End Stage Renal Disease

Education Project

Made By: Lauren Dinkelacker, Meredith Schulte, Lauren Shawgo, Madison Woodard, Mallory Lees, and Sydney Schultz

What is ESRD?

ESRD is when the kidneys stop working well enough for you to live without dialysis or a transplant. This kind of kidney failure is permanent. It cannot be fixed. Most cases of ESRD are caused by diabetes or high blood pressure. Some problems you are born with, some reactions to medicines, and some injuries can also cause ESRD. If you have ESRD, you will need dialysis or a kidney transplant to live.

Pathogenesis

In the event of declining renal function, the products of protein metabolism end up gathering in the blood inside of the urine because of the demise of the nephrons. Uremia will develop in the blood and will ultimately affect each and every body system. If the waste continues to gather and grow, the signs will be more severe. The specific declining rate of the kidneys has to do with the underlying reason of disorder and declines more quickly in people with large amounts of protein and with hypertension.

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Risk Factors

Risk factors for end-stage renal disease ESRD include age, race, gender, smoking, diabetes, education, weight, proteinuria, nocturia, genetics and recreational drugs. Risk for ESRD increases with age and men are more likely than women to develop it. African-Americans are also at a higher risk along with people that are not educated about this disease. Those that are overweight may also have an increase risk. Genetic factors have been identified which either increasing the risk of or quickening the progression of the disease. For people who smoke, smoking had been linked to the progression of renal disease also those with diabetes. Those that use recreational drugs such as opiates and cocaine have been linked to increase the likelihood of getting this disease along with overuse of over-the-counter pain medicine. Noturia applies to the people that frequently get up during the night to urinate which may increase your risk for developing ERSD.

Diagnostics

  • Blood tests- tests kidney function to determine level of waste products (creatinine and urea) in the blood
  • Urine tests- could identify the cause of the chronic kidney failure
  • Renal ultrasound – non invasive test - determines size and shape of the kidney and detects a mass, kidney stone, cyst, or other obstruction or abnormalities
  • Kidney biopsy - removal of tissue samples which determines if cancer or other abnormal cells are present and can also determine the cause of the kidney failure
  • CT scan

Treatments

ESRD cannot be cured, but treatment may be hepful. Medications help manage symptoms. In later stages, filtering the blood with a machine (dialysis) or a transplant may be needed.


Some prescription medication to help with kidney failure include Paricalcitol (Zemplar) and Calcitriol (Rocaltrol). Diuretics help rid the body of excess fluid. These are sometimes called

"water pills". Some diuretic medications are Furosemide (Lasix) and Bumetanide (Bumex). Self-treatment may include eating a low protein diet, and getting an adequate amount of iron and calcium carbonate.


One specific treatment choice is hemodialysis. Hemodialysis is a procedure that cleans and filters your blood. It rids your body of harmful wastes and extra salt and fluids. It also controls blood pressure and helps your body keep the proper balance of chemicals such as potassium, sodium, and chloride.


Another treatment choice is Peritoneal Dialysis. Peritoneal dialysis is another procedure that replaces the work of your kidneys. It removes extra water, wastes, and chemicals from your body. This type of dialysis uses the lining of your abdomen to filter your blood. This lining is called the peritoneal membrane.


A kidney transplantation is another treatment option available. Kidney transplantation is a procedure that places a healthy kidney from another person into your body. This one new kidney does all the work that your two failed kidneys cannot do.

Clinical Manifestations

Clinical manifestations of ESRD include a decrease in urination, inability to urinate at all, fatigue, headaches, unexplained weight loss, loss of appetite, nausea or vomiting, confusion, difficulty concentrating, dry or itchy skin, changes in the color of a person skin, bone pain, easily bruising, frequent nosebleeds, excessive thirst (dehydration), no menstruation, sleep apnea, swelling and edema in legs and hands, possible seizures, and numbness in hands or feet.

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Symptoms

The symptoms for acute and chronic renal failure may be different. The following are the most common symptoms of acute and chronic renal failure. However, each individual may experience symptoms differently.

Symptoms of Acute ESRD

(Symptoms of acute renal failure depend largely on the underlying cause.):

· Hemorrhage

· Fever

· Weakness

· Fatigue

· Rash

· Diarrhea or bloody diarrhea

· Poor appetite

· Severe vomiting

· Abdominal pain

· Back pain

· Muscle cramps

· No urine output or high urine output

· History of recent infection (a risk factor for acute renal failure)

· Pale skin

· Nosebleeds

· History of taking certain medications (a risk factor for acute renal failure)

· History of trauma (a risk factor for acute renal failure)

· Swelling of the tissues

· Inflammation of the eye

· Detectable abdominal mass

· Exposure to heavy metals or toxic solvents (a risk factor for acute renal failure)

Symptoms of Chronic ESRD


· Poor appetite

· Vomiting

· Bone pain

· Headache

· Insomnia

· Itching

· Dry skin

· Malaise

· Fatigue with light activity

· Muscle cramps

· High urine output or no urine output

· Recurrent urinary tract infections

· Urinary incontinence

· Pale skin

· Bad breath

· Hearing deficit

· Detectable abdominal mass

· Tissue swelling

· Irritability

· Poor muscle tone

· Change in mental alertness

· Metallic taste in mouth

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***OTHER FACTS***

One in 10 American adults (more than 20 million) have some level of chronic kidney disease

High blood pressure and diabetes are the two leading causes of kidney disease

Kidney disease is the 9th leading cause of death in the United States

Black Americans are 3 times more likely to experience kidney failure

Men with kidney disease are more likely than women to progress to kidney failure

Approximately 450,000 Americans are on dialysis and approximately 185,000 live with a functioning kidney transplant

Every day, 12 people die waiting for a kidney

Of more than 122,000 Americans currently on the waiting list for a lifesaving organ transplant, over 101,000 need a kidney. Fewer than 17,000 people receive one each year

References


Arora, P. (2015, April 7). Chronic Kidney Disease: Practice Essentials, Background, Pathophysiology. Retrieved from http://emedicine.medscape.com/article/238798-overview#a3


Chronic Kidney Disease - World Kidney Day. (2015, March). Retrieved from http://www.worldkidneyday.org/faqs/chronic-kidney-disease/


John Hopkins University. (2015). End Stage Renal Disease (ESRD). Retrieved from www.hopkinsmedicine.org/healthlibrary/conditions/kidney_and_urinary_system_disorders/end_stage_renal_disease_esrd_85,P01474/


Kostadaras, A. (2015). Ari Kostadaras, M.D. Nephrology-Hypertension-Dialysis. Retrieved from http://kostadara1.wix.com/kidneydoctor#!page3/cjg9


Mayo Clinic Staff. (2015, January 30). Chronic kidney disease Tests and diagnosis - Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/kidney-disease/basics/tests-diagnosis/con-20026778


National Kidney and Urologic Diseases Information Clearinghouse. (n.d.). Kidney Disease Statistics for the United States. Retrieved from http://www.niddk.nih.gov/health-information/health-statistics/Pages/kidney-disease-statistics-united-states.aspx


Wood, D. (2015, May). Symptoms Medications for End-stage Renal Disease (ESRD) Conditions. Retrieved from http://health.cvs.com/GetContent.aspx?token=f75979d3-9c7c-4b16-af56-3e122a3f19e3&chunkiid=19426