1. Chapter 37 Chronic Kidney Disease: The New Epidemic

2. Chronic Kidney Disease: progressive loss of renal function which occurs in five stages which are based on level of renal function, using the glomerular filtration rate (GFR). Undiagnosed and untreated this disease will lead to end stage renal disease

3. Statistics 20 million Americans (1 in 9 adults) suffer from CKD
As of 2006 more than 470,000 Americans are being treated for ESRD.

4. 180,000 people with kidney failure 380,000 people with kidney failure
1990
180,000 people with kidney failure
2000
380,000 people with kidney failure
                                              Between 1990 and 2000, the number of people with kidney failure requiring dialysis or transplantation more than doubled. (NIH)

5. Kidneys The main functions of the kidneys are:
Maintenance of body composition
Excretion of metabolic end products and foreign substances
Hormone synthesis
Erythropoietin
Renin
Vitamin D3

6. Risk Factors for CKD CLINICAL FACTORS SOCIODEMOGRAPHIC FACTORS
Hypertension Older age
Diabetes US ethnic minority status:
Autoimmune diseases African American, American Indian,
Systemic infections Hispanic, Pacific Islander
Low birth weight Exposure to certain chemicals and
Reduction in kidney mass environmental conditions
Recovery from acute kidney failure
Exposure to certain drugs
Neoplasia
Family history of chronic kidney disease
Lower urinary tract obstruction

7. Signs and Symptoms of CKD
Fluid and electrolyte abnormalities:
Ex. hyperkalemia, metabolic acidosis, and volume overload.
Endocrine system abnormalities:
Ex.carbohydrate intolerance, bone disorders and secondary hyperparathyroidism.
Hematologic abnormalities:
Ex. anemia, or bleeding.
Neurologic system disturbances:
Ex. irritability, sleep disorders, muscle cramps, seizures and in advanced stages, coma and death.
Dermatologic symptoms
Ex. itching, pallor, and bruising

8. Treatment of CKD Medications Dietary Modifications Loss excess weight
Manage diabetes and/or blood pressure

9. End Stage Renal Disease: permanent failure of the kidneys to excrete wastes, concentrate urine, and regulate electrolytes.
About 84,000 ESRD patients died in 2004

10. Treatment for ESRD
Dialysis or kidney transplantation are the only treatments for ESRD.
Kidney transplantation has been shown to be associated with better survival than dialysis.
Dialysis: A routine procedure of removing wastes and fluids from the blood a process that would normally be done by the kidneys.