Chronic Kidney Disease essay

ChronicKidney Disease

ChronicKidney Disease

Chronic kidney disease is a healthcondition characterized by the gradual loss of kidney functions.Kidneys are vital organs in the body due to their primary function ofremoving waste and excess fluids from the body as urine. Theproduction of urine in the body involves a series of complexprocesses that require excretion and reabsorption. The processes arenecessary for maintaining the stability of body chemicals. Thekidneys regulate the level of potassium, salt, and acids in the body.They also produce hormones that control the functioning of otherorgans. For example, they secrete hormones that stimulate theproduction of red blood cells while other hormones regulate bloodpressure and monitor the metabolism of calcium (Meguid &amp Levin,2009).

Chronic kidney disease results inabnormalities such as having protein in the urine. Protein appears inthe urine after the kidney becomes dysfunctional for at least threemonths. Although there are many causes of kidney disease, the majorcause includes high blood pressure and diabetes. However, some kidneyconditions are inherited. Diabetes emanates from the inability ofthe body to make enough insulin. It results in high blood sugar levelthat overworks the kidneys and contributes to their failure. Diabetesis the primary cause of kidney disease (Meguid &amp Levin, 2009).

High blood pressure is also knownas hypertension. It occurs when there is a high force of blood in thearteries. The increase in pressure increases the supply of blood intothe kidneys, which further outworks them, resulting in kidneymalfunction, and later, the kidney disease. Other causes of theillness include glomerulonephritis that causes inflammation of thekidney`s filtering units. Kidney stones result from massive depositsof calcium into the organ, thereby, causing obstruction. Other causesinclude urinary tract infections and congenital diseases thatinterrupt efficient operation of the kidneys (Meguid &amp Levin,2009).

Kidney disease is a serious healthcondition that is associated with decreased quality of life,premature mortality and increased expenditures in healthcare. Whenuntreated, the disease results in an end-stage renal disease thatnecessitates a kidney transplant or dialysis. The key risk factorsfor kidney disease entail diabetes, hypertension, obesity, andcardiovascular disease. Statistics from a study conducted on theprevalence of the disease for the period 1999- 2004 indicates that17% of the U.S population below the age of 16 years has chronickidney disease. The prevalence rate shows an increase compared to thestudy conducted a decade earlier (1988-1994 that indicated theprevalence rate to be 15%) (Meguid &amp Levin, 2009).

Concerning comorbidity, researchrevealed that people with diabetes or cardiovascular disease had agreater prevalence of the chronic kidney disease compared to peoplewithout such conditions. Besides, the incidence of the disease bystage was as follows. Stage 1- 6%, stage 2-5% stage 3-5% and stage4/5 – 0.4%. Besides, statistics indicate that the chronic kidneydisease has a higher prevalence for people aged above 60 years at 39%compared to people between 40- 59 years with a prevalence of 13% andpeople between 20-39 years at 8.5%. The chronic heart disease has ahigh prevalence among people with less than high school education at22% compared to people with a high school education at 16%. Theprevalence of the disease among people with diabetes is 40% comparedto people without diabetes at 15%. The prevalence of the chronickidney disease among people with cardiovascular disease was 28.2%compared to individuals without the condition at 15%. The disease hasa high prevalence among non-Hispanic blacks at 20% compared toMexicans and Americans at 18.7%. Besides, there is a lower prevalenceof the disease among non-Hispanic whites at 16.1%. The racial/ ethnicdisparity in the prevalence of the disease is most pronounced amongpeople with stage 1 of the chronic kidney disease. The MexicanAmericans had a prevalence of 10.2%, the non-Hispanic blacks had arate of 9.4%, and the non-Hispanic whites had a prevalence of 4.2%(Meguid &amp Levin, 2009).

The chronic kidney disease isassociated with various effects on an individual and the society as awhole. The greatest impact of the disease is on the health of anindividual. The condition results in tremendous financial cost andloss of productivity that is associated with kidney failure. Personsaffected by the disease pose a substantial expense to the health caresystem. Patients diagnosed with an end-stage renal disease incurexponential costs. For example, in the U.S, the total cost of careprovided to patients diagnosed with chronic kidney disease amountedto 23 billion dollars from Medicare in the year 2006. The figurerepresents 6% of the total Medicare budget used on less than 1% ofMedicare beneficiaries (Meguid &amp Levin, 2009).

The key goal of healthy people 2020is to reduce the number of cases of the disease and itscomplications, death, disability and economic costs. The Healthypeople 2020 attributesthe condition to being the leading cause of premature deaths and acontributor to high medical cost in both the public and the privatesector. The key objectives of the organization are to reduce thekidney disease burden, to ensure longer quality lives of the U.S.citizens diagnosed with the disease and to eliminate the disparityamong patients with chronic kidney disease. Consequently, theorganization has initiated several programs to reduce the cases ofdiabetes, which are highly correlated with the disease inorder to achieve its objectives. The program aims at providingawareness to patients to take healthy diets, moderate exercises aswell as adopt weight reduction measures. The organization has alsodevised a strategy to oversee an increase in the number of organs fortransplants. The strategy was proposed after the Healthy people 2020observed a declining rate of kidney transplants. For example, thenumber of kidney patients receiving transplants within three years ofregistration has declined tremendously due to lack of donors.Consequently, the organization created the awareness program thatcalls people to donate their kidneys to individuals in need (Meguid &ampLevin, 2009).

Questionnaire

Thefollowing questions shall be administered to patients who visithealthcare facilities to enhance the identification of patients withchronic kidney disease.

Section 1: Kidney disease

Kindlyindicate your age–

1. Have you ever been told you have a kidney disease? a) Y b) N

(Ifno, skip to the next section)

2. How long has it been since you were first diagnosed? (Tick one)

1. &lt 1 year

2. 1-3 years

3. 3-5 years

4. 5-10 years

5. &gt 10 years

3. How was this diagnosed? (Check those that apply)

1. Blood test (elevated creatinine)

2. Protein in the urine

3. other: __

4. Have you been told what caused your kidney disease (e.g. diabetes, high blood pressure, glomerulonephritis, kidney stones, medication, related to surgery or severe medical illness)?

5. Have you ever had any of the following (Check if yes):

1. Kidney problems at birth or in childhood?

2. Hospitalization due to kidney failure?

3. Kidney failure while hospitalized for another reason?

4. Kidney stones?

5. Bladder or kidney infections?

6. Difficulty emptying your bladder?

7. Bladder or other urologic surgery?

8. Radiation to the abdomen or pelvis?

9. Chemotherapy for cancer?

10. Family history of kidney disease?

11. Blood in the urine?

12. Foamy urine?

Ifyou answered yes to any of the above, please enter more details here:Section II: Medications

1. Do you use regularly pain or antiinflammatory medicines or NSAIDS (i.e. Aleve, naproxen, ibuprofen, Motrin)?a) Yb)N

1. If yes, how often?(Circle one)

1. a)At least daily

2. b) 3 Times per week

3. c) Once a week

4. d)Once a month

2. Do you use herbal supplements? a)Yb) N

Section III: High blood pressure

1. Do you have high blood pressure or take medicine for high blood pressure? a) Y b) N (If no, skip to next section).

2. How long ago were you first diagnosed?

1. &lt 1 year

2. 1-3 years

3. 3-5 years

4. 5-10 years

5. &gt 10 years

3. Do you check your blood pressure at home? a ) Y b) N

4. If yes, how often?

1. Daily

2. Severaltimes per week

3. Once per week

4. Once per month)

5. How often is your blood pressure greater than 140/90?

1. Most of the time

2. Occasionally

3. Never

6. Do you add salt to your food?

1. No

2. Occasionally

3. Often

4. With each meal

7. Do you eat canned or processed food?

1. No

2. Occasionally

3. Few times a week

4. Every day

8. If you exercise, how often?

1. At least daily

2. 3 times per week

3. Once a week

4. Once a month

9. Do you snore? a).Y b). N

10. If yes, are you sleepy during the daytime or take frequent naps? a).Y b). N

11. Have you ever been hospitalized for high blood pressure? a).Y b). N

12. Have you had a stroke? a).Y b). N

13. Do you have heart failure? a).Y b). N

14. Have you had a heart attack? a).Y b). N

15. Have you had a surgery for arteries supplying the legs? a).Y b). N

SectionIV: Diabetes

1. Have you ever been told you have diabetes or prediabetes? a).Y b). N

(Ifno, skip to next section)

2. How long ago were you first diagnosed?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

3. Do you take or have you ever taken pills for diabetes? a).Y b). N

-Ifyes, how many years did you take it?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

-Ifyou have stopped taking, how long ago did you stop (yrs)?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

4. Do you take or have you ever taken insulin? a).Y b). N

-Ifyes, how many years did you take it?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

-If you have stopped taking, how long ago did you stop (yrs)?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

5. How well have your blood sugars been controlled? Usually

1. &lt 100

2. 100-150

3. 150-200

4. &gt 200

5. I don’t check them

6. Do you have eye disease from diabetes? a).Y b). N

7. Have you had laser treatment for your eyes? a).Y b). N

8. Do you have numb feet? a).Y b). N

SectionV: Anemia

1. Have you ever been told you were anemic, had a low blood or hemoglobin count? a).Y b). N

2. (If no, skip to next section).

3. How long ago were you first diagnosed?

1. &lt 1 year

2. 1-3 years,

3. 3-5 years

4. 5-10 years

5. &gt 10 years

4. Have you had to take medication to prevent anemia? a).Y b). N

Ifyes what type:

Folateor folic acid a).Y b). NDose:_

Iron(pills or injections) a).Y b). NDose:_

VitaminB12 a).Y b). NDose:_

(Epogenor Aranespa).Y b). NDose:_

5. Do you have any black stools? a).Y b). N

6. Do you have any bright red blood in your stool? a).Y b). N

7. Do you have any blood in your urine? a).Y b). N

8. If female, do you still menstruate? a).Y b). N

Ifyes, how often:_

References

Meguid, E.N., &amp Levin, A. (2009).&nbspChronickidney disease: A practical guide to understanding and management.Oxford: Oxford University Press.