* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download to - Owokoniran Memorial Hospital Limited
Survey
Document related concepts
Transcript
SEPTEMBER PRESENTATION AS PRESENTED BY AWOLESI AISHAT AND ODUNEYE O.D The human kidney is a bean-shaped organ located at each side of the vertebral column approximately after the twelfth rib i.e. there is one kidney on each side of the spine. It is about 4-5in (11-14cm) long,2.4in (6cm) wide,1.6in (4cm)thick and it weighs approximately 150g Formation and excretion of urine and other waste products Regulation of body water, electrolyte and acid-base balance Production and secretion of hormones e.g. erythropoietin which aids production of red blood cells and vitamin D Control of blood pressure by producing rennin Reabsorption of vital nutrients e.g. glucose, amino acids. Chronic kidney disease also known as chronic renal disease is a slow gradual process of kidney destruction which may go unidentified until there is destruction of the functional renal tissue. It is therefore defined as the progressive loss of renal function affecting one or both kidneys over a long period of time. This disease can be differentiated from acute kidney disease in that the reduction in kidney function must be present for over 3months. CAUSES Diabetes Hypertension Sickle cell anaemia Prolong use of certain medications Bladder tumor Family history of kidney disease Bladder obstruction Stage 1 - GFR rate is normal. However, evidence of kidney disease has been detected. Stage 2 - GFR rate is lower than 90 ml (60-89mL/min/1.73 m², and evidence of kidney disease has been detected. Stage 3 - GFR rate is lower than 60 ml, regardless of whether evidence of kidney disease has been detected. Stage 4 - GRF rate is lower than 30 ml,. regardless of whether evidence of kidney disease has been detected Stage 5 - GFR rate is lower than 15 ml. Renal failure has occurred. The majority of patients with chronic kidney failure rarely progress beyond Stage 2. If the patient does not feel symptoms until Stage 4, any kidney damage is irreversible. Stage 5 being a severe illness with poor expectancy if untreated it is often called end-stage kidney disease or end stage renal disease or end stage kidney failure. Chronic renal failure usually means the patient requires renal replacement therapy which may involve a form of dialysis but ideally constitutes a kidney transplant. Non Dialysis Dependent Chronic Kidney Disease (NDD-CKD): Means that the patient do not require the life support treatments for renal failure known as renal replacement therapy which includes dialysis or renal transplantation. End Stage Renal Disease (ESRD): Identifies patients who either require dialysis or transplant. This also means that the beginning of ESRD is practically the irreversible conclusion of NDD-CKD Anemia Blood in urine Dark urine Decreased mental alertness Decreased urine output Edema - swollen feet, hands and ankles Fatigue (tiredness) Hypertension (high blood pressure) Insomnia More frequent urination, especially at night Muscle cramps Muscle twitches Nausea Pain on the side or mid to lower back Panting (shortness of breath) Protein in urine Sudden change in bodyweight Unexplained headaches Itchy skin, can become persistent Loss of appetite Male inability to get or maintain an erection (erectile dysfunction) Blood test - to determine whether waste substances are being adequately filtered out. If levels of urea and creatinine are persistently high, the doctor will most likely diagnose end-stage kidney disease. Urine test - to find out whether there is either blood and/or protein in the urine. Kidney scans - this may include a magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, or an ultrasound scan. The aim is to determine whether there are any blockages in the urine flow. These scans can also reveal the size and shape of the kidneys - in advanced stages of kidney disease the kidneys are smaller and have an uneven shape. Kidney biopsy - a small sample of kidney tissue is extracted and examined for cell damage. An analysis of kidney tissue makes it easier to make a specific diagnosis of kidney disease. Chest X-ray - the aim here is to check for pulmonary edema (fluid retained in the lungs). There is no current cure for chronic kidney failure. However, there are therapies that can help control the signs and symptoms, reduce the risk of complications, and slow the progression of the disease. The management of chronic kidney disease includes treatment of underlying causes and dialysis. Reduction of diary intakes i.e. eggs, red meat and fish to help reduce phosphate Calcitrol may be given to help activate vitamin D Angiotensin Converting Enzymes(ACE) Inhibitors e.g. Caporal, Enalapril,Lisinopril and Ramipril may be given to help control blood pressure. Angiotensin Receptor Blockers (ARBs) e.g. Losartan,valsartan may also be given to help control blood pressure Loop diuretic e.g. Lasix is given to help reduce fluid retention in the body Anti-emetics e.g. metoclopramide is administered to help relieve nausea Anti-histamine e.g. chlorphenamine is administered to help relieve itching Protein, salt, phosphorus and potassium intake is restricted NSAIDs (nonsteroidal anti-inflammatory drugs) - such as aspirin or ibuprofen should be avoided. Kidney dialysis - this is the removal of waste products and excessive fluids from blood when the kidneys cannot properly do the job any more. There are two main types of kidney dialysis. Each type also has subtypes. The two main types are: Hemodialysis - blood is pumped out of the patient's body and goes through a dialyzer (an artificial kidney). The patient undergoes hemodialysis about three times per week. Each session lasts for at least three hours. Peritoneal dialysis - the blood is filtered in the patient's own abdomen, a catheter is implanted into the abdomen, into which a dialysis solution is infused and drained out for as long as is necessary to remove waste and excess fluid. Continuous ambulatory peritoneal dialysis - the dialysis solution is exchanged in the abdomen four times a day, every day. Sessions are equally spaced throughout the day. The patient carries out the procedure himself/herself. Continuous cycling peritoneal dialysis - a cycler machine automatically infuses daily solution into the peritoneal cavity and takes it out while the patient is sleeping. Kidney transplant is also considered where dialysis fails COMPLICATIONS Anemia Central nervous system damage. Hyperkalemia Insomnia Lower libido (sex drive) and male erectile dysfunction Ostemalacia Pecarditis Drugs are defined as natural or synthetic substances that are used for medical or recreational purposes and the repeated use leads to transient or chronic dependency. Some drugs may cause kidney damage/failure either directly or indirectly since they are involved in drug metabolism. Significant alterations have been observed in the structures of the kidney. The continuation of substance or drug abuse after the appearance of renal damage increases the risk of permanent renal disease and consequently leads to ESRD Drugs that can cause kidney damage include: Heroin Amphetamines Benzodiazepines: diazepam Cannabis Cocaine Marijuana Morphine Painkillers Ketamine Depressants Babiturates Drug abuse must now be considered in the differential diagnosis of any patient with unexplained renal pathology. Decreasing the numbers of users seems to be the best way to avoid renal complications. THANK YOU FOR LISTENING