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18th July 2012 @ 8:49am |
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Volume 6, Special Issue 2, Apr-May-Jun 2009POPULAR POPULAR POPULAR DID YOU KNOW?Improving Organ Donation Registration in Primary Care Organ transplants can save or dramatically improve lives, yet figures for 11 February 2009 showed there were 7,903 people in the UK still on waiting lists for transplants, with the majority waiting for a kidney transplant. Last year, more than 400 people died while on the transplant waiting list. POPULAR What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD. DISEASE FOCUSAnaemia of Chronic Kidney Disease Chronic kidney disease (CKD) is a multifaceted disease that has several associated complications. Anaemia is one of the most common complications that can develop early in the course of the disease process. It is associated with increased mortality, increased hospitalisation rates, and reduced quality of life. Lower levels of kidney function are associated with lower haemoglobin (Hb) levels and a higher prevalence and severity of anaemia. EDITORIALEditorial Chronic kidney disease (CKD) has moved rapidly up the healthcare agenda over the last few years. It has shifted from being considered as a rather nebulous condition of interest mainly to nephrologists to the front line of chronic disease detection and prevention in primary care as part of integrated management of vascular risk. In fact, the links between cardiovascular disease, kidney disease and diabetes are so close that CKD could also stand for cardiovascular, kidney, diabetes. EDITORIALEditorial Feel the fear and do it anyway. That could be the message of this special issue of the British Journal of Primary Care Nursing focusing on chronic kidney disease (CKD). Kidneys can be really confusing for practice nurses, with lots of technical sounding tests and numbers. But the good news is that the step-by-step guides and clear articles in this issue will help you get to grips with this important condition and feel empowered to make a real difference to the health and wellbeing of your patients. POPULAR Diet and lifestyle strategies are essential in the treatment and possibly in the prevention of chronic kidney disease (CKD). Dietary modification plays a fundamental role in helping to control increased levels of blood electrolytes and metabolic waste products that are often seen as renal function declines. Evidence already exists to support the benefit of dietary and lifestyle modification in the management of diabetes and hypertension, which are two of the leading causes of CKD, and evidence is emerging that diet is crucial in halting the progression of CKD. EVIDENCE IN PRACTICEEvidence in Practice There are just not enough hours in the day to read all the research journals, even if you wanted to. This section of BJPCN Evidence in Practice will keep you on top of relevant research without having to spend hours in the library. Each review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action that you might consider taking. HAVE YOU HEARD?Have you Heard? MONITORINGMonitoring Chronic Kidney Disease Practice The NICE guideline for chronic kidney disease (CKD) was introduced in 2008, with the aim of assisting practitioners both in primary and secondary care in the early identification and management of patients with evidence of kidney disease. However, some debate still exists surrounding the implementation of this guideline in everyday clinical practice. In this article, we sort out PREVENTION IN PRACTICEVascular Risk Checks in Patients with Chronic Kidney Disease QUALITY MATTERSChronic Kidney Disease and QOF: Ticking the Right Boxes for the Right Reasons The Quality and Outcomes Framework (QOF) was implemented in 2004 with the aim of ensuring that all patients had access to standardised, evidence-based care for their long-term condition. Points are awarded for meeting certain standards in each of these conditions and the number of points earned is translated into money that is paid to the practice. Chronic kidney disease (CKD) is one of the long-term conditions with QOF points for registering and monitoring. POPULAR Chronic kidney disease (CKD) affects renal drug elimination and other important processes involved in drug disposition, including absorption, drug distribution and non-renal clearance. As a result, the reduced renal excretion of a drug or its metabolites can cause toxicity and the sensitivity to some drugs is increased even if elimination is unimpaired. PATIENT INFORMATIONKidney Damage and What it Means to You POPULAR This article will discuss the evidence for the self-management of long-term conditions, with a focus on chronic kidney disease (CKD). Self-management of CKD can include activities to control and manage blood pressure (BP); changes to diet such as reduced salt intake; smoking cessation; and understanding of the action and side-effects of prescribed medicines. HANDS ONImproving the Care of Patients with Chronic Kidney Disease Chronic kidney disease (CKD) has a high mortality rate once it reaches the most severe stage. However, complications can be reduced and even prevented if it is diagnosed and treated earlier. Many people who develop CKD become symptomatic only when the disease is well established. By that point, the opportunity for some of the interventions aimed at minimising the impact of the disease has passed. Nurses working in general practice are well placed to recognise people at risk for CKD, diagnose them early and ensure that treatment is initiated and optimised to protect their renal and cardiovascular health. |
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