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Discussion On Chronic Kidney Diseases

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Question:

Discuss about the Chronic Kidney Diseases.
 
 

Answer:

Introduction:

There are a number of health concerns that have started to dominate the majority of human life ever since the society started to advance itself. Undoubtedly there have been a number of boons that the society has bestowed upon us with its technological advances and the spike in the economy however what it has taken away in turn is time (Coca, Singanamala, & Parikh, 2012). Time is nowadays the most expensive commodity there is and in the rat race of success, everyone is chasing the unattainable and ignoring the rest of what human life is (Han, 2014). There is no time for anyone to spend with their loved ones, no time to just stop and catch your breath and no time to take adequate care of our health (Chawla & Kimmel, 2012). From feeding habits to lack of sleep to paramount stress, the culmination of these factors has given us the ultimate plunge to a myriad of health concerns. Be it diabetes, coronary heart diseases or cancer, the health of the entire society continues to deteriorate (Coca, Singanamala, & Parikh, 2012). Chronic kidney disorders are one of the most prevalent lethal health disorders there is that has a vast majority of the society crippled. This report will attempt to evaluate and analyse different aspects associated with chronic kidney disorders and its prevalence taking Australia as an example.

 

Chronic kidney diseases:

In order to characterize the prevalence of kidney disorders across Australia and what factors are associated with the predominance of this disease it is important to evaluate the basics of this disease. A more medically acceptable term for critical kidney disorders are chronic renal diseases (Coca, Singanamala, & Parikh, 2012). This particular disease is characterized by the progressive loss of kidney functions, symptoms of which however are not very specific or easily distinguishable. However individuals with the higher blood pressure and diabetes, the risk for succumbing to chronic kidney diseases are higher (Hedayati, Yalamanchili, & Finkelstein, 2012). Apart from the tell tale signs of higher blood pressure, uremic symptoms like lethargy and pericarditis due to the abnormal accumulation of urea is another conspicuous symptom for chronic renal diseases (Lahmer & Heemann, 2012). Hyperkalemia or higher concentration of potassium accumulated in the blood is another effect of malfunctioning kidneys (Han, 2014).

Elaborating on the causes leading to this, the most commonly recognized cause is diabetes mellitus, apart from that glomerulonephritis also is a major cause leading to kidney failures (Sellares, et al., 2012). Renal artery tenosis and idiopathic kidneys are also deemed as the contributing factors to kidney failures. Now idiopathic kidneys are nothing but smaller size of kidneys that are not compatible to the needs of an adult body. Glomerular diseases however have some subdivisions, primary conditions appear as focal segmental glomerulosclerosis that is known as IgA nephropathy and the secondary glomerular diseases develop diabetic nephropathy or lupus nephritis (Hallan, et al., 2012). Obstructive bilateral nephropathy characterized by the kidney stones also leads to kidney failure in the prolonged situations that lead to chronic kidney failures (Sellares, et al., 2012).

Global scenario:

Chronic kidney disorders are considered to be the one of the most prevalent health concerns all over the globe, encompassing people irrespective of their age and gender. The global health care data suggests that roughly 200 million individuals all across the world are suffering from chronic renal diseases (Goldsmith, et al., 2010). Considering the demographics, the African Americans have almost fourfold risk to kidney diseases than the rest of the cosmopolitan population (Hallan, et al., 2012). The impact of socio-economic status and the standard of lifestyle also have a large impact on the risk factor. Studies suggest that low to middle income families in the developing countries also have a significantly higher risk to kidney disorders. It has to be also considered that the health care costs of the kidney disorders in the health care facilities worldwide increase the mortality rates for this disease (Chawla & Kimmel, 2012). According to the reports of the world health organization kidney disorders are considered to be one of the top ten contributors to the global mortality rate and the condition continues to deteriorate (Hallan, et al., 2012).

 

Prevalence in particular nations:

Chronic kidney diseases have no wonder become the most prevalent public health issue all over the world and have gained a subsequent impact on the mortality rates. Taking the example of Australia, one of three Australians are at risk of chronic kidney disorders (Aihw.gov.au., 2017). It has to be considered that the statistics are frightening and it is not showing any signs of improvement. Different explorative studies on the prevalence of kidney disorders in Australia suggest that more than 40 % of the elderly Australian residents are at risk to kidney failure, specially for the 75 years and higher (Aihw.gov.au., 2017). Other than that studies have also been successful to discover that the patents suffering from kidney disorders are at higher risk to coronary heart failures as well. Along with that it has also been witnessed that the Australians with chronic kidney diseases had the risk of dying due to heart failure 20 folds higher than the rest. Now coming to the younger population, 1.7 millions of Australian youngsters taking up the more than 10% of the entire Australian population have the symptoms to chronic heart diseases (Aihw.gov.au., 2017). Considering the numerical data, the risk to chronic kidney diseases in the Australians are, 42% in the respondents aged 75 or more, 21% in the respondents aged 65 to 74, and 6% in the respondents aged 18 to 54. These frightening statistics are not of the Australia alone, conditions all over the globe are very similar (Aihw.gov.au., 2017).                                    

For instance, if we take the example of China to draw a comparison, the risk to kidney disorders is similar to some extent. In a exploratory study 10.8% of the younger adults were found to be suffering with chronic kidney diseases (Zhang, et al., 2012). In another exploratory study more than 21.3% of the diabetics of the country were found to have been struggling with kidney disorders as well. Obesity, hypertension and diabetes have been discovered to be the major contributing factors behind the escalating kidney malfunctions in China as well (Zhang, et al., 2012).

Incidence of CKD in Australia                             incidence of CKD and kidney transplant in China

                                                               (Aihw.gov.au., 2017)                              (Zhang, et al., 2012)

Treatments and preventions:

With kidney disorders being one of the major public health disorders there are a number of treatment pathways available as well. In more advanced stages of chronic kidney disorders the treatment pathways that can be opted are dialysis and kidney transplant (Goldsmith, et al., 2010). Both of these techniques are opted for in case of end stage kidney disorders, the patients experience stages of near complete or complete kidney failures, where the kidneys can longer participate in the excretion (Chawla & Kimmel, 2012). In this case dialysis helps in removing the waste material and excess excretory fluid from the body. It can be done by two specific techniques, heamodialysis is where a machine connected to the circulatory system removes the excretory products from the body and in peritoneal dialysis, the dialysis solution is inserted into the abdominal cavity of the of the patient through a thin catheter, this solution absorbs the excretory product (Hedayati, Yalamanchili, & Finkelstein, 2012).

When the dialysis method cannot yield any positive results kidney transplant is opted as the last resort, where the patient will receive a donated kidney via a surgical transplant. However, in case of early stages medications are also used in the treatment of the kidney disorders. The drugs that are commonly prescribed to kidney patients are ACE inhibitors to lower blood pressure and decrease kidney load, along with diuretics (Hallan, et al., 2012).

In case of preventative measures, care should be taken to prevent the confounding factors to kidney disorders like blood pressure, diabetes, high blood sugar. Hence healthy diet, regular exercise regime and limited consumption of alcohol and tobacco has proven to help in minimizing the risk to kidney failure (Hallan, et al., 2012).

 

Role of health professional:

In any treatment procedure the role of health professionals are tremendous, if we consider dialysis as the treatment of example the two health professionals that will be involved in the procedure are a doctor and a nurse (Sellares, et al., 2012).The clinical practitioner that is certified to aid a patient dealing with kidney disorder is the nephrologist. He will relay the order for the type of dialysis that the patient will undergo and will make the clinical judgment about the details of the dialysis procedure (James, Hemmelgarn, & Tonelli, 2010).

The nursing professional that the patient will require is the nephrology nurse, a registered nurse certified to specialize in nephrology care. A registered nurse specialized in the kidney failure related care will help in assessing the vital signs of the patient and will also take adequate notice of the medication administered to the patient and will ensure that the dialysis bags are timely placed and replaced (Lahmer & Heemann, 2012). Along with that the nephrology unit RN will be responsible for assessing the changes in the patient’s conditions during and after the dialysis procedure and provide adequate care to the grievances of the patient (Goldsmith, et al., 2010).

 

Impact on community:

If we consider the prevalence of the kidney disorders in different ethnic or modern communities, it can be seen that, the African Americans have the biggest risk of succumbing to kidney failures among the rest of the racial communities (James, Hemmelgarn, & Tonelli, 2010). As mentioned above the risk to chronic kidney failures is 4 times higher than any other ethnic or racial communities and the contributing factor to this scenario can be the lower lifestyle standards of this community (Liyanage, et al., Worldwide access to treatment for end-stage kidney disease: a systematic review., 2015).

The number of CKD patients in the Hispanics has been rising steadily since the year of 2010 and has not shown any signs of decreasing ever since, however their incidence rates are near 1.5 times than the rest (Han, 2014). Lastly, the aboriginal communities also have a higher of CKD incidence that the non aboriginal population and the research shows that 11 times more aboriginals seek medical care for kidney failure than the non-aboriginal populations (Sellares, et al., 2012).

Conclusion:

On a concluding note, it can be said that chronic kidney diseases are a growing public health concern and this particular disease has an adverse effect on not just the physical health of the individual but also affects the psych of the individual as well. Malfunctioning kidneys and the medical dependence and inabilities it comes coupled with can seriously depress the patients. However with the right treatment plan and adequate preventative measures the escalating statistics of kidney disorders can be averted.

 

Bibliography

Aihw.gov.au. (2017). How many Australians have chronic kidney disease? Retrieved from Aihw.gov.au: https://www.aihw.gov.au/chronic-kidney-disease/prevalence

Chawla, L. S., & Kimmel, P. L. (2012). Acute kidney injury and chronic kidney disease: an integrated clinical syndrome. Kidney international, 516-524.

Coca, S. G., Singanamala, S., & Parikh, C. R. (2012). Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney international, 442-448.

Goldsmith, D. J., Covic, A., Fouque, D., Locatelli, F., Olgaard, K., Rodriguez, M., & Vanholder, R. (2010). Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) Guidelines: a European Renal Best Practice (ERBP) commentary statement. Nephrology Dialysis Transplantation.

Hallan, S. I. (2012). Age and association of kidney measures with mortality and end-stage renal disease. Jama, 2349-2360.

Hallan, S. I., Matsushita, K., Sang, Y., Mahmoodi, B. K., Black, C., Ishani, A., & Wetzels, J. F. (2012). Age and association of kidney measures with mortality and end-stage renal disease. Jama, 2349-2360.

Han, Y. Z. (2014). hort-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease. Journal of the American College of Cardiology, 62-70.

Hedayati, S. S., Yalamanchili, V., & Finkelstein, F. O. (2012). A practical approach to the treatment of depression in patients with chronic kidney disease and end-stage renal disease. Kidney international,, 247-255.

James, M. T., Hemmelgarn, B. R., & Tonelli, M. (2010). Early recognition and prevention of chronic kidney disease. . The Lancet, 1296-1309.

Lahmer, T., & Heemann, U. (2012). Anti-glomerular basement membrane antibody disease: a rare autoimmune disorder affecting the kidney and the lung. Autoimmunity reviews, 169-173.

Liyanage, T., Ninomiya, T., Jha, V., Neal, B., Patrice, H. M., Okpechi, I., & Rodgers, A. (2014). Worldwide access to treatment for end-stage kidney disease: a systematic review. The Lancet, 1975-1982.

Liyanage, T., Ninomiya, T., Jha, V., Neal, B., Patrice, H., Okpechi, I., . . . Rodgers, A. (2015). Worldwide access to treatment for end-stage kidney disease: a systematic review. The Lancet, 1975-1982.

Sellares, J., De Freitas, D. G., Mengel, M., Reeve, J., Einecke, G. S., & Halloran, P. F. (2012). Understanding the Causes of Kidney Transplant Failure: The Dominant Role of Antibody?Mediated Rejection and Nonadherence. American Journal of Transplantation, 388-399.

Zhang, L., Wang, F., Wang, L., Wang, W., Liu, B., Liu, J., & Chen, N. (2012). Prevalence of chronic kidney disease in China: a cross-sectional survey. The Lancet, 815-822.

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