Discussion about the Chronic Kidney Disease (Term Paper Sample)

CHRONIC KIDNEY DISEASE
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Introduction
Chronic kidney disease is a slow and a long-term disease that affects the kidney. The disease may have observable symptoms but sometimes there will be no symptoms at early stages. Progression of the disease can lead to kidney failure which may cause death to individuals. To support life incase of the kidney failure dialysis or transplant of the kidney can be performed to patients. The paper talks of the chronic kidney disease clinical presentations, diagnosis, treatment and patient factors in diagnosis.
Clinical presentation
The chronic kidney disease first stage to the third stage are mostly asymptomatic. The chronic kidney disease in the fourth to fifth stages clinically manifests which is so disturbing stage of the disease. In the fifth stage, Metabolic acidosis may manifest too since there is protein energy malnutritions, and body mass loss including weakness of muscles which hence destroys kidney’s handling salt and water in chronic kidney disease which can hence cause peripheral edema.
Chronic kidney disease develops like primary disease due to the renal synthesis of erythropoietin decrease which leads to Anemia; it manifests like fatigue (Adams, de Jonge, van der Cammen, Zietse & Hoorn, 2011). Cardiovascular disease which is the new onset of heart failureis also associated in Anemia. At end stages of uremia, other manifestations are more likely to be seen. These may include, skin manifestations whereby the dry skin, pruritus, and ecchymosis may be noticed. Also, platelets dysfunction with a tendency to bleed, malnutrition, peripheral neuropathy, and many others.
Diagnosis
Chronic kidney disease is asymptomatic and it’s usually unrecognised disease since there are no specific symptoms also it’s a disease that is not often diagnosed or can be diagnosed when it has advanced. In the clinical presentation, some common symptoms can be seen in the diagnosis of the disease. The common symptoms are; in severe chronic kidney disease, some specific symptoms usually develops which include nausea, anorexia, vomiting, and weakness, Fatigue, pruritus, lethargy, peripheric oedema, dyspnea, polyuria, and headache (Assadi, 2010). Sexual dysfunction is also a common symptom of the chronic kidney disease. At a severe stage in patients with the disease also experience hiccups, pericarditis, seizures and also can experience a coma. Chronic kidney disease can be discovered by the chances following routine blood and also urine test.
Physical examination may reveal the characteristics of underlying causes of arteriosclerosis and hypertension or even complications of chronic kidney disease like bleeding, anaemia, and pericarditis (Thomas, Kanso & Sedor, 2008). Increase in skin pigmentation and excoriation, pallor are common signs of chronic kidney disease. Other signs are peripheral neuropathy, restless legs syndrome and peripheral vascular disease.
The blood test is the Estimated glomerular filtration rate, whereby a normal test should be about 90ml per minute. The kidney is said to have reduced its function or impaired its function when some of the glomeruli doesn't filter as much as it should normally filter.
Glomerular filtration rate includes the test of blood which helps in measuring creatines which are the breakdown of muscle products(Buttaro, Trybulski, Polgar Bailey & Sandberg-Cook, 2013). They are then cleared from the blood by the kidney. When the kidney is not working accordingly, and the glomeruli are not filtering as much blood as normal, there will be an increased creatine levels in the blood.
History of a patient should be focused on since it differentiates acute kidney injuries or disease from a chronic kidney disease and gets the information about the duration and even chronically of kidney dysfunction. Obtain and review of previous urine findings, kidney function test and also imaging studies (Crawford & Lerma, 2008). When chronic kidney diseases are confirmed in a patient, history should be focused on to find an underlying cause. Questioning for any signs and even symptoms of a patient is necessary. The patient history should be reviewed and well documented.
Potential treatment option
Glycemic control can prevent the progression of nephropathy in patients with diabetes mellitus. Yearly screening is recommended for the microalbuminuria and blood pressure control whereby ACE inhibits or angiotensin-II antagonist. Progression of chronic kidney disease can be controlled by correction of anemia, a recommended hemoglobin concentration of eleven to twelve grams per decilitre(dl) in the patients with chronic kidney disease (Thomas, Kanso & Sedor, 2008). The patients with the plasma ferritin concentration below 100 mcg per litre which should be given iron supplements. Predialysis patient with anemia dependent angina or even severe anaemia having hemoglobin concentration below 10grams per decilitre is given Erythropoietin. Close monitoring of patients receiving erythropoietin should be present at all time.
When creatinine clearance falls below 60ml per minute, the parathyroid hormones begins to increase. By restricting dietary phosphate intake, hyperparathyroidism can be administered to the patient. Surgical treatment can be advised to patients with refractory hyperparathyroidism due to parathyroid hyperplasia. Immediate dialysis is shown by the Acute uremia which resul