Managing CKD: Fluid Bal, Hyperkalemia & More

Chronic Kidney Disease (CKD) is a global health issue with more cases of rising prevalence. The results of CKD include complications in the functioning of the kidney and cardiovascular disease. Sadly, CKD has, in many cases gone undetected at initial stages and undertreated because stealthy onset to manifest kidney failure. From findings of research by Ahmed, and Leila (2014) ways of managing CKD include; Fluid Balance is also known as maintenance of euvolemia, Hyperkalemia which includes potassium retaining medication or diet restrictions of high potassium intake and Acidemia.

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The National Kidney Foundation (NFK) delineates CKD as damage to the kidney or reduced regular kidney activity for more than three months. Reduced kidney function is characterized by glomerular filtration rate (GFR) of less than 60 mL per minute per 1.73 m2 body surface area (Garlo et al.,2015). The primary indicator of CKD is the existence of continuous protein in the while passing urine. Also, another sign of a kidney disease abnormal sediments of urine and blood-urine biochemistry. The best measure to find the overall functioning of a kidney is the Glomerular Filtration Rate (GFR). The outcome of the CKD categorizes the disease into five distinct stages based on the results of GFR and the existence of a damaged kidney. The first and second stage presents a normal rise in GFR thus are not connected with any symptoms that increase from the reduction in GFR. Stage three represents moderate GFR, and phase four represents severe GFR. When the disease progresses to stage three and four laboratory complications become more advanced. In stage three and four, all organs are virtually affected, and evident signs include anemia and abnormal calcium.

The objectives of the research study include;

Outline the options of treatment for patients suffering from CKD to reduce the progression of renal worsening and potential reduction of morbidity and mortality.

Identify shared comorbid condition like cardiovascular disease and diabetes, highlighting that essentiality of aggressive management of these conditions.

To evaluate the pathogenesis of Chronic Kidney Disease

To assess the link between chronic anemia and readmission and length of stay (LOS) among individuals suffering chronic kidney disease stage 3-5

Treatment and Prevention of Common Complications of Chronic Kidney Disease Research by Ahmed, Khan and Laila, (2014)' and 'Severity of anemia predicts hospital length of stay but not readmission in patients with chronic kidney disease: a retrospective cohort study by Garlo et al. (2015)' are among the research literature that provides data supporting the management and prevention of patients with CKD.

Summary of a Study by Garlo et al. (2015)

Chronic Kidney Disease affects the outcomes and length of stay of patients diagnosed with anemia. This is because anemia increases the risk of dialysis. The study by Garlo et al. (2015) was done on patients with severe anemia that results in CKD and the chances of their readmission. Studies suggest that anemia rises the risk of readmission of the patient with stage three CKD. According to Garlo et al. (2015), anemia is highly prevalent among people with CKD with almost half a percentage of those diagnosed not on dialysis. The findings of this study were collected from men diagnosed with moderate CKD stages. A retrospective cohort study was done at Maine Medical Centre, which is a care hospital with 606 beds. Additionally, the results of the survey of readmission of patients with higher hemoglobin the outpatient management of these conditions could be an influence on low outcomes of hospital readmission. However, the findings of this research were unexpected since the readmission of CKD patients was not much influenced by anemia. Reasons being that Care Transition Intervention (CTI) employs a registered health care provider who takes care of the patients as they changeover to ambulatory environments following their stay in hospital. The study also revealed that severe cases of anemia increased the (LOS) in hospitals in patients in stage 5 CKD. This research increases clinical sensitization for patients suffering from moderate CKD and chronic anemia as a greater risked demographics for which focused approaches and improved assets may progress hospital results.

Summary of Treatment and prevention of common complications of chronic kidney disease by Ahmed, Khan., & Laila, (2014).

This article explores the treatment and prevention of common complications of chronic kidney disease. According to this article, chances of CKD being unrecognized or misdiagnosed at the initial stages are high. The report also denotes that it is essential that the cause of CKD be known to allow for the administration of specific therapy. Some of the causes of CKD, according to the author may include glomerulonephritis, diabetes mellitus (DM), and urinary tract infection, among others. The article also denotes that CKD can be managed through fluid balance, Hyperkalemia, and academia. Some of the disorders include related to CKD include CKD Mineral Bone Disorder. To control the disease in its late stages, the focus should be much placed on patients with cardiovascular risk factors. These patients should be encouraged to exercise, maintain a healthy weight, and to avoid smoking completely. For the preventive progression of the CKD, treatment should be done on underlying diseases such as diabetes. According to the article, management of diabetes should be done more seriously at initial stages of CKD. Some of the conditions that may indicate acute dialysis include severe uremia that results in the progression of the disease. This study is an essential acquisition of knowledge on management, treatment, and prevention of common problems that may occur due to delayed detection and wrong dialysis procedures.

Plan

The institutional standards include early diagnosis and institutions of secondary preventive measure helps to reduce the progression of CKD. Institution standards presented in this research include the employment of nurses to help offer outpatient services. Some of the care areas that are important in the management and prevention of CKD include keeping fit, control of blood pressure, low intake of sugar, and maintain required weight and fluid intake. From the studies and need for care, a survey study is done in Maine Medical Centre. The survey is a quantitative study to answer the following objective questions. (1) To evaluate the pathogenesis of Chronic Kidney Disease (2)To assess the link between chronic anemia and readmission and length of stay (LOS) among individuals suffering chronic kidney disease stage 3-5. The reimbursement of nurses providing outpatient services leads to an increase in job satisfaction. This is because job performance is directly connected with good pay and in-turn results in job retention. ANA official positioning statements states that; "ANA establishes positions applicable to nursing training, health policy, and social concerns impacting the health of patients and families" (ANA). The educational requirements of becoming a nurse include achievement of diploma courses offered at hospitals and subordinate degree offered in college or universities which may take two to three years. Regarding certification, graduates of nursing are required to excel in national licensing examination known as the National Council Licensure Examination (NCLEX-RN) to attain a nursing license. However, other requirements for licensing are different in various states. IOM may inspect and yield recommendations that related to the different nursing issues, to identify the essential duties of nurses in designing more effective and efficient health care. ANA and GNA standards of requirements may include preparations of APRNs at the graduate level, and clinicians are only regarded competent on promotion and passage of national certification. CDC and WHO plays a significant role in protecting public health and safety by control and prevention of disease in the United States and internationally.

Conclusion and Reflection of Overall Experience of the Survey.

I regard my survey on the Management and Prevention of Chronic Kidney Disease as a straightforward approach to information mining on health. The examination was made more accessible through the checklist I made for increased efficiency. The larger group of patients used in the study was necessary for the collection of a small amount of useful information to help make inferences about the wider population. In sum, I have learned that Chronic Kidney Disease (CKD) is a global health issue with more cases of rising prevalence. I have also discovered that the National Kidney Foundation (NFK) delineates CKD as damage to the kidney or reduced regular kidney activity for more than three months. Reduced kidney function is characterized by glomerular filtration rate (GFR) of less than 60 mL per minute per 1.73 m2 body surface area. I have additionally learned that Some of the causes of CKD, according to the author may include glomerulonephritis, diabetes mellitus (DM), and urinary tract infection, among others. The article also denotes that CKD can be managed through fluid balance, Hyperkalemia, and academia. Some of the disorders include related to CKD include CKD Mineral Bone Disorder. And finally, I have gained knowledge for future use on the standards and requirements of practicing nursing.

References

Ahmed, S. S., Khan, M. A. H., & Laila, T. R. (2014). Treatment and prevention of common complications of chronic kidney disease. Journal of Enam Medical College, 4(1), 45-55. Retrieved from: https://www.researchgate.net/publication/274734471_Treatment_and_Prevention_of_Common_Complications_of_Chronic_Kidney_Disease

Garlo, K., Williams, D., Lucas, L., Wong, R., Botler, J., Abramson, S., & Parker, M. G. (2015). Severity of Anemia predicts hospital length of stay but not readmission in patients with chronic kidney disease: a retrospective cohort study. Medicine, 94(25). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504650/