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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 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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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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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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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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Acute Kidney Injury V: Interprofessional Care01:20

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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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Decision support training for chronic kidney disease dyads: the ImPart Study protocol.

Shena Gazaway1,2,3, Rachel Wells4,5, Orlando M Gutierrez6,7

  • 1School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, NB 485C, Birmingham, AL, 35294, USA. gazaways@uab.edu.

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|December 25, 2025
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Summary

This study tested the ImPart intervention to improve shared decision-making for stage 4 chronic kidney disease (CKD) patients and their caregivers. The goal was to enhance support skills and patient outcomes in CKD care.

Keywords:
Dyadic decision-makingFactorial trialKidney diseaseMultiphase optimization strategy

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Area of Science:

  • Nephrology
  • Health Services Research
  • Behavioral Science

Background:

  • Stage 4 chronic kidney disease (CKD) presents significant decision-making challenges for patients and caregivers.
  • Effective decision support is crucial for managing CKD progression and improving patient-centered care.
  • The ImPart intervention was developed to enhance decision-making partnerships in CKD dyads.

Purpose of the Study:

  • To evaluate the feasibility, acceptability, and preliminary efficacy of the ImPart decision-support intervention.
  • To assess the impact of different intervention components on patient and caregiver outcomes.
  • To inform the development of a fully powered randomized controlled trial for CKD decision support.

Main Methods:

  • A single-site, 2^3 factorial pilot trial involving 64 patients with stage 4 CKD and 64 caregivers.
  • Random assignment to 8 combinations of three intervention components: caregiver coaching, communication training, and patient psychoeducation.
  • Primary outcomes: feasibility and acceptability. Secondary outcomes: decision conflict, quality of life, distress, and dyadic coping.

Main Results:

  • The study protocol outlines the evaluation of a community-engaged, co-developed decision-support intervention.
  • Results will guide the refinement of the ImPart intervention for future large-scale trials.
  • Feasibility and acceptability data will be crucial for optimizing the intervention components.

Conclusions:

  • This pilot factorial trial protocol details a community-informed intervention for stage 4 CKD dyads.
  • The multiphase optimization strategy guides the evaluation of decision-support components.
  • The findings will contribute to improved shared decision-making in chronic kidney disease care.