Name: chronic kidney disease: testing, diet, and dialysis
Uploaded: 2025-06-19T09:32:48.000Z
Duration: 1 min 28 s
Channel: JoVE

Chronic Kidney Disease requires collaborative management.Diagnosis involves measuring the glomerular filtration rate and serum creatinine, with early signs like proteinuria.Imaging studies such as renal ultrasound assess kidney size and obstruction, CT scans detect stones and tumors, and kidney biopsy helps diagnose diseases like glomerulonephritis.Medical management involves controlling hypertension with ACE inhibitors or angiotensin II receptor blockers to protect kidney function.Hyperkalemia management involves dietary potassium restrictions and medications like patiromer; in emergencies, calcium gluconate stabilizes cardiac membranes, while insulin promotes cellular potassium uptake.Dialysis is indicated for patients with end-stage kidney disease or severe complications, like fluid overload, hyperkalemia, or metabolic acidosis.Options include hemodialysis, peritoneal dialysis, and continuous renal replacement therapy.Nutrition therapy limits protein intake to 0.6&#8211;1.0 g/kg/day for non-dialysis patients and 1.2&#8211;1.3 g/kg/day for dialysis patients.

chronic kidney disease iii: interprofessional care

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.<h3>Diagnostic approach for chronic kidney disease</h3>The diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well kidneys filter blood. Additionally, serum creatinine and blood urea nitrogen (BUN) levels are monitored to evaluate kidney health. Early signs of CKD often include proteinuria, an indicator of kidney damage that requires timely intervention to slow disease progression. Imaging studies provide insights into underlying conditions; for instance, renal ultrasounds measure kidney size and detect obstructions, while CT scans identify kidney stones and tumors. A kidney biopsy can confirm diagnoses such as glomerulonephritis in specific cases, facilitating precise treatment planning&#8203;.<h3>Medical management of chronic kidney disease</h3>Medical management centers on controlling hypertension, a major contributor to CKD progression. Blood pressure control, typically below 125&#8211;130/80 mm Hg, is achieved through ACE inhibitors or angiotensin II receptor blockers, reducing proteinuria and protecting kidney function. Additional risk factors like hyperglycemia, smoking, and obesity are addressed through lifestyle interventions and medications. Hyperkalemia, a common complication, is managed by limiting dietary potassium, using potassium-binding agents like patiromer, and stabilizing cardiac membranes with calcium gluconate in acute cases. Insulin administration is also effective as it shifts potassium back into cells&#8203;.<h3>Dialysis and treatment for end-stage kidney disease (ESKD)</h3>Dialysis becomes essential for patients with ESKD or severe complications, such as fluid overload, hyperkalemia, or metabolic acidosis. Depending on the patient's clinical status and preferences, treatment options include hemodialysis, peritoneal dialysis, and continuous renal replacement therapy. Dialysis filters toxins and excess fluids from the blood, compensating for lost kidney function and stabilizing electrolyte levels&#8203;.<h3>Nutritional therapy in chronic kidney disease</h3>Nutritional therapy plays a vital role in managing CKD. For patients not on dialysis, protein intake is generally limited to 0.6&#8211;1.0 grams per kilogram of body weight per day to reduce metabolic waste and kidney workload. Dialysis patients, however, require more protein due to protein loss during treatment, with a recommended intake of 1.2&#8211;1.3 grams per kilogram per day. Sodium, potassium, and phosphorus are also carefully regulated to maintain electrolyte balance and prevent complications like hyperkalemia and mineral bone disorders. A renal dietitian&#8217;s guidance is invaluable for individualized nutrition management and ensuring adequate caloric and nutrient intake&#8203;.

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease ...

chronic-kidney-disease-iii-interprofessional-care

Education

JoVE Core

Medical-Surgical Nursing

Unit 1

Management of Patients with Kidney Disorders

management-of-patients-with-kidney-disorders

KEY TERMS AND CONCEPTS

chronic kidney disease: testing, diet, and dialysis

Chronic kidney disease (CKD) is managed through testing, medicine, diet, and dialysis. It can progress through stages and may lead to end-stage kidney disease (ESKD) if it is not treated. Care often depends on teamwork among health professionals, and patient education helps people manage the condition and protect quality of life.

Doctors often track CKD by checking glomerular filtration rate, or GFR, which shows how well the kidneys filter blood. They also monitor serum creatinine and blood urea nitrogen, or BUN, to assess kidney health. Early CKD may show proteinuria, which means protein is found in the urine and can signal kidney damage.

Imaging and biopsy can help find the cause of kidney problems. A renal ultrasound can measure kidney size and look for blockages. A CT scan can identify kidney stones and tumors. In some cases, a kidney biopsy is used to confirm conditions such as glomerulonephritis and guide treatment.

Medical treatment focuses on controlling blood pressure, since hypertension is a major driver of CKD progression. Blood pressure is often kept below 125-130/80 mm Hg with ACE inhibitors or angiotensin II receptor blockers. These medicines can also lower proteinuria and help protect kidney function. Other risks, such as hyperglycemia, smoking, and obesity, are also addressed with lifestyle changes and medications.

A common complication of CKD is hyperkalemia, which means too much potassium in the blood. It may be managed by limiting potassium in the diet and using potassium-binding agents such as patiromer. In acute cases, calcium gluconate can help stabilize cardiac membranes, and insulin can move potassium back into cells.

Dialysis is needed for people with ESKD or severe problems such as fluid overload, hyperkalemia, or metabolic acidosis. Treatment options include hemodialysis, peritoneal dialysis, and continuous renal replacement therapy, depending on the person’s condition and preferences. Dialysis removes toxins and extra fluid from the blood and helps maintain electrolyte balance when the kidneys can no longer do this well.

Nutrition is also a major part of CKD care. For people not on dialysis, protein is usually limited to 0.6-1.0 grams per kilogram of body weight per day to reduce waste and lessen kidney workload. People on dialysis need more protein, usually 1.2-1.3 grams per kilogram per day, because some protein is lost during treatment. Sodium, potassium, and phosphorus are also watched closely, and a renal dietitian can help plan an individual diet.

Chronic Kidney Disease: Testing, Diet, and Dialysis

chronic-kidney-disease-testing-diet-and-dialysis

acute kidney injury i: introduction

Acute Kidney Injury: Signs and Stages

Acute Kidney Injury (AKI) is a sudden drop in kidney function that happens over hours to days. The kidneys cannot remove waste products from the blood as well as they should. This can cause metabolic acidosis, fluid overload, and electrolyte problems such as hyperkalemia. High potassium can lead to life-threatening heart rhythm changes. AKI is seen in both hospitals and outpatient settings. It can be caused by dehydration, sepsis, or nephrotoxic drugs, which are drugs that can damage the...

acute kidney injury ii: pathophysiology

Acute Kidney Injury: Causes and Kidney Damage

Acute kidney injury (AKI) can be grouped by where the problem starts in the kidney system. The three main categories are prerenal, intrarenal, and postrenal causes. This breakdown helps explain how kidney function is disrupted and supports clinical decision-making. Prerenal acute kidney injury is the most common type. It happens when blood flow to the kidneys drops, so filtration falls even though the kidney tissue itself is not directly damaged. Common causes include hypovolemia from...

acute kidney injury iii: clinical manifestations

acute-kidney-injury-iii-clinical-manifestations

Acute Kidney Injury: Stage Changes and Symptoms

Acute kidney injury (AKI) changes through three clinical stages: oliguric, diuretic, and recovery. Each stage has its own signs and care needs. The main pattern is a shift from low urine output to high urine output and then gradual healing. The oliguric phase is the first stage and usually lasts 10 to 14 days. Urine output drops to less than 400 mL per day, which shows that the kidneys are not working well. Fluid builds up in the body and can cause edema, high blood pressure, and distended...

acute kidney injury iv: diagnostic studies and prevention

acute-kidney-injury-iv-diagnostic-studies-and-prevention

Acute Kidney Injury IV: Testing and Prevention

Acute kidney injury (AKI) requires early testing and prevention to reduce kidney damage. AKI is linked to high mortality, with reported rates ranging from 10% to 80%. Careful monitoring helps identify at-risk patients before the injury becomes severe. Diagnosis starts with a detailed medical history. Clinicians look for prerenal causes, intrarenal causes, and postrenal causes. Prerenal AKI may follow dehydration, low blood pressure, or blood loss. Intrarenal AKI can result from nephrotoxic...

acute kidney injury v: interprofessional care

acute-kidney-injury-v-interprofessional-care

Managing Fluid, Potassium in Acute Kidney Injury

Acute kidney injury requires close care to manage fluid balance, potassium levels, medicines, dialysis, and nutrition. The goal is to support kidney recovery and prevent complications. Nurses and other clinicians often work together to watch for early changes and respond quickly. Fluid monitoring is a major part of care. Body weight, central venous pressure, and urine output are checked regularly. Intake and output are recorded to help prevent fluid overload, which can lead to pulmonary edema...

acute kidney injury vi: nursing management

acute-kidney-injury-vi-nursing-management

Acute Kidney Injury VI: Fluid Balance Care

Acute kidney injury can make it hard to keep fluid, electrolyte, and acid-base balance in range. Nursing care focuses on careful assessment and targeted actions to improve patient outcomes. A complete patient history is the first step. Nurses should ask about recent infections, nephrotoxic medications, and chronic conditions such as hypertension and diabetes that may contribute to acute kidney injury. The physical exam should look for fluid overload. Key signs include oliguria, which means...

chronic kidney disease i: introduction

Chronic Kidney Disease: Causes and Progression

Chronic kidney disease (CKD) develops when the kidneys slowly lose their ability to work. As the disease advances, it can lead to end-stage renal disease. At that point, the kidneys can no longer filter wastes or help maintain essential body functions, so survival depends on renal replacement therapy, such as dialysis or a kidney transplant. Early CKD can be hard to detect. Healthy nephrons, the kidney’s filtering units, often make up for damaged ones at first. This compensation can hide the...

chronic kidney disease ii: clinical manifestations

chronic-kidney-disease-ii-clinical-manifestations

Chronic Kidney Disease: Body System Effects

Chronic kidney disease affects many body systems as uremic toxins build up and disrupt normal cell function. As the kidneys lose filtering ability, symptoms can appear in the brain, skin, heart, lungs, digestive tract, blood, bones, and reproductive system. These changes often develop gradually, but they can become serious as the disease advances. Neurologic symptoms often appear early. People may feel tired, have headaches, feel confused, or have trouble concentrating. In severe cases,...

Chronic kidney disease (CKD) is managed through testing, medicine, diet, and dialysis. It can progress through stages and may lead to end-stage kidney disease (ESKD) if it is not treated. Care often depends on teamwork among health professionals, and patient education helps people manage the condition and protect quality of life. Doctors often track CKD by checking glomerular filtration rate, or GFR, which shows how well the kidneys filter blood. They also monitor serum creatinine and blood...

chronic kidney disease iv: nursing management

chronic-kidney-disease-iv-nursing-management

CKD Nursing Care: Assessment to Follow-Up

Chronic kidney disease nursing care focuses on assessment, monitoring, and follow-up to help prevent complications and keep patients stable. Nurses use a structured approach to slow CKD progression and support quality of life. Care starts with a full patient assessment. Nurses review medical history and look for risk factors such as diabetes, hypertension, and nephrotoxic drug use, which are medicines that can harm the kidneys. They also check for fluid retention, including peripheral edema,...

key terms and concepts

Learn how chronic kidney disease is diagnosed and managed with GFR testing, blood pressure control, dialysis options, and kidney-friendly nutrition.

Chronic Kidney Disease: Testing, Diet, and Dialysis | JoVE K12

JoVE Core Medical-Surgical Nursing offers comprehensive animated lessons that cover major systems of the human body, integrating anatomy and physiology with system-specific assessments. This collection encompasses disease conditions based on the body systems, detailing their pathophysiology, medical and surgical management, and nursing interventions. These lessons provide a clear and practical understanding of medical-surgical care, equipping students with essential skills for managing patient care in various clinical settings.

Chronic Kidney Disease: Testing, Diet, and Dialysis

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