Kidney disease, chronic

In cases of chronic kidney diseases, a doctor should he consulted before using Bladder and kidney tea. 

Disorders of lipoprotein metabolism involve perturbations which cause elevation of triglycerides and/or cholesterol, reduction of HDL-C, or alteration of properties of lipoproteins, such as their size or composition. These perturbations can be genetic (primary) or occur as a result of other diseases, conditions, or drugs (secondary). Some of the most important secondary disorders include hypothyroidism, diabetes mellitus, renal disease, and alcohol use. Hypothyroidism causes elevated LDL-C levels due primarily to downregulation of the LDL receptor. Insulin-resistance and type 2 diabetes mellitus result in impaired capacity to catabolize chylomicrons and VLDL, as well as excess hepatic triglyceride and VLDL production. Chronic kidney disease, including but not limited to end-stage... 

Creatinine clearance < 60 mL/min/1.73 m2 (stages III-V chronic kidney disease), diabetes mellitus (with renal insufficiency), hypertension, chronic heart failure, cirrhosis, nephrosis, age >75 yr, cholesterol emboli syndrome, multiple myeloma (questionable)... 

Patients with diabetes and hypertension should initially be treated with either P-blockers, ACE inhibitors, ARBs, diuretics, or calcium channel blockers. There is a general consensus that therapy focused on RAAS inhibition by ACE inhibitors or ARBs may be optimal if the patient has additional cardiovascular risk factors such as left ventricular hypertrophy or chronic kidney disease.2,3,59,67... 

In patients with chronic kidney disease and hypertension, ACE inhibitors and ARBs are preferred, usually in combination with a diuretic.67 ACE inhibitors in combination with a thiazide diuretic are also preferred in patients with a history of... 

Chymostatin-sensitive Il-generating enzyme Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction Trial Collaborative Study Captopril Trial ( The Effect of Angiotensin-Converting Enzyme Inhibition on Diabetic Nephropathy ) calcium channel blocking agents Candesartan in Heart Failure Assessment of Reduction in Morbidity and Mortality Trial congestive heart failure, but the latest recommendations use HF for heart failure chronic kidney disease cardiac output... 

K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis 2004 43(5 Suppl 1) S1—S290. 

A 73-year-old man with a history of diabetes mellitus, chronic kidney disease, gout, osteoarthritis, and hypertension is hospitalized with possible urosepsis. He recently completed a 10-day course of antibiotics and was ready for discharge when his morning labs showed an increase in BUN and serum creatinine concentration. Upon examination, he was found to have 2+ pitting edema, weight gain, nausea, elevated blood pressure, and rales on chest auscultation. 

Father with a history of type 2 diabetes mellitus, hypertension, and stage 5 chronic kidney disease he died from a myocardial infarction at age 68 mother with a history of hypertension she died from injuries sustained in a motor vehicle accident at the age of 52... 

List the risk factors for progression of chronic kidney disease (CKD). 

O Chronic kidney disease is a progressive disease that eventually leads to renal failure [end-stage renal disease (ESRD)]. 

Chronic kidney disease (CKD), also known as chronic renal insufficiency, progressive kidney disease, or nephropathy, is defined as the presence of kidney damage or decreased... 

TABLE 23-1. NKF-DOQI Classification for Chronic Kidney Disease... 

FIGURE 23-1. Proposed mechanisms for progression of renal disease. (From Joy MS, Kshirsagar A, Paparello J. Chronic kidney disease Progression-modifying therapies. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 803, with permission.)... 

Ca-P, calcium-phosphorus product CKD, chronic kidney disease PTH, parathyroid hormone. 

Agarwal R, Curley TM. The role of statins in chronic kidney disease. Am J Med Sci 2005 333 69-81. 

Hudson JQ, Schonder KS. Advances in anemia management in chronic kidney disease. J Pharm Pract 2002 15 437-455. 

National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 2006 47 (suppl 3) S1-S146. 

Uric acid excretion is reduced in patients with chronic kidney disease, putting them at risk for hyperuricemia. In patients with persistently acidic urine and hyperuricemia, uric acid nephrolithiasis can occur in up to 25% of patients in severe cases, uric acid stones can cause nephropathy and renal failure. Extreme hyperuricemia can occur because of rapid tumor cell destruction in patients undergoing chemotherapy for certain types of cancer (see Chap. 85). 

Comorbid conditions can increase the risk of anemia substantially. Anemia is especially common in cancer patients receiving chemotherapy and patients with chronic kidney disease (CKD). The incidence of anemia in cancer patients varies based on tumor type and the level of myelo-suppression the chemotherapy regimen causes. For instance, serious anemia [hemoglobin 7.9 g/dL or less (79 g/L or 4.9 mmol/L)] occurs in at least 75% of patients who receive a common chemotherapy regimen for lymphoma, but serious anemia may occur in only approximately 10% of patients who receive common chemotherapy regimens for... 

High WBC/platelets may be from anemia of chronic disease, malignancy, or chronic kidney disease. 

Levey AS, Coresh J, Balk E, et al. National Kidney Foundation practice guidelines for chronic kidney disease Evaluation, classification, and stratification. Ann Intern Med 2003 139(2) 137-147. 

Adults and children 6 months of age and older who needed regular medical care or were in a hospital during the previous year because of a metabolic disease (such as diabetes), chronic kidney disease, or weakened immune system (including immune system problems caused by medicines or by infection with HIV/AIDS)... 

---