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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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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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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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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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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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Kidney failure, CKD progression and mortality after nephrectomy.

Robert J Ellis1,2,3, Anne Cameron4,5, Glenda C Gobe4,6,5

  • 1Princess Alexandra Hospital, Brisbane, QLD, Australia. robert.ellis2@health.qld.gov.au.

International Urology and Nephrology
|January 27, 2022
PubMed
Summary

Chronic kidney disease (CKD) progression after nephrectomy is comparable to most other causes, but not as aggressive as diabetic nephropathy. Patients with CKD post-nephrectomy face a tangible risk of kidney failure and death.

Keywords:
Chronic kidney diseaseKidney failureNephrectomy

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Area of Science:

  • Nephrology
  • Renal Medicine
  • Urology

Background:

  • Chronic kidney disease (CKD) affects millions globally, with diverse etiologies influencing its progression.
  • Understanding the comparative aggressiveness of different CKD causes is crucial for patient management and prognosis.
  • Nephrectomy, the surgical removal of a kidney, can lead to CKD in the remaining kidney.

Purpose of the Study:

  • To test the hypothesis that CKD progression is less aggressive in patients whose primary cause was nephrectomy compared to non-surgical causes.
  • To compare the rates of kidney failure and death among patients with CKD from different primary etiologies.

Main Methods:

  • A cohort of 5983 patients was analyzed from the Queensland CKD Registry.
  • Multivariable Cox proportional hazards models were used to compare kidney failure/death rates based on primary CKD etiology.
  • Multivariable linear and logistic regression analyses assessed CKD progression.

Main Results:

  • Among 235 patients with CKD post-nephrectomy, 10% and 17% experienced kidney failure or death at median follow-up.
  • Patients with diabetic nephropathy and polycystic kidney disease (PCKD) exhibited the highest kidney failure rates, especially with eGFR < 45 mL/min.
  • Patients with glomerulonephritis and post-nephrectomy CKD showed lower kidney failure rates compared to diabetic nephropathy.

Conclusions:

  • CKD following nephrectomy presents adverse event rates similar to most other CKD causes, except for diabetic nephropathy, which is associated with worse outcomes.
  • While not the most aggressive cause, CKD post-nephrectomy carries a significant risk of kidney failure and mortality.
  • The risk of adverse outcomes in post-nephrectomy CKD is comparable to other major CKD etiologies.