kidney transplant. In CKD numerous uremic toxins accumulate in the blood.
Even when ESKD largely synonymous with CKD5 is treated with dialysis, the toxin levels do not go back to normal as dialysis is not that efficient. If it does, the creatinine level is often normal. The toxins show various cytotoxic activities in the serum and have different molecular weights, and some of them are bound to other proteins, primarily to albumin. Uremic toxins are a wise mans dissertation into three groups as small water-soluble solutes, a wise mans dissertation, middle molecular-weight solutes, and protein-bound solutes.
Middle molecular weight molecules are removed more effectively with hemodialysis using a high-flux membrane, hemodiafiltration and hemofiltration. However, conventional dialysis treatment is limited a wise mans dissertation its ability to remove protein-bound uremic toxins.
CKD increases the risk of cardiovascular disease, and people with CKD often have a wise mans dissertation risk factors for heart disease, such as high blood lipids, a wise mans dissertation. The most common cause of death in people with CKD is cardiovascular disease rather than kidney failure, a wise mans dissertation. Chronic kidney disease results in worse all-cause mortality the overall death rate which increases as kidney function decreases. While kidney replacement therapies can maintain people indefinitely and prolong life, the quality of life is negatively affected.
Transplantation aside, high-intensity home hemodialysis appears to be associated with improved survival and a greater quality of life, when compared to the conventional three-times-a-week hemodialysis and peritoneal dialysis. People with ESKD are at increased overall risk for cancer. About one in ten people have chronic kidney disease. In Canada 1. adults aged 20 years and older in the period from to Chronic kidney disease was the cause ofdeaths globally inup froma wise mans dissertation, deaths in The cause of chronic kidney disease is in some cases not known; it is referred to as chronic kidney disease of unknown aetiology CKDu.
As of [update] a rapidly progressive chronic kidney disease, unexplained by diabetes and hypertension, had increased dramatically in prevalence over a few decades in several regions in Central America and Mexico, a CKDu referred to as the Mesoamerican nephropathy MeN. It was estimated in that at least 20, men had died prematurely, some in their 20s and 30s; a figure of 40, per year was estimated in In some affected areas CKD mortality was five times the national rate.
MeN primarily affects men working as sugarcane labourers. Although CKDu was first documented among sugar cane workers in Costa Rica in the s, it may well have affected plantation labourers since the introduction of sugar cane farming to the Caribbean in the s.
In colonial times the death records of slaves on sugar plantations was much higher than for slaves forced into other labour. AfricanHispanicsand South Asiansparticularly those from PakistanSri LankaBangladeshand Indiaare at high risk of developing CKD.
Africans are at greater risk due to the number of people affected with hypertension among them. Administration of antihypertensive drugs generally halts disease progression in white populations but has little effect in a wise mans dissertation kidney disease among black people, and additional treatment such as bicarbonate therapy is often required. The International Society of Nephrology is an international body representing specialists in kidney diseases.
It was said to be costing the National Health Service about £1. Kidney Care UK and The UK National Kidney Federation represent people with chronic kidney disease.
The Renal Association represents Kidney physicians and works closely with the National Service Framework for kidney disease. The incidence rate of CKD in dogs was The mortality rate of CKD was 9.
rates developed from a population ofinsured Swedish dogs; one dog year at risk is one dog at risk for one year The breeds with the highest rates were the Bernese mountain dog, miniature schnauzer and boxer. The Swedish elkhound, Siberian husky and Finnish spitz were the breeds with the lowest rates. Currently, several compounds are in development for the treatment of CKD.
These include the angiotensin receptor blocker ARB olmesartan medoxomil ; and sulodexidea mixture of low molecular weight heparin and dermatan sulfate. Unbiased research with complete reporting is required to determine the safety and effectiveness of acupuncture to treat depressionpain, sleep problemsand uraemic pruritus in people who are undergoing dialysis treatments on a regular basis.
From Wikipedia, the free encyclopedia. Progressive loss in kidney function over a period of months or years. Medical condition, a wise mans dissertation. doi : PMID National Institute of Diabetes and Digestive and Kidney Diseases. June Retrieved 19 December PMC
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