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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

Chronic Kidney Disease III: Interprofessional Care

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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

Chronic Kidney Disease II: Clinical Manifestations

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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

Chronic Kidney Disease IV: Nursing Management

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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

Nephrons

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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 III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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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5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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Enfermedad renal crónica

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
Resumen
Este resumen es generado por máquina.

La preservación de la función renal en la enfermedad renal crónica (ERC) implica cambios en la dieta y medicamentos que reducen la presión dentro de los riñones. Estas estrategias tienen como objetivo retrasar la progresión de la enfermedad y mejorar la longevidad del paciente.

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Área de la Ciencia:

  • Nefrología
  • Médico interno
  • Salud pública

Sus antecedentes:

  • La enfermedad renal crónica (ERC) es una enfermedad prevalente y progresiva con una morbilidad y mortalidad significativas, especialmente en personas con diabetes e hipertensión.
  • Las estrategias de manejo efectivas son cruciales para mejorar los resultados de los pacientes y preservar la función renal.

Objetivo del estudio:

  • Revisar las estrategias actuales para preservar la función renal en pacientes con enfermedad renal crónica.
  • Destacar el papel de las intervenciones no farmacológicas y farmacológicas en la mitigación de la progresión de la ERC.

Principales métodos:

  • Revisión de la literatura existente sobre las intervenciones dietéticas, incluidas las dietas dominantes de plantas, bajas en proteínas y bajas en sal.
  • Análisis de terapias farmacológicas dirigidas a la hemodinámica intrarenal (por ejemplo, moduladores de RAAS, inhibidores de SGLT2) y otros mecanismos de protección (por ejemplo, ARM).
  • Tener en cuenta las terapias específicas de la enfermedad, el manejo de los riesgos asociados (cardiovascular, infección, IAC) y los enfoques para la terapia de reemplazo renal.

Principales resultados:

  • Los ajustes dietéticos pueden ayudar a reducir la hiperfiltración glomerular e influir positivamente en el equilibrio ácido-base y el microbioma intestinal.
  • Las farmacoterapias como los moduladores de RAAS y los inhibidores de SGLT2 reducen la presión intraglomerular, mientras que los nuevos agentes ofrecen beneficios antiinflamatorios y antifibróticos.
  • El manejo integral incluye abordar el riesgo cardiovascular, prevenir infecciones y lesiones renales agudas, y considerar transiciones incrementales de diálisis.

Conclusiones:

  • La preservación de la función renal en la ERC requiere un enfoque multifacético que combine modificaciones en el estilo de vida, farmacoterapias dirigidas y manejo proactivo de las complicaciones.
  • La investigación adicional sobre nuevas intervenciones dietéticas y farmacológicas es esencial para mejorar la longevidad y la calidad de vida de los pacientes.