Kidney Disease

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Chronic Kidney Disease
Eileen Daza-Gallego
The Center for Allied Health Nursing Education

Abstract

An estimated 26 million adults in the United States have Chronic Kidney Disease (CKD). Persons with CKD are unlikely to be aware of their disease and seek appropriate treatment before it is too late. Among those that have the disease, a large majority of them are obese and are suffering from diabetes or hypertension or both. The majority of the individuals with hypertension and/or diabetes will develop kidney disease as a result of non-compliance with the prescribed lifestyle change and/or medication prescribed. These patients account for the higher rate of chronic kidney disease in the United States. Efficacy of treatment for hypertension has been reduced mainly due to patient non-compliance with medication and lifestyle change advice (Lüscher TF, 1985). The same can be said for diabetes. Medical non-compliance is a major public health problem in the treatment of hypertension and diabetes, and the leading cause of CKD to date. In fact, an estimated 60% of patients take medication as prescribed (Gascón, Sánchez-Ortuño, Llor, Skidmore, & Saturno, 2003). Research has been conducted focusing on the understanding of this problem, but to date, the majority of the studies have been focused from the medical care point of view not the patient’s point of view which suggest that non-compliance could be associated with reservations about the drugs as well as a lack of knowledge on which to build and understanding of the condition and treatment. Although the study pertains to the disease of hypertension and the non-compliance of its medications, the same concept can be applied to the disease of diabetes and how the non-compliance of both diseases can lead to CKD.

Chronic Kidney Disease
A growing number of Americans have chronic kidney disease, but most remain unaware of it, hampering efforts to prevent irreversible kidney failure requiring dialysis or a transplant. An estimated 26 million Americans now have chronic kidney disease (CKD). The majority of the individuals with hypertension and/or diabetes will develop kidney disease as a result of non-compliance. What is chronic kidney disease?

Chronic kidney disease is any condition that may damage your kidneys and decrease the ability to filter waste products from your body. From 1999–2006, the National Health and Nutrition Examination Survey conducted a survey to determine the national average of Americans with kidney disease. Less than five (5%) percent of the participants during stage 1 or 2 (mild disease) reported being aware of having the disease. Of those with stage 3 (moderate disease), only 7.5% were aware and for stage 4, awareness was still less than half of 40% (Coresh J, 2007). For stage 3 or 4, 21% non-Hispanic blacks had the greatest level of awareness relative to their counterparts. Yet, non-Hispanic blacks are the highest group of Americans to be diagnosed with CKD. Awareness rates for CKD stage 3 or 4 were higher in those with combined diagnoses of diabetes and hypertension, but still quite low.

Facts about Chronic Kidney Disease:
* Heart disease is a major cause of death for all individuals with CKD. * Persistent proteinuria (protein in the urine) is another indicator that CKD is present and merits further studies. * Glomerular filtration rate (GFR) is the best estimate of kidney function. * High risk groups include those with diabetes, hypertension and a family history of kidney disease.   * Africa American, Hispanics, Pacific Islanders, Native Americans, and seniors are at increased risk. * Three simple tests that can detect CKD are blood pressure, urine albumin and serum creatinine. What can cause CKD?

Aside from glomerulonephritis, inherited diseases such as polycystic kidney disease, malformations (from birth), lupus, kidney obstructions, repeated urinary tract infections, and alcohol abuse,...
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