Health

The Causes and Treatment of Chronic Kidney Disease

Abstract:

A kidney is a bean-shaped organ, which is associated with the filtering of the blood. Human has to bean-shaped kidney each of which consists of several tiny filtering tubes. A kidney is an important organ in a human body, which separate the waste products from blood and water and maintain the salt balance within the volume of the body fluid and body. Chronic kidney disease (CKD) is defined as the long-term health condition, which is associated with the complications in structural as well as functional coordination of kidney. This type of damage is considered as irreversible as it is occurred due to malfunction of the kidney. As per the database of WHO, 2012, the majority of the mortality cases is occurred due to development of CKD in the community. From the database, it can also be stated that CKD has ranked 14th position as the potential reason behind the high rate of mortality in the community in years 2012. Although different causes associated with the global mortality cases, CKD had ranked 27th position in 1990 in case of high rates of global mortality. A high number of health complications in the global community results from the severe kidney failure. CKD has taken the second position after the AIDS/HIV in promoting vulnerability to different lethal disease. In 2010, CKD has ranked 18th in terms of promoting sudden death in older adults. The current report is going to focus on the description of the CKD in terms of depicting the importance of kidney in maintaining the normal body functions. Moreover, this report will also explore the management as well as the aetiology of the CKD. By representing the future research potentials, this report is going to discuss advantages of selecting this topic

Introduction

From the recent study, it can be seen that more than 80% of the patient suffering from end-stage kidney disorders, which affect their other organ function thereby leading to mortality. Majority of the kidney disorders occurs in elderly people due to the inability of their kidney to maintain the proper filtration. It is important for the patient as well as the doctors to recognise the functional ability of the kidney in terms of making proper health assessment process. In case of the third world country or developing countries, the renal replacement therapy is less available. In case of South Asian countries, the renal therapies are less available as the majority of the people cannot afford the costly renal treatment. However, as the economy grows, medical sciences in these countries are improved with the introduction of proper medical equipment as well as technologies, which makes the citizen avail the renal replacement therapy. From the WHO database, it can be seen that in South Asian countries, people are more likely to be exposed to the eng-stage renal disease increasing number of elder community in the population. In some developed countries, chronic kidney disorders are divisible into the different community such as blackish and whitish people in the UK. However, diabetes and hypertension can be defined as the common outcome in wealthy as well as developing countries. Obesity can be considered as the important factor in occurring the chronic kidney disease (Webster et al. 2017). Poor sanitation as well as poor water supply is the main reason behind diabetes as well as hypertension, which is associated with kidney disorders. In the cause of developing as well as developed countries elderly people are the common suffering from the chronic renal complication due to obesity and hypertension.

Epidemiology

The categorisation of the chronic renal disorders has been changed over years due to changes in health condition, cultural aspects and socio-economic aspect of the community. Recent health investigation has represented the fact that, more than 11% of the highly develops countries show the apparent existence of CKD, due to irregularity in lifestyles and unhealthy food habits. On the other hand, the occurrence of renal disorders is associated with ethnicity, socio-economic status and the cultural aspects of the countries. For example, it has been seen, that people residing in the bottom social level have 65% more chance of getting affect by the CKD than that of the people who stay on the high social level. Tope societies groups are less like to be affected by the renal disorders than that of the low society’s groups. Ethnicity also affects the occurrence of the renal disorders, which not only affect the healthy outcomes of the people but also affect their overall socioeconomic status. The certain ethnic group are more vulnerable to CKD and renal disorders than that of the other community group. For example, in UK Asian as well as blackish people are more vulnerable to the development of chronic kidney disorders than the whitish people. Socio economic status of the different ethnic groups is associated with their health condition (Hildebrandt 2010). For example, due to severe discrimination in the employments opportunities blackish community in the UK and other developed countries are more like to be addicted to different drugs, alcohol and malpractices, which not only affect their overall health status but also affect their mental stress. Majority of the south Asian community and blackish people, who stay in developed countries, suffers from depression, hypertension, diabetes and mal nutrition, which directly affect the function ability of kidney.

Although, there are different categories of CKD instances in the different countries, the main causes of this types of renal disorders is associated with hypertension as well as diabetes. From the recent report WHO ion CKD occurrence, it has been seen that nearly 50% of the CKD cases occur due to diabetes and hypertension. In the majority of the developing countries, nearly 25% of the CDK cases occur due to hypertension. The recent study also has stated that, some genetic factors are also associated with the development of the renal disorders. Certain people have health abnormalities, genetic disorders' that are associated with the development of CDK (Jha et al. 2013. In some cases genetic abnormalities are associated with the development of malfunction of the kidney, which reduces the filtrating ability of this organ thereby leading to kidney failure. Based on the biological point of view, it can be stated that, the mutation in particular gene that regulates the organ function can lead top reduction of filtration ability of kidney which not only affect the healthy status if the people but also affect the overall mental ability of the patient.

Genes are associated with monitoring the proper functioning of kidney. Therefore, any abnormalities or mutation in this particular genes can lead to the development of chronic renal disorders as well as CDK. It is important the health professional recognise actual cause of CDK to provide proper renal replacement therapies. Different evidence also shows that oxidative stress as well as chronic inflammation is associated with the development of CDK among the elderly people. Recent medical research has highlighted the fact that, oxidative stress affects the gene expression on particular DNA sequence and genetic mutation, which directly affects the regular function of the kidney.

Investigation

One of the best methods for determining the functioning of the kidney is measuring the Glomerular filtration Rate (GFR). GFR is crucial for determining the ability of kidney in filtrate the waste product and maintain proper salt balance within the body fluid. If there is the huge fluctuation of the GFR from the normal range, it means the person has renal disorders and need the proper diagnosis. Health professional uses this process in the prompt determination of CDK and renal disorders. However, this test is associated with the age, gender, sex and healthy condition. GFR is different in case of male and females. It is also different in case of young people and elderly people. Therefore, when health professional uses this process in determining the renal disorders it is important to records the age, sex, health condition of the suspected person.

Another important method for determining the ability of kidney is measuring the creatinine level in the body. Creatinine is one of the major paste product produces ob kidney, which is excreted in the urine from the human body. Due to normal breakdown of the muscle cells and tissues, Creatinine is produced, which is then excreted from the body. Creatininne can be tested after collected the 24-hour urine sample and it can be matched with the blood creatinine level. This process would assist the health professional in determining the waste product that is developed and excreted from the body in every minute with the help ofg kidney.

In terms of determining the renal function, health professionals can make the standardised measurement of the amount of fluid that filtered through the kidney. In this aspect, one of the commonly used processes of determining the kidney ability is Glomerular Filtration rate (GFR). Different types of chronic kidney disease are described in medical science, which deals with different criteria. GFR is proved to be beneficial process in determining the ability of the kidney in different types of process. Recent testing criteria that are considered by the today’s health professional are represented below:

GFR test has five stages, which are associated with the meticulous job by the kidney. In case of the 1st stage, the meticulous job of kidney needs to be determined in order to determine the functional ability of the kidney.

A further test is associated with the determination of the protein level. The most common method for determining the protein level is testing the sediment in the urine. The sediment occurs due to the urinary tract infections and it contains cells like pus and blood cells. The lab technicians and health professionals use a microscopic method for determining the fact that does not seem to the naked eye. Urinary casts are known as the cylindrical microscopic structure that is produced by the kidney. For determining the protein level,. The clinicians need to determine the amount of white and red blood cells, casts urinary crystals. This information then transferred to the renal specialist for proper interpretation in terms of describing the underlying nature of the pathology. For monitoring the disease, progression as well as conducting the CKD diagnosis play vital role in identifying the reason behind renal disorders and provide proper medical support to the patient. The ultrasound technique that is associated with the determining the kidney disorder is associated with the determination of the functions and structural formation of the kidney (Remer et al., 2014). From the ultra sound technique, it can be seen that smaller kidney is also associated with the reason behind occurring the renal disorders as well as CKD. Ultra sound process is effective one, which assists the health professional and renal specialist to determine the cause as well as an effect of the renal disorders. By conducting the ultra sound process, health professional is able to recognise the type of kidney damage occurs in case of the patient such as swelling of the kidney,, build up of the urine and inflammation of the kidney surface. Moreover, this process is also effective in terms of conducting the biopsy of the kidney sample to determine the site of damage, the ultra sound technique is highly beneficial as well as important.

Urine and blood test:

In terms of determining the function of the kidney, a urine test is also crucial method that the health professional can use. In this aspect, the urine test is important to the process, which recognises the way kidney performs its to function. By conducting the urine test, the healthy professional is able to determine whether the kidney is efficient in filtering the blood as well, as excreting the waste products from the body. Through urine test, people health processional can easily determine whether the kidney leaks protein into the abdominal region. If this happens, then it is the strong signal that kidney is going to be damaged.

Creatine is the waste product, which is considered as the unusual body part as well as tear of the muscles. In terms of determining the creatine level, health professional needs to consider the age, and body mass, which directly affects the level of creatine in the human body. Moreover, ethnicity as well as race is also associated with the amount of creatine within the human body. In consideration of the sex and gender, it has been proved that, creatine level is more in women than that in men. The normal creatine level in women is 1.4. In case of the damaged kidney patient, the level reduces to 1.2, which products that the kidney of this woman is not performing well. If kidney damages, it looses the power of filtering the waste products from the blood which is stored in the tissue and leads to damages of the immunological ability of the person (Kidney.org, 2017).

Normal GFR varies with the age and sex. In case of the elderly people, GFR decreases in sharp rate. GFR is an important factor that assists the health professional in determining the function and ability of the kidney to perform its daily functions. From the above table, it can seem that the normal rate of GFR in the human being is 90 or slightly above. If any person has GFR below 60, it provides the strong sign of damaging the kidney. This situation describes that, kidney of that person with 60 GFR is not performing well. Moreover, if the GFR is below 15, it will be important for the health profession al to conduct the ultra sound test and creatine test of the kidney, as the damage is severe and can lead to death. In this case, the person needs urgent diagnosis and treatment for improving the functioning of kidney. Kidney transplant and dialysis are the two important methods that are needed tp be perform for recovering the health of the patient. Moreover, urine test in every hour can be helpful for the health professional in determining the ability of the kidney in filtering the blood. However, the recent study stated that, fir conducting the urine test, the health professional needs to collect the urine sample after 24 hours as the proper urine is firmed after 24 hours in case of human being.

Urinalysis

This process is the microscopic examination of the urine sample by using the dipstick test. In conducting this test, a chemical strip is used to be treated and dipped into the urine sample. This strip changes colour and texture in case of any abnormalities in there kidney function. This type of test is useful; in determining the abnormalities of urinary track, blood and protein.

Urine protein:

This process is similar to the urinalysis and the dipstick method. The excess protein in urines is known as proteinuria. This process is important for the patient with kidney damage to determine the amount of the protein that is leaked by the kidney into the abdominal part.

Microalbumin:

This test is the sensitive dipstick test that can determine the smallest amount of protein such as albumin in the urine. Individual who suffer from high BP, hypertension and CKD, can be treated with this test top determiner the position as well as an amount of smallest protein within in the urine. This type of test is conducted in case of the patient, in which the proteinuria test is negative.

Imaging test:

Ultra sound:

This type of test uses the sound waves in obtaining the images of the kidney from the different angle. This type of test is helpful in determining actual size as well as a position of the kidney in terms of identifying the type of renal abnormalities in-patient.

CT scan:

This is the imaging technique that X-rays are used to determine the function as well as the power of the kidney. This type of test is associated with the using the intravenous dye that can appear only in case of the patient having the kidney abnormalities.

Kidney biopsy:

This process is used determining the severity of the kidney disease as well as renal inflammation, which is important to be diagnosed in terms of providing the proper care and support to the patient. This process is helpful in investigating the efficiency of the renal transplant process in recovering the health of the patient with the renal abnormalities. This process assists the health professional in order to determine the amount of damage occur in the kidney and relevancy of renal transplant process in healing this damage.

Pathophysiology:

In case of the CKD the main outcome is considered as the eventual, fibrosis that is the hardening as well as tearing or the renal tissue. After the bout of the chronic injury, thre is the continuous unsuccessful process of healing in case of the renal tissue. Scarring of the tissue in case of the renal parts leads to the tissue loss, chronic injury and blood cell damage. CKD is associated with abnormal GFR which predicts the severe inflammation of the kidney, in terms of providing proper treatment it is important for health professionals to conduct renal transplant and dialysis. In terms of describing the related factors of casing the CDK, it can be seen that smoking as well as addiction to different drugs are associated with the development of renal disorders. Scarring of the kidney is associated with high level of drug consumption and fat lipid consumptions. Fat consumption leads to hypertension, which affects the function of kidney in terms of, filter the blood. It has been seen in the recent research that, the inflammatory foam cell within the kidney that are developed against any foreign particle that has entered into body, cam leads to produce severe inflammation over the kidney surface.

In order to describing the symptoms as well as sign of the CKD, it can be stated that there are various symptoms of this disease. Manifestation of the CKD can occurs in form of abnormalities within the blood as well as urinary track. Urinary track inflammation as well as protein leakage into the abdominal track can be considers as the common symptoms of CKD, moreover, various changes in the urine output, such as sudden decrease as well as increase of the urine can be consider as the proper sign of renal abnormalities. Symptoms of the renal failure and CK are vomiting, anorexia, loss of the appetite and anaemia. In most of the deficiency of the red blood cells occurs which leads to anaemia. Mental disturbances is one of the common symptoms of the CKD in which patient suffer from hallucination, poor remembering ability, short-term memory loss and poor decision making ability.

Complications associated with CKD:

Several complications are associated with the development of CKD which not only affect the physical health of the patient but also the mental as well as emotiona health of the pati8ent. If remain untreated, CKD leads to development of the End stage Kidney Disease which leads to impaired renal ability. CKD is highly associated with the development of tghe cardio vascular disease which leads to reduced function of heart and impaired pumping ability. Moreover, due to renal damages in case of CKD, the person comes unable to maintain the healthy red blood cells which leads to the condition of anemia. In anemic patient iit is important for the health professional to diagnose the entire problem and provide proper treatment process for enhancing the RBC level.

For marinating the proper heath of patient with renal disorders, hypertension and reduced RBC, proper dietary supplement and medicines are needed. Injections and proper medicines need to be provided to the patient to boost the RBC as well as iron supplement. Proper process in reducing the blood transfusion process is important for this patient in order to maintain the blood level within the body.

Bone mineral disorder complication:

One of the major role of kidney in maintaining the serum mineral level within the human body,. Moreover, kidneys play important role in absorption of these minerals. It is important for maintaining the proper healthy bone metabolism. Minerals such as calcium and other minerals are maintained in proper amount within the serum by the kidney. Therefore it can be stated that kidney is associated with the maintaining the proper absorption rate of the different minerals within the blood. In case of CKD cases, the patients have impaired renal function, which is unable to maintain the mineral balance within the body. Therefore, if the mineral rises in be blood vessels it directly affect the functions and structure of the different organs. In majority of the CKD cases, the rising number of minerals directly affects the density a well as structure of the bone, which leads to the tearing, and fracture of the bone.

Cardio vascular complication:

It has been seen the recent medical researches that, people with severe CKD condition, suffer from the high mortality rate and heart stroke. Kidney is important organ that control the proper functioning of heart by filtering the blood and purifying it to jump back into the heart. In case of renal disorder, heart is unable to have the purified blood which increases the chances if heart attack. Due to mineral imbalances within the body, calcium and other proteins as well as minerals are stored into the blood vessel thereby reducing the inner diameter of the vein and arteries that enhance the blood pressure. If BP increases, it directly affects on the heart rate and leads to severe heart attack. Moreover, due to kidney inability, heart is unable to maintain the proper blood level within the blood vessel. CKD is associated with abnormal GFR, which predicts the severe inflammation of the kidney, in terms of providing proper treatment it is important for health professionals to conduct renal transplant and dialysis. In terms of describing the related factors of casing the CDK, it can be seen that smoking as well as addiction to different drugs are associated with the development of renal disorders. Scarring of the kidney is associated with high level of drug consumption and fat lipid consumptions. Fat consumption leads to hypertension, which affect the function of kidney in terms of, filter the blood.

Complications – Cancer

CKD is a serious disease which further creates different forms of cancer mainly for the patients who are in the last stage of kidney disease and who are on dialysis (Lowrance et al., 2014; Stengel, 2010; Nakamura et al., 2011). The machine filter in this regard is effective for purifying the blood by removing the waste and excess fluid from the body and it further helps to clean the blood successfully and improve the immunity power of the patients. In addition to these, the dialysis machine is also another effective technology through which it is possible to deliver proper treatment and service to the patients who are suffering from kidney damages. For the CKD patients, there is high risk of cancer and mainly for the patients who are undergone a kidney transplant, it is very risky for hem as there is high chance to be affected by cancer (Vajdic et al., 2006). The type of cancer depends on the variety of factors but as per the previous study, thyroid and cancer are increasing among the individuals. If the patients, who are going under the kidney transplant, take drugs, their immunity power will be hampered and it is difficult for them to survive. This is serious concern where the disease may hamper the health condition of the patients and there is high risk of cancer. The skin of the patients is also affected by the treatment and there is increasing chance of affecting from viral infection associated with cancer which is one type of skin cancer (Stewart et al., 2009).

There is no such significant evidence which can suggest about the fact that the CLK patients have high chance of affected by cancer. However, some evidences have suggested that there is no such relationship between the kidney function and the disease of cancer (Wong et al., 2009). Small decrease in GFR indicates that the men have the risk of cancer. Decrease in the GFR implies that there is increasing risk of mortality including the cancer related complications. There are lots of debates surrounded by this topic of screening cancer in the CKD patients but there are no such guidelines or recommendations for improving the health condition of the CKD patients. There are many complications apart from the cancer among the CKD patients which lead them towards ultimate death for example heart disease (Collins et al., 2009). Furthermore, the patients are suffering from the cost of the treatment in the recent years where the screening of every CKD patient is very expensive.

Management of CKD

The doctors and nurses as well as the other experts in the hospitals or nursing homes try to consider variety of treatments and they decide the best treatment for the patients in order to improving their health condition. The major aim of the management of the hospitals or nursing home is to maximise the patient’s care by controlling the signs and symptoms of the CKD patients. The patients need proper care and support from the nurses as well as treatment where the doctors cooperate with them to improve the condition of kidney. It is necessary to improve the condition of kidney where the patients can prevent and minimise the risk of kidney failure. The diseases such as cardiovascular disease, cancer and bone mineral are also related to the kidney failure and it is the responsibility of the health care professionals to manage the diseases and help them to maximise their health condition.

As per the previous study, it has been seen that, one of the major activities of the kidneys is to act as a filter for the bloodstream, and remove waste and toxic products from the body which are excreted via urine. When kidney function is reduced as is the case for CKD patients, then waste products can build up and reach dangerous levels including normal electrolytes like potassium, which can be very dangerous for the heart if levels become too high. Treatment can focus on alleviating the factors associated with the underlying cause of the decrease in kidney function as measured using GFR. One of the causes of a decrease in kidney function is a narrowing of the kidney’s blood vessels, which are responsible for delivering approximately 20% of the total cardiac output to the kidneys to be filtered. If these high blood flow arteries become narrow, then they will not be able to carry as much blood at any given time. This means less blood will pass through the kidneys, so less blood will be filtered. As a result, waste products are not effectively removed from the blood and they can reach dangerous levels. This can also have the impact of raising the patient’s blood pressure, causing hypertension. This raises the risk of patients having heart attacks.

Regarding the treatment options, medication is one of the best ways to maintain the kidney functions and prevent other future diseases. Hypertension medication is a drug group which is used in this regard to manage the blood flow to the kidney (Vegter et al., 2012; Wolf and Ritz, 2005; Klahr and Morrissey, 1997; Navis et al., 1996). These drugs act to increase the GFR thus restoring kidney function, they do this by allowing the narrow blood vessels to dilate and become wider. This allows them to carry more blood at any given time, and therefore the kidneys can do a better job at filtering out the waste products. However, previous studies argued that these drugs are not good for health and these further worse the function of kidney among some CKD patients, because once the GFR falls below a certain amount, then these medications can actually reduce the blood flow even further (Onuigbo, 2011). As a consequence of this potentially dangerous side effects, hypertension medication must be utilised with great concern in patients with end stage kidney disease, whereby their GFR and hence kidney function is at a bare minimal level. Another benefit of the hypertension medication is that they act to reduce the patient’s blood pressure. This is of particular importance among the patients suffering from chronic kidney disease, who are already at a higher possibility of suffering from ischaemic events such as heart attacks. So keeping the blood pressure relatively low in chronic kidney disease patients will help reduce any further complications and also reduce the overall chance of death occurring.

Another major risk factor for chronic kidney disease is the occurrence of diabetes, which is an impairment in blood glucose regulation, where either the patient does not produce enough insulin (type 1 diabetes mellitus), or the patient’s body has developed a resistance to insulin overtime (type 2 diabetes mellitus). Both types of diabetes are characterised by high levels of blood glucose, which can have a variety of complications which are associated with chronic kidney disease. For instance, high glucose concentrations in the blood mean that the blood vessels can be damaged and changed over time. In diabetic patients, one of the most common blood vessels affected are those of the kidneys. The high glucose concentrations can damage the small blood vessels of the kidney and therefore reduce the GFR. This decrease kidney function can lead to chronic kidney disease. It is therefore very important to maintain very good control on blood sugar levels in diabetic patients. There are different ways to manage the high glucose levels in diabetic patients. Patients with type 1 diabetes can be given insulin which helps remove glucose from the blood. On the other hand, the patients who are suffering with type 2 diabetes can be given be given drugs such as metformin to improve insulin sensitivity.

Kidney Function Replacement

There are different medications for treating the complications of CKD patients, however it is risky as once the kidney function of the patients are damaged, and it is not possible to filter the blood sufficiently in the body which may lead the patients towards the end stage of kidney failure. In addition to these, the functions of kidney need to be carried out alternatively in order to prevent toxic accumulation. For the CKD patients, there are two main treatment which are dialysis and kidney transplant. The treatment of dialysis is clinical procedure for treating the patients carefully where the accumulated waste is filtered by an external machine, where the kidney is no longer removed the waste in the body (Rathinavelu et al., 2017). So in effect the dialysis machines become an artificial kidney, as it carries out the same function, just outside the body. In the same way blood is filtered by the kidneys, it can instead be passed through a machine with a thin membrane, via which waste products can diffuse through as well as excess electrolytes. Dialysis is an innovative and effective treatment for sustaining the kidney functions, but there are some side effects that may hamper the health condition of the patients suffering from CKD. However, the side effects are minor such as muscle cramps, skin irritation, infection etc. as the treatment is for long time (Wilkie, 2013).

Kidney Transplant

Another process, for treating the patients who are undergoing through the last stage of kidney disease, is kidney transplant (Hariharan et al., 2002). The treatment of kidney transplant is mainly utilised for the patients whose kidney s not functioning properly and the kidney of the CKD patients are replaced from a suitable donor. Healthy and proper kidney is inserted in the human body without removing their own kidney. This is conducted through surgical process and there may raise other complications such as infection and bleeding. It is risky for the patient to survive as the surgery is a long process. The treatment of kidney transplant is one of the best ways for improving the function of the kidney and helps the CKD patients to improve their health condition and immunity power. It is necessary to diagnose the patients for acknowledging their health condition and immunity power before the surgery and in this regard the main factors which must be considered are such as fitness, immunity power, other infection etc. It is therefore one of the best treatments for improving the patient’s care. The patients, who are going under the process of kidney transplant, commit to tale different medicines and meet the daily clinical appointment as they need proper monitoring and observations. There are some people who are not able to manage the surgery due to low immunity power and in this regard the health care professionals do not agree to advice the patients for kidney transplant. The patients, those are suffering from chronic infection, AIDS, have lower immunity power and in this regard the doctors do not suggest kidney transplant treatment for them (Hariharan et al., 2002).

Discussion

There are increasing numbers of patients who are suffering from the chronic kidney disease when the individual is growing old and it has been across the globe. The disease of hypertension, diabetes and kidney disease are occurred together frequently and the immune system of the patient is started deteriorating. Being overweight is also another problem where the people is suffering from obesity and it is also critical issue as this further raises the chances of heart attack and it is difficult to survive through the dialysis process as it is a long process for improving the kidney functions. Across the globe, the doctors and nurses are concerned about the treatment of kidney failure, but there are other diseases related to the chronic kidney disease such as infections, irritation, toxin substances and drugs. The doctors and health care professionals try to provide effective treatment worldwide to safe the patients and dialysis and medication are helpful for the patients to improve the functions of the kidney. Moreover, the kidney transplant is a long time process for the patients where proper observations and medical treatment are necessary for the individuals who are undergoing the process of kidney transplants. The study indicated that, there are increasing numbers of the patients who are undergone through the process of kidney transplant and it is becoming more successful treatment for improving the kidney functions of the patients.

In the recent years, as the disease of diabetes is increasing at a rapid rate among the social communities, there is also huge increase of the CKD patients who are suffering from kidney infections and malfunction of their kidney (Collins et al., 2009). This disease further raises lots of problems in the human body where the patients mainly notice problems when they are in toilet. The patients with chronic kidney disease face several problems in living normal lives such as premature mortality and morbidity which can lead the patients towards cardiovascular disease along with heart attack and it also affects the liver function, eyes and other body parts of the patients. The presence of albumin is the sign of the kidney disease where albumin is the major protein substance. The kidney disease is associated with other risk factors such as cardiovascular disease, strokes, cancer, damages of blood vessels and arteries and infectious disease which deteriorate the immune power of the human body of the patients who are suffering from the CKD. They are also suffering from injury of liver, malfunctions of the liver and that is also raising complications in the body. Major complications of the patients who are suffering from the CKD are such as incapability, tiredness, nausea, lack of minerals in the body, disorders in the digestive system due to liver damage and disorders of bones. Due to these complications, the patients cannot survive for long time though there are effective treatments for the individuals who are suffering from CKD such as dialysis and kidney transplant (Palmer et al., 2009).

There is high number sof the patents who have diabetes across the world and the disease of diabetes first attacks the kidney system leading to staring malfunctions in the kidney. These patients are suffering from CKD further which is critical to be resolved though there are effective government intervention and treatment for helping the patients who are suffering from the kidney damages. The best way for treating the kidney disease depend on the management strategy of the hospitals or nursing home as the doctors and health care professionals try to attend general meeting and diagnose the patients effectively so that their previous health record and immunity power can be acknowledged. Apart from that, he medical practitioners try to increase the social community program for improving awareness among the population for the non-communicable disease which further provides a scope to lower the burden of cost of the treatment related to kidney damages.

The disease of chronic kidney damages is generated in the human body from different factors such as diabetes, living style, working habits, hygienic issues and eating style and this further affects the kidney functions leading to kidney damages and ultimate death. The patients, who are suffering from the kidney disease and failure of the kidney as well as malfunctions, are unable to eat properly and start losing their weight and apart from that the immunity power to survive in life is also hampered. The main symptom is that blood starts to appear through urine and the condition of oedema in hands, swelling ankles and feet and other disorders in the body. The disease further raises the risk of hypertension and type 2 diabetes, where people are suffering from stress, obesity and depression and this can stop kidney to function normally in the body. This further raises the risk of heart problems and cardiovascular disease as well as it affect veins, arteries, nerves and coronary. Kidney stone is another cause of having CKD among the population across the globe and one common symptom for this disease is having enlarged prostate condition where other is the disease of lupus. CKD can be also the disease of inherited where other members of the family may be affected for the family history of CKD patients.

There are effective preventive care and treatment that can be helpful for the patients who are suffering from CKD and it further helps to reduce the complications and symptoms of the CKD (Levey et al., 2003). One of the vital steps is to stabilise the issue of hypertension where in this stage, the patients are undoing through depression which needs to be resolved and in this regard the social care professionals play significant role in reducing hypertension among the patients. There is realistic target for the patients who are suffering for CKD that there pressure needs to be less than 130/180mm Hg. As per the previous study, it can be stated that, less blood pressure indicates less arterial pressure leading to low progress towards the disease of chronic kidney damage. In order to treat the patients of CKD, drug related medication and treatment are good for them as there is high progression rate where the patients can recover their health condition and reduce the complications of having CKD. In this regard, the doctors and nurses are concerned about the prevention and control of the problems so that they can provide good treatment and better service to the patients for overcoming their present health issues (Nahas and Bello, 2005).

There needs to have clear process of treating the patients who are suffering from CKD and in this regard the monitoring process and treatment are in advance stage where the patients get quality acre and effective support from the doctors and other health care professionals (Morton et al., 2016). As the risk of failing the kidney function is high for the CKD patients, the treatment needs to be advanced and there should be personal clinical actions plan which provides a scope to the patients to recover soon. The doctors are concerned about the certain precautions such as lowering the risk of cardiovascular disease so that it is possible to lower the risk of CKD and the personalised treatment is effective in this regard for the patients as the doctors and nurses plan to develop proper treatment and actions that will be beneficial for the patients to recover their health (Nahas and Bello, 2005).

In the early stages of chronic kidney disease, it is very important when it comes to having a discussion with a specialised doctor who is in the field of chronic kidney disease and the team they work with that is supporting you. The information relating to chronic kidney disease that the doctor and the specialist team which is treating the individual talk about when in consultation with the patient can be regarded as important for the individual. Involving the immediate family will be a very good idea to have, a regular contact with the doctors and also with the close family. It will be vital to draw up a list of questions to help you understand what is happening to you as a CKD patient and what to expect. It is also important for your consultants to know what you are thinking about when experiencing symptoms and if you are concerned with any questions you might want to be answered. The more questions raised during consultations by the individual about their health can help the doctor and specialist to create the care plan the patient requires and this can make a difference when matching the correct treatment to the individual’s needs (NHS, 2018).

There are a variety of questions a patient can ask the nephrologists (the kidney specialist), these include questions such as: how does kidney failure occur and how to treat the disease. Finding out what measures can be used by a patient to look after their health and how individuals can look for the first indications of chronic kidney disease can be the first step into the light of the actual symptoms that relate to chronic kidney disease. The first warning sign of chronic kidney disease that worries the individual and prompts them to contact the doctor is not noticeable until the disease reaches the more advanced stages. A change to a healthy diet to ensure nutritional needs is met and arranging to see a renal dietician can also help the patient to understand what adjustments are needed to create a healthy eating plan. Frequent health problems that can progress to chronic kidney disease are hypertension and diabetes as these health conditions are directly linked to a decrease in kidney function. There are other problems that can also occur which result from a poor blood supplies such as heart disease and stroke. With CKD certain problems will occur where the entire body is not functioning. The following complications with chronic kidney disease will be bone, heart disease and water retention. Other health issues to monitor with CKD patients will be if they are having hypertension the amount of pressure put on the small vessels within the kidney leads to persistent damage to the kidneys (Webster et al., 2017).

The end stage of the renal disease comes with the following symptoms: feelings of sickness (including vomiting), do not feel like eating, being fatigue and becoming very weak. The sleeping routine becomes a problem and feeling the need to go the toilet more frequently. The need of remembering things becomes an issue because of loss of cognitive function. The patient starts having the symptoms of muscle cramps and muscle twitches. An early understanding about the treatment options are important as this enables management to continue along with the health care specialist to begin a kidney failure treatment or medical plan. There are a variety of factors which help to manage the CKD firstly to control the BP, by meeting the goals the blood glucose with the diabetes, checking the blood glucose level on a regular basis. The result can direct the patient to the food, medicines and physical activities, having regular checks to monitor the functioning of the kidneys. Taking part in regular physical activities can make this a part of the patient’s everyday exercise plan. The next thing will be to aim for a healthy weight as being overweight can also lead to many further complications (Levey et al., 2003).

Having a kidney transplant can be quite a journey as this can take up to two to three years in total. Individuals who require a kidney transplant but are unable to find a living donor which can be one of your blood intermediate family or a friend. The waiting time could be very long because the requirement for donated kidneys within the United Kingdom is higher which is available with the supply of the donors. It is more difficult to obtain a kidney donor from individuals of certain ethnic groups especially the South Asian, African and the Caribbean ethnic groups. Within these groups there seems to be a large decrease from these communities. When a donor is received from a living donor this procedure is a carefully planned operation. There are several risk factors which come with a kidney transplant, and this can include blood clots and infections throughout the body. The other main group of problems can be diabetes with an increased risk of getting infections these are connected to the medication that is needed to decrease the chance of the rejection of the kidney (NHS, 2018).

Conclusion

People who have undergone a kidney transplant are required to have regular appointments with their doctor to monitor their kidney function. Living a healthier lifestyle is important to avoid the complications the patients need to have a change around of stop smoking, having a healthy dietary, lose weight and take more steps to decrease the risk of getting infections. How long a kidney will last will have a lot of risk factors. This will include where the kidney came from in the first instance. In what condition it was in, came from a living donor and did the kidney matched with the blood group and the tissue type. What was the age of the person and was that individual healthy that got the kidney transplanted? The actual one-year survival rate for the average kidney transplant can be as high as 95 percent (NHS, 2018). The five-year survival rate is around the 85 to 90 percent range, whereas the rate for ten years is closer to 75 percent. If the kidney transplant does fail, the individual can be put back on the waiting list once again for a transplant once again but within this time the person will need dialysis until a successful donor is found. In England it is vital that the patient’s consent is obtained before any organs can be taken from their body for the purpose of donating. Most people are able to give their legal right to become a donor after their death, given they have capacity. An individual’s organs can also be donated with the decision of the individual’s relative or next of kin (NHS, 2018).

There is a great need for care guidelines regarding having excellent care and with cooperation management of CKD. The regularity of the damage kidney function of the kidney has been risen to a high rate within the adulthood population around 10% and 20% in most nations. When the decrease function of the kidney is noticeable now as one of the circumstances for the consequences and this will need immediate awareness in the population. A lot of measures need to be considered to be upgraded with the level of care given to the patient. When it come for caring with someone with CKD there are a number of approaches we need to consider by having a different route when caring for the CKD patient. Especially those in the medical field also the researchers. CKD need to have looked to improve by identifying the management skills needed when having a damage kidney with nil performance. A high level of aid is needed wither by the specialised team or doctors within the primary health care program (Wilkie, 2013).

There is a need to identify the chronic kidney disease early this will help with the patient having treatment early and preventing early deaths. It is known people who suffer from CKD dies before reaching the stage of getting dialysis treatment. The reason for this there is a great lack of identifying the CKD and to look of having the care packages customised to tackle the disease. The testing for chronic kidney disease is done too late and is transfer far too late to get the treatment commenced. This causes a great strain on the specialist and patients when you are diagnosis late. Patients would like to know if they have CKD early to get the best treatment and the right level of care.

The risk factors could be elevated from the patients’ mind knowing from an early stage can prolong their like. The other causes can be diabetes as this plays a large factor in CKD and hypertension. The patient can set goals by having a low reading or by setting a target of achieving low blood pressure. Once the disease of CKD is diagnosed it is important for the doctor and the care team help the patient to get the knowledge and the level of care that is now needed. The guideline need to be implemented for both the doctor and patients to have a great achievement. Knowing the actual condition that can encourage CKD the therapist and doctor need to get more education on a specialised level. Ongoing research is required to acknowledge this disease and who to manage the CKD patients. The need for an educational program to help patients understand the approach the ongoing studies and the delivering of care is needed. The understanding is the patient need to be understood within system of the caring and the health issues.

Due to the lacking of data from the result of patients who were not referred these were the ones the low GFR from the lab testing. Traditional and non-traditional risk factors are there for both the mortality. There are only a few comparisons in the developing studies expressing the contact of diminishing of the risk factors of progression on this disease CKD (Wilkie, 2013).

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