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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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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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Chronic Kidney Disease II: Clinical Manifestations01:24

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease IV: Nursing Management01:18

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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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Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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A perspective on chronic kidney disease progression.

Jianyong Zhong1,2, Hai-Chun Yang1,2, Agnes B Fogo3,2,4

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American Journal of Physiology. Renal Physiology
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Summary

Chronic kidney disease (CKD) can progress without treatment. New markers and therapies offer potential for earlier intervention and improved outcomes in CKD management.

Keywords:
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Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Genomics and Epigenomics

Background:

  • Chronic kidney disease (CKD) often progresses to end-stage renal disease without intervention.
  • Renal function decline in CKD may not follow a linear trajectory.
  • Acute kidney injury is increasingly recognized as a significant risk factor for progressive CKD.

Purpose of the Study:

  • To explore novel surrogate markers for earlier detection and intervention in CKD.
  • To investigate new genomic and epigenomic mechanisms driving CKD progression.
  • To review current and emerging therapeutic strategies for ameliorating CKD progression.

Main Methods:

  • Analysis of novel surrogate markers including kidney injury molecule-1, neutrophil gelatinase-associated protein, apolipoprotein A-IV, and soluble urokinase receptor.
  • Application of omic-based technologies to identify genomic and epigenomic alterations in CKD.
  • Review of clinical studies on acute kidney injury and its role in CKD progression.
  • Evaluation of therapeutic approaches such as renin-angiotensin-aldosterone system blockade and novel drug targets.

Main Results:

  • New surrogate markers show promise for earlier CKD detection and intervention compared to traditional markers.
  • Omic technologies reveal distinct genomic and epigenomic pathways contributing to CKD.
  • Acute kidney injury is a significant risk factor for CKD progression.
  • Optimizing renin-angiotensin-aldosterone system blockade is a primary therapeutic step.

Conclusions:

  • Novel biomarkers and omic insights offer new avenues for early CKD intervention.
  • Emerging therapies targeting specific pathways and regenerative medicine hold promise for managing CKD progression.
  • Integrated approaches combining biomarker discovery, understanding disease mechanisms, and novel treatments are crucial for improving CKD patient outcomes.