Download - CASE ANALYSIS FIN
-
8/7/2019 CASE ANALYSIS FIN
1/64
PREPARED BY:
DIANNE MAE E. MACARAIG
BSN 4D SHC
CASE ANALYSIS
CHRONIC KIDNEY
DISEASE
-
8/7/2019 CASE ANALYSIS FIN
2/64
Patient Data Profile
y Demographic DataName: Mr. X
Age: 58 y/o
Sex: Male
Civil Status: Married
Religion: Roman Catholic
y Admission Data
Date of Admission: January 7, 2011
Attending Physician: Dra. Tayao
Chief complaint: difficulty of breathingDiagnosis: Chronic Kidney Disease
-
8/7/2019 CASE ANALYSIS FIN
3/64
Chronic kidney
disease
DISEASE ENTITY
-
8/7/2019 CASE ANALYSIS FIN
4/64
y Chronic kidney disease (CKD), also known as chronic
renal disease, is a progressive loss of renal function over
a period of months or years. The symptoms of
worsening kidney function are unspecific, and might
include feeling generally unwell and experiencing a
reduced appetite.
y occurs when one suffers from gradual and usually
permanent loss of kidney function over time. This
happens gradually, usually months to years. Chronic
kidney disease is divided into five stages of increasing
severity
y The term "renal" refers to the kidney, so another name
for kidney failure is "renal failure.
y Mild kidney disease is often called renal insufficiency.
-
8/7/2019 CASE ANALYSIS FIN
5/64
yWith loss of kidney function, there is anaccumulation of water; waste; and toxic substances,
in the body, that are normally excreted by the
kidney.
Loss of kidney function also causes other problemssuch as
y anemia,
y
high blood pressure,y acidosis (excessive acidity of body fluids),
y disorders of cholesterol and fatty acids, and
y bone disease.
-
8/7/2019 CASE ANALYSIS FIN
6/64
y Stage 5 chronic kidney disease is also referred to as
kidney failure, end-stage kidney disease, or end-
stage renal disease, wherein there is total or near-total loss of kidney function. There is dangerous
accumulation of water, waste, and toxic
substances, and most individuals in this stage of
kidney disease need dialysis or transplantation tostay alive.
-
8/7/2019 CASE ANALYSIS FIN
7/64
y Unlike chronic kidney disease, acute kidney failure
develops rapidly, over days or weeks.
y Acute kidney failure usually develops in response to a
disorder that directly affects the kidney, its blood
supply, or urine flow from it.
y
Acute kidney failure is often reversible, with completerecovery of kidney function.
y Some patients are left with residual damage and can
have a progressive decline in kidney function in the
future.y Others may develop irreversible kidney failure after
an acute injury and remain dialysis-dependent.
-
8/7/2019 CASE ANALYSIS FIN
8/64
Stage DescriptionGFR*
mL/min/1.73m2
1Slight kidney damage with normal
or increased filtrationMore than 90
2 Mild decrease in kidney function 60-89
3Moderate decrease in kidney
function30-59
4Severe decrease in kidney
function15-29
5 Kidney failure Less than 15 (or dialysis)
-
8/7/2019 CASE ANALYSIS FIN
9/64
Causes
1. Type 1 and type 2 diabetes mellitus cause a condition calleddiabetic nephropathy, which is the leading cause of kidney
disease in the United States.
2. High blood pressure (hypertension), if not controlled, can
damage the kidneys over time.3. Glomerulonephritis is the inflammation and damage of the
filtration system of the kidneys, which can cause kidney
failure. Postinfectious conditions and lupus are among the
many causes of glomerulonephritis.4. Polycystic kidney disease is an example of a hereditary
cause of chronic kidney disease wherein both kidneys have
multiple cysts.
-
8/7/2019 CASE ANALYSIS FIN
10/64
5. Use of analgesics such as acetaminophen (Tylenol) andibuprofen (Motrin, Advil) regularly over long durations of
time can cause analgesic nephropathy, another cause ofkidney disease. Certain other medications can also damagethe kidneys.
6. Clogging and hardening of the arteries (atherosclerosis)leading to the kidneys causes a condition called ischemic
nephropathy, which is another cause of progressive kidneydamage.
7. Obstruction of the flow of urine by stones, an enlargedprostate, strictures (narrowings), or cancers may alsocause kidney disease.
8. Other causes of chronic kidney disease include HIVinfection, sickle cell disease, heroin abuse, amyloidosis,kidney stones, chronic kidney infections, and certaincancers.
-
8/7/2019 CASE ANALYSIS FIN
11/64
Symptomsy Effects and symptoms of chronic kidney disease include;
1. need to urinate frequently, especially at night (nocturia);
2. swelling of the legs and puffiness around the eyes (fluidretention);
3. high blood pressure;
4. fatigue and weakness (from anemia or accumulation of wasteproducts in the body);
5. loss of appetite, nausea and vomiting;6. itching, easy bruising, and pale skin (from anemia);
7. shortness of breath from fluid accumulation in the lungs;
-
8/7/2019 CASE ANALYSIS FIN
12/64
8. headache, numbness in the feet or hands (peripheral
neuropathy), disturbed sleep, altered mental status(encephalopathy from the accumulation of waste
products or uremic poisons),
9. Chest pain due to pericarditis (inflammation around the
heart);
10. bleeding (due to poor blood clotting);
11. bone pain and fractures; and
12. decreased sexual interest and erectile dysfunction.
-
8/7/2019 CASE ANALYSIS FIN
13/64
Anatomy and
Physiology
-
8/7/2019 CASE ANALYSIS FIN
14/64
URINARY SYSTEM
-
8/7/2019 CASE ANALYSIS FIN
15/64
Normal Kidneys and Their Function
y The kidneys are a pair of bean-shaped organs that lie on
either side of the spine in the lower middle of the back.Each kidney weighs about pound and containsapproximately one million filtering units called nephrons.
y Each nephron is made of a glomerulus and a tubule.
y The glomerulus is a miniature filtering or sieving devicewhile the tubule is a tiny tube like structure attached tothe glomerulus.
y The kidneys are connected to the urinary bladder bytubes called ureters.
y Urine is stored in the urinary bladder until the bladder isemptied by urinating. The bladder is connected to theoutside of the body by another tube like structure calledthe urethra.
-
8/7/2019 CASE ANALYSIS FIN
16/64
The main function of the kidneys
1. is to remove waste products and excess water from the blood.The kidneys process about 200 liters of blood every day and
produce about two liters of urine.
2. The waste products are generated from normal metabolic
processes including the breakdown of active tissues, ingestedfoods, and other substances.
3. The kidneys allow consumption of a variety of foods, drugs,
vitamins and supplements, additives, and excess fluids
without worry that toxic by-products will build up to
harmful levels.
4. The kidney also plays a major role in regulating levels of
various minerals such as calcium, sodium, and potassium in
the blood.
-
8/7/2019 CASE ANALYSIS FIN
17/64
y As the first step in filtration, blood is delivered into the
glomeruli by microscopic leaky blood vessels called
capillaries. Here, blood is filtered of waste products and
fluid while red blood cells, proteins, and large molecules
are retained in the capillaries. In addition to wastes,
some useful substances are also filtered out. The filtrate
collects in a sac called Bowman's capsule.
y The tubules are the next step in the filtration process.
The tubules are lined with highly functional cells which
process the filtrate, reabsorbing water and chemicals
useful to the body while secreting some additional wasteproducts into the tubule.
-
8/7/2019 CASE ANALYSIS FIN
18/64
-
8/7/2019 CASE ANALYSIS FIN
19/64
PATHOPHYSIOLOGY
-
8/7/2019 CASE ANALYSIS FIN
20/64
-
8/7/2019 CASE ANALYSIS FIN
21/64
-
8/7/2019 CASE ANALYSIS FIN
22/64
-
8/7/2019 CASE ANALYSIS FIN
23/64
-
8/7/2019 CASE ANALYSIS FIN
24/64
LABORATORY RESULT
January 7, 2011
-
8/7/2019 CASE ANALYSIS FIN
25/64
CHEST X-RAY
y FIBROTICDENSITIES ARE NOTED, INTHERIGHTUPPER LOBE
y HEARTIS NOTENLARGED
y AORTA ISTORTUOUS AND CALCIFIED
y ELEVATED RIGHTHENIDIAPHRAGM
y RIGHTHEMIDIAPHRAGMAND SULCUS ARE PRESERVESINTACTBONYTHORAX.
y IMPRESSION:
y FIBROTICPTB, RIGHT.y ATHEROMATOUS AORTA
y ELEVATED RIGHTHEMIDIAPHRAGM, ETIOLOGY?
-
8/7/2019 CASE ANALYSIS FIN
26/64
COMPLETE BLOOD COUNT
TES
T RESUL
TN
ORMAL VALUES
IN
TE
RP
RE
TA
TION
CREATININE 70.7 62 - 124 umol/L Within normal range
SODIUM 135.4 134 148 mmol/L Within normal range
POTASSIUM 3.33 3.5- 5.3 mmol/L (hypokalemia)
commonly result from
aldosteronism or cushing
syndrome, loss of body
fluids( as with long-termdiuretic therapy)
-
8/7/2019 CASE ANALYSIS FIN
27/64
January 8, 2011
-
8/7/2019 CASE ANALYSIS FIN
28/64
BLOOD CHEMISTRY
TEST RESULT NORMAL VALUES INTERPRETATION
HEMOGLOBIN 9.5 14.0 18 gm/dL indicates anemia, recent hemorrhage or fluid
retention, causing hemodilution
HEMATOCRIT 28 40 50 gm/dL indicates anemia, hemodilution or massive
blood loss
WBC 10,200 5,000- 10, 000/cumm
(leukocytosis) signals infection such asabscess, meningitis etc. it may also results from
leukemia and tissue necrosis from burns, MI or
gangrene
NEUTROPHILS 81 40- 60 indicates bacterial infection
LYMPHOCYTES 19 35 - 40 indicates defective lymphatic circulation;
decresed by severe debilitating illness like renal
failure and advanced TB
-
8/7/2019 CASE ANALYSIS FIN
29/64
DRU
G STU
DY
-
8/7/2019 CASE ANALYSIS FIN
30/64
Generic name/
dosage/BRAND
NAME
Mechanism of action Specific Indication Adverse
Reaction
Nursing responsibilities
/Route of administration
Paracetamol
500 mg 1 tab q4
PRN
Analgesic / antipyretic
- Decrease fever by
inhibiting the effect of
pyrogens on the
hypothalamic heat
regulating centers
- Control pain due to
headache
- To reduce fever in
bacterial or viral
infection
Urticaria
Rash
Jaundice
Drowsiness
Hemolytic
anemia
1. Monitor vital signs(
temp)
2. Take as directed with
food or milk to decrease
GIupset
3. Document presence of
pain/fever
4. Check urine for occult
blood.Kalium durule 1
tab TID
(Potassium
chloride)
Electrolyte and minerals
Potassium chloride is a
major cation of the
intracellular fluid. It plays an
active role in the conduction
of nerve impulses in theheart, brain and skeletal
musclecontraction of cardiac
skeletal and smooth muscle;
maintenance of normal renal
function, acid base balance,
carbohydrate metabolism,
gastric secretion
- For hypokalemia
- As prophylaxis
during treatment
with diuretics
Hyperkalemia
Rash
Vomiting
GIdiscomfort
ECGchanges
1. Administer oral drugs
after meals or with food
to decrease GIupset
2. Monitor serum
potassium level and ECG
-
8/7/2019 CASE ANALYSIS FIN
31/64
Generic name/
dosage/BRAND
NAME
Mechanism of action Specific Indication Adverse Reaction Nursing responsibilities /Route of
administration
Furosemide 60
mg IV q6 with BP
precaution
Loop diuretic
- Inhibits reabsorption
of sodium andchloride from the
proximal and distal
tubules as well as the
ascending loop of
henle. This results in
the excretion of
sodium, chloride andto a lesser degree,
potassium and
bicarbonate loss
- Treatment for
edema, as with
heart failure,hypertension
y Orthostatic
hypotension
y Urinarybladder
spasms
y Headache
y fatigue
1. Test if the patient is allergic to the
drug.
2. To prevent nocturia, give POandIMpreparations in the morning. Give
second dose in early afternoon.
3. Monitor weight, blood pressure, and
pulse rate routinely with long term
use and during rapid dieresis. Use
can lead to profound water and
electrolyte depletion.4. Monitor fluid intake and output and
electrolyte, BUN, and carbon
dioxide levels.
5. Watch for signs of hypokalemia,
such as muscle weakness and
cramps.
Ketosteril 60 mg
1 tab 2 tabs TID
ketoanalogues & essential
amino acids
- Normalizes metabolic
process, promotes
cycling product
exchange. Reduces
ion concentration of
potassim, magnesium
and phosphate.
- Prevention &
therapy of
damages due to
faulty/deficient
protein
metabolism in
chronicrenal
insufficiency.
y Hypercalce
mia..
1. Monitor regularly the serum calcium
level.
2. Ensure the sufficient supply with
calories
-
8/7/2019 CASE ANALYSIS FIN
32/64
NURSING CARE
PLAN
-
8/7/2019 CASE ANALYSIS FIN
33/64
SUBJECTIVE
y Namamanas ako at ang hina ng katawan ko (I have edema and
I feel very weak) as verbalized by the patient
OBJECTIVE:
y Venous distension
y weight gainy Adventitious breath sound like wheezing
y Patient reports of Fatigue, weakness, and malaise
y Decreased hgb and hct
y V/S taken as follows
T: 35CP: 50
R: 13
BP: 130/90
y Abdominal circumference= 37 inches
y Weight= 50 kls.
1. Fluid Volume excess r/t Compromised
regulatory mechanism (renal failure)
-
8/7/2019 CASE ANALYSIS FIN
34/64
PLANNING and EVALUATION
After 8 hours of Nursing intervention, the patient
will
display Appropriate urinary output with specificgravity/laboratory studies near normal;
stable weight, vital signs within patients
normal range; and
absence of edema
-
8/7/2019 CASE ANALYSIS FIN
35/64
INTERVENTION and RATIONALE
1.Record accurate intake and output (I&O).
y Accurate I&O is necessary fordetermining renal function and fluid
replacement needs and reducing risk of fluid overload
2.Weigh daily at same time ofday, on same scale, with same
equipment and Clothing/ measure Abdominal girth
y Daily body weight is best monitor of fluid Status
3.Assess skin, face, dependent areas for Edema
y Edema occurs primarily in dependent tissues of the body, e.g., hands,
feet, lumbosacral area. Patient can gain up to 10 lb (4.5 kg) of fluid
before pitting edema is detected
4. Plan oral fluid replacement with patient, within multiple
restrictions
y Helps avoid periods without fluids, minimizes boredom of limited
choices, and reduces sense ofdeprivation and thirst
-
8/7/2019 CASE ANALYSIS FIN
36/64
5.Administer/restrict fluids as indicated.
y Fluid management is usually calculated to replace
output from all sources plus estimated insensible losses6. Administer medication as IndicatedDiuretics, e.g.,
furosemide (Lasix), mannitol (Osmitrol)
yGiven early in oliguric phase of Renal Failure in an
effort to convert to nonoliguric phase, flush the tubularlumen ofdebris, reduce hyperkalemia, and promote
adequate urine volume.
7..Antihypertensives, e.g., clonidine (Catapres)
yMay be given to treat hypertension by counteracting
effects ofdecreased renal blood flow and/or circulating
volume overload
-
8/7/2019 CASE ANALYSIS FIN
37/64
2. Imbalanced nutrition less than body requirement
related to inability to ingest food; inability to absorb
nutrients
SUBJECTIVE:
Ang sakit ng tiyan ko as verbalized by the patient
OBJECTIVE:
y Weakness of muscle required for swallowing
y
Poorly nourished body appearancey Incomplete set of teeth
y Abnormal laboratory studies ( electrolyte imbalance
y Potassium is decrease (3.33 mmol/L)
-
8/7/2019 CASE ANALYSIS FIN
38/64
PLANNING and EVALUATION
After 3 days of Nursing intervention, the patient will be
able to:
y Demonstrate progressive weight gain toward goal
y Display normalization of the laboratory valuesy Verbalize understanding of causative factors when known
and necessary interventions
y
Demonstrate behaviors, lifestyle changes to regainand/or maintain appropriate weight
-
8/7/2019 CASE ANALYSIS FIN
39/64
INTERVENTION and RATIONALE
1. Determine clients ability to chew, swallow and tastefood. Evaluate teeth and gums for poor oral health
yAll factors that can affect ingestion and/or digestion of
nutrients
2.Ascertain understanding of individual nutritional needs
yTo determine informational needs of the client
3.Assess drug interactions, disease effects, allergies, use of
laxatives, diureticsyThis may be affect the appetite, food intake or
absorption
-
8/7/2019 CASE ANALYSIS FIN
40/64
4.Assess weight; measure the body fat and muscle mass via
triceps skin fold and mid arm muscle circumference orother anthropometric measurements
yTo establish baseline parameters
5. Promote adequate and timely fluid intake. Limit fluids 1
hour prior to meal
yTo monitor effectiveness of efforts
6.Weigh at regular intervals and document results
yTo monitor effectiveness of dietary plan
-
8/7/2019 CASE ANALYSIS FIN
41/64
3. Deficient knowledge r/t unfamiliarity
with information resources
SUBJECTIVE:
y Hindi ko maintindihan kung bakit ganito ang nararamdaman
ko at kung bakit ang lake ng tiyan ko as verbalized by thepatient
OBJECTIVE:
y Inappropriate or exaggerated behaviors
-
8/7/2019 CASE ANALYSIS FIN
42/64
PLANNING and EVALUATION
After 8 hours of Nursing intervention, the patient will be able to:
y Identify interferences to learning and specific actions to deal with
them
y Verbalize understanding of condition, disease process andtreatment
y Identify relationship of signs and symptoms to the disease process
y Initiate necessary lifestyle changes and participate in treatment
regimen.
-
8/7/2019 CASE ANALYSIS FIN
43/64
INTERVENTION and RATIONALE
1. Determine clients ability, readiness and barriers to learning
y Individual may not be physically, emotionally or mentally
capable at this time
2. Be alert to signs of avoidancey Client may need to suffer consequences of lack of knowledge
before he is ready to accept information
3. Provide positive reinforcement
y It can encourage continuation of efforts4. Discuss clients perception of need. Relate information to
clients personal desires, needs, values and beliefs
y So that client feels competent and respected
-
8/7/2019 CASE ANALYSIS FIN
44/64
5. Begin with information the client already knows and move to
what the clients does not know, progressing form simple to
complexy It Can arouse interest/ limit sense of being overwhelmed
6. Deal with clients anxiety or other strong emotions
y Anxiety will interfere clients ability to learn
7. Provide active role for client in learning process
y To promote sense of control over situation and means for
determining the client is assimilating and using new
information.
8. Provide access information for contact person
y To answer questions and validate information post discharge
-
8/7/2019 CASE ANALYSIS FIN
45/64
DISCHARGE PLAN
-
8/7/2019 CASE ANALYSIS FIN
46/64
M The patient may still continue taking medications if some
untoward s/sx occurs like diarrhea, fever, and vomiting. Yet, itmust be in accordance to the order of the physician.
Medications should not be taken without any precautions and
advice from the doctor.
y Instruct the patient and SO, the importance of compliance to
medicines to achieve appropriate therapeutic effects.
y Home Medications:
Ketosteril 600 mg tab 2 tabs 3 x 1 dayFurosemide 60 mg tab 1 tab 2 x/ day x 7 days
-
8/7/2019 CASE ANALYSIS FIN
47/64
E The environment must be free from possible injury. The
floor should not be slippery. If possible trees and flowers
around can also be present to provide good and fresh air from
the patient.
y Encourage SO to provide peaceful environment conducive for
fast recovery and healthy living.y Advise SO to reduce environment destruction as much as
possible so that the client could have an undisturbed sleep.
T Encourage the SO to compliance on further treatment for
the proper maintenance and gain of optimal health.
y If for rehabilitation, it should be attended
-
8/7/2019 CASE ANALYSIS FIN
48/64
H Regular check-up in health centers helps maintain
patients health.y Limit fluid intake to 1 L/day
y Adequate rest and sleep
y Keep back dry at all times
y Importance of adherence to treatment and medical
management
y Importance of rising slowly to sitting or standing position to
minimize orthostatic hypotension
-
8/7/2019 CASE ANALYSIS FIN
49/64
O Inform SO regarding future check-ups and treatment and
the importance of compliance to the scheduled procedures to
maintain and monitor the clients health.y Any patient check-up must be attended to know if the
condition is improving.
D Balanced diet
y Increase protein (fish, egg, meat)
y Decrease fats
y Avoid salty and fatty foods such as pork, beefy Fruits such as banana and apple
-
8/7/2019 CASE ANALYSIS FIN
50/64
Diagnostic testU
rine Testsy Urinalysis
y Twenty-four hour urine tests
y Glomerular filtration rate (GFR)
Blood Tests
y Creatinine and urea (BUN) in the blood
y E
stimated GFR (eGFR)y Electrolyte levels and acid-base balance
y Blood cell counts
-
8/7/2019 CASE ANALYSIS FIN
51/64
Other tests
y Biopsy
y Ultrasound
-
8/7/2019 CASE ANALYSIS FIN
52/64
When to Seek Medical Care
Several signs and symptoms may suggest complications ofchronic kidney disease. Call your health care practitionerif you notice any of the following symptoms:
y Change in energy level or strength
y Increased water retention (puffiness or swelling) in thelegs, around the eyes, or in other parts of the body
y Shortness of breath or change from normal breathing
y Nausea or vomiting
y Lightheadedness
y Severe bone or joint pain
y Easy bruising
y Itching
-
8/7/2019 CASE ANALYSIS FIN
53/64
The following signs and symptoms represent the
possibility of a severe complication of chronic kidney
disease and warrant a visit to the nearest hospital
emergency department.
y Change in level of
consciousness - extreme
sleepiness or difficult toawaken
y fainting
y Chest pain
y Difficulty breathingy Severe nausea and vomiting
y Severe bleeding (from any
source)
y Severe weakness
-
8/7/2019 CASE ANALYSIS FIN
54/64
Treatment
-
8/7/2019 CASE ANALYSIS FIN
55/64
-
8/7/2019 CASE ANALYSIS FIN
56/64
Phosphorus restriction: Decreasing phosphorus intake is
recommended to protect bones. Eggs, beans, cola drinks, and
dairy products are examples of foods high in phosphorus.
Other important measures that you can take include:
1. carefully follow prescribed regimens to control
your blood pressure and/or diabetes;
2. stop smoking; and
3. lose excess weight.
-
8/7/2019 CASE ANALYSIS FIN
57/64
y In chronic kidney disease, several medications can be toxic tothe kidneys and may need to be avoided or given in adjusteddoses. Among over-the-counter medications, the following
need to be avoided or used with caution: Certain analgesics: Aspirin; nonsteroidal antiinflammatorydrugs (NSAIDs, such as ibuprofen [Motrin, for example])
Fleets or phosphosoda enemas because of their high contentof phosphorus
Laxatives and antacids containing magnesium and aluminumsuch as magnesium hydroxide (Milk of Magnesia) andfamotidine (Mylanta)
Ulcer medication H2-receptor antagonists: cimetidine(Tagamet), ranitidine (Zantac), (decreased dosage withkidney disease)
Decongestants such as pseudoephedrine (Sudafed) especiallyif you have high blood pressure
Alka Seltzer, since this contains large amounts of salt
Herbal medications
-
8/7/2019 CASE ANALYSIS FIN
58/64
Medical Treatment
y
There is no cure for chronic kidney disease.The four goals of therapy are to:
1. slow the progression of disease;
2. treat underlying causes and contributing factors;
3. treat complications of disease; and
4. replace lost kidney function.
-
8/7/2019 CASE ANALYSIS FIN
59/64
Strategies for slowing progression and treatingconditions underlying chronic kidney disease include
the following:
y Diet
y Control of high blood pressure
y Control of blood glucose
-
8/7/2019 CASE ANALYSIS FIN
60/64
The complications of chronic kidney disease
may require medical treatment.
y Fluid retention can be treated with any of a number of diureticmedications, which remove excess water from the body. However,these drugs are not suitable for all patients.
y
Anemia can be treated with erythropoiesis stimulating agents suchas erythropoietin or darbepoetin (Aranesp, Aranesp Albumin Free,Aranesp SureClick).
y Bone disease develops in kidney disease due to an inability toexcrete phosphorus and a failure to form activated Vitamin D.
y Acidosis may develop with kidney disease. The acidosis may causebreakdown of proteins, inflammation, and bone disease. If theacidosis is significant, your doctor may use drugs such as sodium
bicarbonate (baking soda) to correct the problem.
-
8/7/2019 CASE ANALYSIS FIN
61/64
Medical and Surgical treatment
y Renal Replacement Therapies
y Dialysis
y Hemodialysis
y
Peritoneal dialysisy Kidney Transplantation
-
8/7/2019 CASE ANALYSIS FIN
62/64
Prevention
1. Kidney disease is usually advanced by the time symptoms appear. Ifyou are at high risk of developing chronic kidney disease, see your
health care practitioner as recommended for screening tests.
2. If you have a chronic condition such as diabetes, high blood
pressure, or high cholesterol, follow the treatmentrecommendations of your health care practitioner. See your
healthcare practitioner regularly for monitoring. Aggressive
treatment of these diseases is essential.
3. Avoid exposure to drugs especially NSAIDs (nonsteroidal antiinflammatory drugs), chemicals, and other toxic substances as
much as possible.
-
8/7/2019 CASE ANALYSIS FIN
63/64
Prognosis
There is no cure for chronic kidney disease. The natural course of
the disease is to progress until dialysis or transplant is required.
Patients with chronic kidney disease are at a much higher risk thanthe general population to develop strokes and heart attacks.
People undergoing dialysis have an overall five year survival rate of
32%. The elderly and those with diabetes have worse outcomes.
Recipients of a kidney transplant from a living related donor have atwo year survival rate greater than 90%.
Recipients of a kidney from a donor who has died have a two year
survival rate of88%.
-
8/7/2019 CASE ANALYSIS FIN
64/64