ckd ppt.pptx chronic kidney disease ppt

Chronic kidney disease

1. SEMINAR ON CHRONIC KIDNEY DISEASE PRESENTED TO: MR . DIPTANU DEBBARMA TUTOR OF TCN PRESENTED BY: PRINCE DEY M.SC NURSING 2 ND SEMESTER ROLLNO: 06

2. INTRODUCTION: Chronic kidney disease involves progressive, irreversible loss of kidney function. It is defined as either the presence of kidney damage or glomerular filtration rate(GFR) <60 ml/ min for 3 months or longer. Kidney damage is defined as either pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. The kidneys have remarkable functional reserve. Up to 80 % of the GRF may be lost with few obvious changes in the functioning of the body.

3. DEFINITION Defined as kidney damage or glomerular filtration rate < 600 mL/min/1.73m for 3 months or more irrespective of cause, kidney disease can be ascertained by the presence of albuminuria. CKD is defined as albumin to creatinine ratio >30 mg/g in two or three spot urine specimen .

4. ETIOLOGY Diabetes mellitus type 2 ( 30- 50 %) Diabetes mellitus type 1 (3.9%) Hypertension ( 27.2%) Primary glomerulonephritis ( 8.2%) Chronic tubulointerstitial nephritis (3.6%) Hereditary (3.1%)

5. RISK FACTORS Diabetes Smoking Obesity Abnormal kidney structure Older age Frequent use of medications that can damage the kidneys

6. STAGES OF KIDNEY DISEASE 1 st stage 2 nd stage 3 rd stage 4 th stage 5 th stage

7. ANATOMY OF THE KIDNEY

8. PHYSIOLOGY OF THE KIDNEY Nephrons and urine production Renal corpuscle Proximal convoluted tubule Loop henle Distal convoluted tubule Collecting ducts Central to the operation of the renal system are the nephrons, of which there are approximately 1-1.3 million per adult kidney ( Zambon et al, 2014). Approximately 80-85% of these are termed cortical nephrons, because the bulk of their structure is in the renal cortex; the remaining 15-20%, called juxtamedullary nephrons, are on the cortex-medulla boundary 

9. PATHOPHYSIOLOGY

10. CLINICAL MANIFESTATION: Psychologic: Denial, anxiety, depression, psychosis Cardiovascular: hypertension, heart failure, pericarditis, myocardiopathy, pericardial effusion. Gastrointestinal: anorexia, nausea, vomiting, uremic fetor, peptic ulcer, stomatitis, gastritis. Endocrine: infertility, sexual dysfunction, azoospermia. Metabolic: gout, nutritional deficiencies, hyperlipidaemia. Hematologic: anemia , bleeding, infection

11. DIAGNOSTIC EVALUATION: History collection and physical examination. Renal ultrasound: to detect cyst, tumors , abscesses , obstruction, fluid collection and infection within around the kidney. Renal scan: to asses the size, location, and shape of the kidneys and related structures, such as the ureters and bladder. Renal biopsy Serum electrolyte. Urine test

12. COMPLICATION: Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema ) A sudden rise in potassium levels in your blood ( hyperkalemia ), which could impair your heart's function and can be life-threatening Anemia Heart disease Weak bones and an increased risk of bone fractures Decreased sex drive, erectile dysfunction or reduced fertility

13. MEDICAL TREAT MENT :

14. NUTRIRION THERAPY: Fluid allowance: as desired Calories: 30-35 kcal/kg Protein: 0.6-1.0 gm/kg Fat: fats, CHO adjusted as per severity of risk factors Sodium: 1-3 g/day Phosphorus: 8-12 mg/kg Calcium: 1000- 1500 mg/ day Vitamin c: 100 mg/day

15. NURSING DIAGNOSIS: Excess fluid volume related to inability to kidneys to excrete fluid and exercise fluid intake as evidenced by edema , hypertention , weight gain. Risk for injury related to alteration in bone structure due to decreased calcium absorption, retention of phosphate and altered vitamin D metabolism. Imbalance nutrition less than body requirement related to restricted intake of nutrients , nausea , vomiting , anorexia as evidenced by loss of appetite and weight. Risk for infection related to suppressive immune system, access sites, and malnutrition secondary to dialysis and uremic.

16. HEALTH EDUCATION Instruct patient in adverse effects of prescribed medications and methods of preventing infection if taking immunosuppressive agents Carefully review with patient and family dietary and fluid restrictions; consult dietitian for assistance in meal planning. Discuss the importance of maintaining exercise, decreasing cholesterol and fat intake, and changing other risk factors, such as smoking, obesity, and stress, to reduce risk of severe thromboembolic complications. In patients with severe disease, prepare for dialysis and possible transplantation

17. CONCLUSION

18. BIBLIOGRAPHY: Lewis’s et.al. Medical Surgical Nursing Assessment & Management of Clinical Problems. 4th edition. South Asia: Elsevie Brunner & Suddarth’s . Textbook of Medical Surgical Nursing. 13th edition. South Asian Edition: Wolters Kluwer (India) Pvt. Ltd. Black JM. Black’s Medical Surgical Nursing: Clinical Management for positive Outcomes. 1st edition. South Asia: Elsevier India.

19. THANK YOU