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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Body composition in chronic kidney disease.

Kirsten L Johansen1, Carol Lee

  • 1Division of Nephrology, University of California, San Francisco, California, USA.

Current Opinion in Nephrology and Hypertension
|April 19, 2015
PubMed
Summary

Body composition in chronic kidney disease (CKD) patients is complex. While higher BMI may aid survival in end-stage renal disease (ESRD), visceral fat and muscle wasting are linked to adverse outcomes and frailty.

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Area of Science:

  • Nephrology
  • Metabolic Disorders
  • Clinical Nutrition

Background:

  • Obesity prevalence is rising in chronic kidney disease (CKD) patients, particularly end-stage renal disease (ESRD) patients.
  • Traditional Body Mass Index (BMI) may not accurately reflect adiposity or health status in CKD.
  • Muscle wasting (sarcopenia) is a significant concern in CKD, often coexisting with obesity.

Purpose of the Study:

  • To review current knowledge on body composition in CKD patients.
  • To examine the relationship between body composition and clinical outcomes in CKD.
  • To synthesize findings on obesity, visceral adiposity, and sarcopenia in CKD.

Main Methods:

  • Literature review of recent studies on body composition in CKD.
  • Analysis of associations between body composition metrics (BMI, visceral fat, muscle mass) and patient outcomes.
  • Evaluation of the impact of interventions on body composition in CKD.

Main Results:

  • Increased prevalence of obesity in ESRD, with direct adiposity measures being more informative than BMI.
  • High BMI is not consistently linked to better survival across all CKD stages; it may be protective in the sickest patients.
  • Visceral fat correlates with cardiovascular issues, while muscle wasting is prevalent and associated with poorer physical function and increased mortality.

Conclusions:

  • High BMI is not universally protective in CKD and can be associated with frailty and poor physical function.
  • Visceral adiposity poses cardiovascular risks, and sarcopenia is a common, detrimental condition in ESRD patients.
  • Further research is needed to determine if body composition interventions improve survival in CKD.