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Download renal disease - CAITLIN MCFARLAND
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RENAL DISEASE CAITLIN MCFARLAND JENNIFER SEEGERS RICKY TURNER STRUCTURE AND FUNCTION OF THE KIDNEY • Paired, bean shaped organ • Filter sodium and potassium ions from the blood and help to reabsorb these substances to maintain normal composition of body fluids. • Substances that are not needed are are passed through urine. WHAT IS RENAL DISEASE? • General term for any damage that reduces the functioning of the kidney • Leading causes are diabetes, high blood pressure, inherited disease, and infection. • Symptoms of disease include; nausea, vomiting, decreased or increased urination, swelling of ankles, puffiness around the eyes, fetid breathe, fatigue, shortness of breathe, loss of appetite, high blood pressure, leg cramps, pale skin, dry/itchy skin. • Acute and Chronic forms of disease ACUTE RENAL FAILURE • Rapid decline in renal function • Caused by: drop in blood flow to kidneys, damage from meds, or blockage that stops urine • Reversible if recognized early and if the contributing factors can be corrected • More often in older people • Most common indicator if it is azotemia (accumulation of nitrogenous waste in the blood) CHRONIC RENAL FAILURE • • • • Irreversible destruction 1 in 9 adults have chronic renal failure Greater risk in African Americans Complication: cardiovascular disease, anemia, or pericarditis • Differentiated from AKD in that reduction of kidney function must be present for over 3 months END STAGE RENAL DISEASE • The last stage of chronic renal disease • Complete kidney failure • Dialysis or kidney transplantation is the only treatment for this condition • Leads to death if you do not have dialysis or a kidney transplant DIALYSIS • Used when kidneys do not function properly • Removes harmful substances from blood when the kidney cannot • 2 types: hemodialysis & peritoneal TREATMENT • • • • Dialysis for kidney failure ACE inhibitors ARB (angiotensin II receptor blocker) Diet- lower amounts of sodium, phosphorus, potassium, and protein • May need extra vitamin D to increase calcium absorption • Exercise • Use caution with alcohol, tobacco, illegal drugs and make sure your doctor knows what medications, over the counter, prescription and herbal that you are taking. DENTAL CONCERNS • • • • • Bad tastes in mouth Halitosis At risk for losing bone from their jaw Abnormalities in PMN Enamel hypoplasia INDICATIONS FOR DENTAL TREATMENT • Aggressive treatment prior to transplant • Restorations, removal of non vital teeth, and prophylaxis CONTRAINDICATIONS FOR DENTAL TREATMENT • Wait 6 months after transplant for elective treatment • Wait to do treatment day after dialysis for no heparin in the blood stream PERIODONTAL MANAGEMENT • Cyclosporine, expect gingival hyperplasia • Weakened immune system TREATMENT MODIFICATIONS • Pre-Med antibiotic prophylaxis 6 months after kidney transplant • 3 months recall • Best time for dental treatment is the day after dialysis treatment • Don’t take blood pressure on same arm with the shunt Cont. • Consult with nephrologist - may need premeds • Obtain a complete blood count before treatment • Monitor blood pressure • Avoid NSAIDS – if on cyclosporine might cause renal toxicity ANY QUESTIONS QUESTION • Dialysis is given to a patient that has no renal failure. – True – False QUESTION • There is no treatment modifications necessary for renal disease patient. – True – False QUESTION • Cyclosporine can result in gingival hyperplasia, and is has no side effects when taken with NSAIDS. – Both statements are true – Both statements are false – The first statement is true, the second statement is false. – The first statement is false, the second statement is true. REFERENCES • • • • http://medical-dictionary.thefreedictionary.com/Kidney+Disease http://nkdep.nih.gov/learn/are-you-at-risk/race-ethnicity.shtml http://www.scribd.com/doc/96752875/Renal-Diseases-Disorders http://www.cdeworld.com/courses/4478Laboratory_Evaluation_of_Chronic_Medical_Conditions_for_Dental_Treat ment--Part_II-Diabetes_and_renal_function • http://www.medicinaoral.com/pubmed/medoralv13_i7_p419.pdf • http://www.dentistrytoday.com/periodontics/1591 • Porth, Carol. Essentials of Pathophysiology: Concepts of Altered Health States. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007. Print.
