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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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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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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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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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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Physical activity in kidney disease: evidence and implementation.

Hannah M L Young1,2,3,4, Roseanne E Billany5,6, Matthew P M Graham-Brown5,6

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Nature Reviews. Nephrology
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Physical activity is safe and beneficial for chronic kidney disease (CKD) patients, improving fitness and quality of life. However, integrating exercise into routine CKD care requires implementation-focused research and addressing key barriers for wider adoption.

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Area of Science:

  • Nephrology
  • Exercise Physiology
  • Public Health

Background:

  • Physical activity guidelines for chronic kidney disease (CKD) exist but are poorly implemented globally.
  • Individuals with CKD, including those on dialysis and transplant recipients, remain largely inactive across all disease stages.

Purpose of the Study:

  • To highlight the gap between evidence supporting physical activity in CKD and its clinical implementation.
  • To emphasize the need for implementation-focused research and strategies to integrate physical activity into routine CKD care.

Main Methods:

  • Review of randomized controlled trials (RCTs) on exercise in CKD populations.
  • Discussion of barriers and facilitators for physical activity intervention delivery in CKD care.
  • Consideration of digital health solutions and 24-h movement behaviors.

Main Results:

  • RCTs consistently demonstrate that structured exercise is safe and improves physical function, cardiorespiratory fitness, muscle strength, and quality of life in CKD patients.
  • Existing evidence generation is often disconnected from service development, hindering workforce capacity and delivery pathways.

Conclusions:

  • Embedding physical activity into clinical care pathways is crucial for improving outcomes for people with CKD.
  • Addressing barriers like health professional training, patient engagement, and system prioritization is essential for successful implementation.
  • Future research should prioritize implementation science to bridge the evidence-practice gap.