Chronic Kideny Disease

Question 1

What is CKD?

Answer 1

is a progressive, irreversible kidney disease.
● A client who has CKD can be free of manifestations
except during periods of stress (infection, surgery, and trauma). As kidney dysfunction progresses, manifestations become apparent.
● Older adult clients are at an increased risk for chronic kidney disease related to the aging process (decreased number of functioning nephrons, decreased GFR).
● Older adult clients who are on bed rest, confused, have a lack of thirst, and do not have easy access to water are at a higher risk for dehydration leading to chronic kidney disease.

Question 2

What are the risk factors?

Answer 2

• Acute kidney injury
• Diabetes mellitus
• Chronic glomerulonephritis
• Nephrotoxic medications (gentamicin, NSAIDs)
  or chemicals
• Hypertension, especially in African American clients
• Autoimmune disorders (systemic lupus erythematosus)
• Polycystic kidney disease
• Pyelonephrosis
• Renal artery stenosis
• Recurrent severe infections

Question 3

What are the stages of CKD?

Question 4

What are the s/s of CKD?

Question 5

What are the lab tests used to check for CKD?

Answer 5

• Urinalysis: Hematuria, proteinuria, and decrease in specific gravity
• Blood creatinine: Gradual increase over months to years for CKD exceeding 4 mg/dL; can increase to 15 to 30 mg/dL
• BUN: Gradual increase with elevated blood creatinine over months to years for CKD; can increase 10 to 20 times the creatinine finding
• Blood electrolytes: Decreased sodium (dilutional) and calcium; increased potassium, phosphorus, and magnesium
• CBC: Decreased hemoglobin and hematocrit from anemia secondary to the loss of erythropoietin in CKD