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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

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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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Nephrons01:10

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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
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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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Chronic kidney disease.

Kamyar Kalantar-Zadeh1, Tazeen H Jafar2, Dorothea Nitsch3

  • 1Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA, USA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA, USA.

Lancet (London, England)
|June 27, 2021
PubMed
Summary
This summary is machine-generated.

Preserving kidney function in chronic kidney disease (CKD) involves dietary changes and medications that reduce pressure within the kidneys. These strategies aim to slow disease progression and improve patient longevity.

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Area of Science:

  • Nephrology
  • Internal Medicine
  • Public Health

Background:

  • Chronic kidney disease (CKD) is a prevalent, progressive condition with significant morbidity and mortality, particularly in individuals with diabetes and hypertension.
  • Effective management strategies are crucial for improving patient outcomes and preserving renal function.

Purpose of the Study:

  • To review current strategies for preserving kidney function in patients with chronic kidney disease.
  • To highlight the roles of non-pharmacological and pharmacological interventions in mitigating CKD progression.

Main Methods:

  • Review of existing literature on dietary interventions, including plant-dominant, low-protein, and low-salt diets.
  • Analysis of pharmacological therapies targeting intrarenal hemodynamics (e.g., RAAS modulators, SGLT2 inhibitors) and other protective mechanisms (e.g., MRAs).
  • Consideration of disease-specific therapies, management of associated risks (cardiovascular, infection, AKI), and approaches to renal replacement therapy.

Main Results:

  • Dietary adjustments may help reduce glomerular hyperfiltration and positively influence acid-base balance and gut microbiome.
  • Pharmacotherapies like RAAS modulators and SGLT2 inhibitors lower intraglomerular pressure, while novel agents offer anti-inflammatory and antifibrotic benefits.
  • Comprehensive management includes addressing cardiovascular risk, preventing infections and acute kidney injury, and considering incremental dialysis transitions.

Conclusions:

  • Kidney function preservation in CKD requires a multifaceted approach combining lifestyle modifications, targeted pharmacotherapies, and proactive management of complications.
  • Further research into novel dietary and pharmacological interventions is essential for enhancing patient longevity and quality of life.