Counseling Kidney Failure 1

7/30/2019 Counseling Kidney Failure 1

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Ahfad University For Women

Dr. Reem Ibrahim Ahmed



In this Lecture we will cover:

1. Anatomy of the Kidneys

2. What is Kidney Failure

3. Types of KF4. Causes of KD

5. Treatment of KD



Anatomy

•

Most people havetwo kidneys, each

about 10

centimeters (4inches) long.

• They are positioned

in the back of thebody behind the

lower ribs.



Defining “CKD”

Kidney damage for ≥ 3 months, definedby structural or functional abnormalitiesof the kidney, with or without decreasedGFR(Glomerulornephritis), manifest byeither

Pathologic abnormalities, or

Markers of kidney damage, such asabnormalities of the blood or urine, orin imaging tests.

GFR < 60 mL/min/1.73 m2 for ≥ 3 months

with or without kidne dama e.



–GFR is widely accepted as the best

overall index of kidney function in

health and disease.1,2

–Normal GFR varies according to age,

sex, and body size; in young adults it is

approximately 120 to 130 mL/min/1.73

m2 and declines with age.

–A decrease in GFR precedes the onset

of kidney failure; therefore, a

persistently reduced GFR is a specific

indication of CKD.2



*Plantiga, Arch Int Med 168(20) , 2008

Stages of CKDStage Description GFR

1 Kidney Damage with normal ordecreased Kidney function

>90

2 Kidney damage with milddecrease in kidney function 60-89

3 Moderate decrease in kidneyfunction

30-59

4 Severe decrease in kidneyfunction

15-29

5 Severe decrease in kidneyfunction. Transplant or Dialysis

<15



Summary: What is CKD?

• CKD (chronic kidney disease)

–Means the kidneys are damaged and

may no longer filter blood well.

–This damage happens over many years.

–As more damage occurs, the kidneys

are unable to keep the body healthy—then dialysis or a kidney transplant

may be needed



Functions of the Kidneys

• Acts as a filter system• Gets rid of waste products

• Balances the body's fluid

• Produces hormones that controlblood pressure

• Produces the hormone Erythropoietin tohelp make red blood cells.

• Activates vitamin D to maintain healthybones



What causes kidney failure?

Pre renal: Bloodpressure, diabetes

Renal:polycystickidney disease,

infections

Post renal:obstruction

CongenitalDisorders PKD

(polycystic kidney

disease)

InfectiousdisordersPyelonephritisRenal absess,

renaltuberculosis



Symptoms of kidney failure

• Generally feeling ill

•lacking interest in everyday activities; difficulty inconcentrating or relaxing

• Tiredness and loss of energy

•

Shortness of breath• Altered taste sensation/appetite

• Increased night-time urine production

•

Sickness and nausea• Loss of libido/sex drive

• Itch

•

Swelling of the legs



Treatment of Renal Failure

• Kidney

transplant

• Medications

• Diet

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1- Phosphate Binders

• It can also cause itchiness and affect the

strength of the bones and joints.

•

being deposited on the blood vessel walls.2- Diuretics

3-Laxatives: Constipation

4- Blood pressure pills

• Problem with medications: they may

remain in the blood in high concentrations.

Me ications



Medications

4- Erythropoietin

5- Iron and Vitamins:

Vitamin D, C, B



Hemodialysis

–Blood is removed

and circulatedthrough an

“artificial kidney”

to remove excessfluid, electrolytes,

wastes

–Dialyzed bloodthen returned to

the patient



• Access

• Fistula

• Catheter

• the needles...

•

Complications• compliance

• session /4X3

• Centre/home

• Counseling

atmosphere



Peritoneal dialysis

–Uses the patient’s own

peritoneum as asemipermeable dialyzing

membrane

–Fluid instilled into

peritoneal cavity

–

Waste products drawninto the fluid, which is

then drained from the

peritoneal cavity



May be temporary or permanent

•Temporary:catheter inserted

into the peritoneal

cavity through theabdominal wall

• Long-term:

catheter isimplanted into the

peritoneal cavity

Ad h di l i



–Advantages over hemodialysis:

less anemia, reduced cost,

fewer dietary and fluidrestrictions, independence

closer to normal kidney

function –Disadvantages: risk of peritonitis (the major

complication) and catheter site infection,

hyperglycemia, elevated serum lipids, andbody image disturbance

–Three phases: inflow, dwell, and drain



• CAPD stands for Continuous Ambulatory

peritoneal dialysis because it happensthroughout the day, at home or at work,while the person goes about his or her dailylife.

• APDL An alternative to CAPD is anautomated kind of peritoneal dialysis (APD)in which the dialysate solution is changed

by a machine, at night, usually while youare asleep. This involves being attached tothe machine for between 8-10 hours.



Renal Transplantation/Kidney donation

–Healthy kidney from live donor (a relative)

or cadaver –Tissues must match or recipient will reject

new kidney

–Matching based on ABO blood groups andhuman leukocyte antigens

–Kidney donors must be at least 18 years of

age, free of systemic disease or infection,have no history of cancer or renal disease,have normal renal function, and be without

major medical problems



• Surgical procedure

–Donor kidney removed

from live donor in OR;taken to adjacent roomwhere the recipient has

been prepared –Cadaver kidney removed under sterile

conditions and transported to the hospital

where recipient is waiting –Donor kidney placed in recipient’s abdomen

and anastomosed (attached) to bladder and

blood vessels



Kidney Transplant

• Having a kidney transplant

• The waiting list/ Donor /live or cadever

• The relationship with the donor.

•

The operation• After the transplant Immune

suppressants.

• Complications

• Rejection

•

Assessing compliance/ ms/ QOL



How will dialysis affect your life?

• restrict activities on certain days , For

instance, if you work, you could be dialysed in

the evening.

• Travelling can also be a problem. Peritoneal

dialysis CAPD/ APD

• Restrictions



Plz drink lots

of waterKeep fit &

exercise



ANY QUESTIONS???



Thank You

Counseling Kidney Failure 1

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