Chronic Kidney Disease

Chronic Kidney Disease

The kidneys are bean-shaped organs, about the size of a fist (150 grams) in a healthy person. There are two kidneys, located on either side of the spine, around the 12th rib.

Functions of the kidneys:

1. Eliminating waste through urine; the kidneys can filter waste from the blood at a rate of about 120-125 ml per minute.
2. Maintaining balance:
   1. Water balance
   2. Electrolyte balance
   3. Acid-base balance
3. Helping to produce enzymes and hormones:
   1. Angiotensin
   2. Erythropoietin
   3. Vitamin D

How to know when kidney function decreases:

• • • Feeling unwell due to an accumulation of waste in the blood
    • Fatigue, confusion, nausea, and loss of appetite
    • Anemia and easy exhaustion

Chronic kidney failure is a condition in which kidney function is impaired over a long period and progresses to end-stage renal disease (ESRD).

Kidney disease treatment methods

1. Hemodialysis: blood purification using an artificial kidney machine
2. CAPD (Continuous Ambulatory Peritoneal Dialysis): continuous peritoneal dialysis
3. Kidney transplant surgery

Hemodialysis

Blood is taken out of the body, passed through a filter in the artificial kidney machine to remove waste and excess water, and then returned to the body.

Advantages of hemodialysis

1. Quickly eliminates excess water and waste
2. Allows for increased nutrition and medication delivery
3. Lower risk of infection compared to peritoneal dialysis
4. Convenient, fast, and efficient
5. Requires a hemodialysis machine and an RO water system
6. Must be performed in a hospital 2-3 times per week
7. Requires blood-thinning medication
8. Potential complications during the process, such as low blood pressure, headaches, cramps, etc.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

This method removes waste and excess water from the body by introducing fluid into the abdominal cavity. Blood vessels in the abdominal cavity absorb waste through the peritoneal membrane, which acts as a filter to exchange waste.

Advantages of CAPD

1. Requires fewer personnel than hemodialysis
2. Patients can eat all types of food
3. Patients can walk and work normally, with full self-care capabilities
4. Suitable for patients with heart disease and long-term diabetes
5. Patients treated with this method usually do not have dark and dry skin like those treated with artificial kidney machines
6. Can be performed at home
7. Lower cost than hemodialysis
8. Better residual kidney function
9. Improved quality of life

Disadvantages of CAPD:

1. Higher risk of abdominal infection
2. Discomfort and bloating when fluid is in the abdomen

Nursing

Pre-treatment:

1. Administer medication according to the doctor's treatment plan.
2. Ensure the patient's comfort, both physically and emotionally.
3. Provide appropriate diet for the disease.

During kidney replacement therapy:

1. Administer medication according to the doctor's treatment plan.
2. Provide nursing care based on symptoms.
3. Monitor nutritional status.

Hemodialysis patients

During treatment

1. Complications can arise easily; nurses must provide close care.
2. Measure vital signs every 15 minutes for 1 hour.

After treatment:

1. Monitor potential complications such as dizziness and fainting.
2. Record vital signs periodically.
3. Assess the level of discomfort.
4. Weigh the patient and compare with pre-treatment weight.
5. Check the needle insertion site for bleeding.
6. If the patient experiences dizziness or fainting, report to the doctor.

Appropriate diet for chronic kidney disease patients undergoing dialysis:

• Low-protein diet: 40 grams per day.
• Use egg whites and fish as protein sources.
• Avoid animal organs.
• Avoid animal fats and coconut milk.
• Avoid salty foods and limit water intake.
• Avoid fruits except on the mornings of dialysis days.
• Avoid high-phosphate foods such as seeds, fresh milk, butter, and egg yolks.
• Consume vitamin B complex, vitamin C, and folic acid. Take vitamin D as prescribed by the doctor.

Caring for CAPD patients:

• Care requires a team of doctors, nurses, and nutritionists to teach the patient or their relatives how to change the dialysis fluid.
• Maintain hygiene and cleanliness of the body.
• If the skin is dry, use lotion.
• Weigh the patient and measure blood pressure daily.
• Exercise according to individual capacity.

The patient can eat all types of food.