The kidneys in the human body are required to filter all the blood in an individual’s organism every half an hour. These organs perform the job of removing wastes, toxins, and excess fluid and participate in the process of blood pressure control, stimulate the production of red blood cells, and regulate blood chemicals, which are essential for life. However, many people all over the world have chronic kidney disease (CKD). In the United States, it is one of the diagnoses with a high level of mortality. This condition is characterized by the damage of an individual’s kidney, leading to its inability to filter blood properly. According to estimations, this condition can lead to serious health problems as a stroke or heart attack, diabetes, and high blood pressure (Centers for Disease Control and Prevention [CDC], 2020). However, medical science has found many facts about the disease to be able to detect it in time to apply treatment and prevent further damage to the organism.
Medical Information on Kidney Disease
Definition and Main Characteristics
Chronic kidney disease is the damage of kidneys, which does not allow the organ to clean the blood properly. According to the definition, CKD is a “condition that causes reduced kidney function over a period of time <…>, may develop over many years and lead to end-stage kidney (or renal) disease (ESRD)” (National Institute of Diabetes and Digestive and Kidney Diseases [NIH], 2016, para. 4). The statistics of the Centers for Disease Control and Prevention show that in the United States, there are more than one in seven adults having this condition (2020). There are certain risk factors, which are important to consider: diabetes, high blood pressure, heart disease, family history of CKD, and obesity. In case a person has one or a few of these problems, they should be careful and take a regular examination of their kidneys’ function. It will help to prevent serious consequences, such as anemia, increased risks of infections, low calcium, high potassium, and high phosphorus levels in the blood, loss of appetite, and depression. In severe cases, CKD can lead to serious health conditions, including heart and pressure problems, which can evolve into strokes or heart attacks and become lethal.
Concepts and Theories about the Disease
There are a few theories and models, which have been examined in predicting and improving long-term medication adherence for patients having CKD, including the common-sense model, theory of planned behavior, Orem self-care, and health belief model (Chironda et al., 2019). The first model is aimed at explaining ways “in which patients are conscious of and able to formulate interventions to cure their health threat” (Chironda et al., 2019, p. 52). The position implies that the outcome depends on the perceptions of the patient, and making them change their lifestyle towards a healthier one is a key for recovery. The second theory was compound from a few components: perceived behavioral control and intention, attitudes, and subjective and social norms (Chironda et al., 2019). According to this model, the attitudes of the patient define the possible outcomes. However, this theory does not consider factors beyond an individual’s voluntary control, such as emotions and religious beliefs.
The third theory, the Orem self-care model, facilitates the care of CKD patients. Its three basic nursing systems are “the wholly compensatory nursing system, the partly compensatory, nursing system, and the supportive educative system” (Chironda et al., 2019, p. 53). The main idea of this approach is the active participation of patients. According to the theory, patient-centered care helps to make the lives of these people better. However, this method was proved to be insufficient in predicting and improving adherence behaviors of patients suffering from CKD. The last theory is the health belief model, which predicts and explains health behaviors on the basis of the balance of the barriers and benefits of undertaken action (Chironda et al., 2019). The theory implies that the effectiveness of any health behavior is influenced by the perception of its possible benefits and barriers, although it does not take into consideration emotions, either. All of the theories of kidney disease have their strong and weak points, and the studies of their applications continue as there is no model, which could answer all the questions.
Statistics of the Disease
CKD is an important health issue as it is a reason for the death of many people all over the world. According to the statistics, in the United States, there is 15% of the adult population or 37 million people, are suffering from this disease (CDC, 2021). The current estimates demonstrate that the condition is more typical for people aged 65 years or older (38%), while there is 12% of people of 45–64 years, and only 6% of those of 18–44 years (CDC, 2021). CKD “is slightly more common in women (14%) than men (12%) and is more common in non-Hispanic Black adults (16%) than in non-Hispanic White adults (13%) or non-Hispanic Asian adults (13%)” (CDC, 2021, p.1). According to the studies, kidney disease is the ninth leading cause of death in the United States (CDC, 2020). The estimations show that every year the condition kills more people than breast or prostate cancer. For example, in 2013, more than 47,000 Americans died from CKD (NIH, 2016). However, today, the mortality rates for these patients decrease every year as the medicine becomes more progressed, allowing to detect of the disorder in time to prevent lethal consequences.
Symptoms and Ways of Detection
Typically, people with CKD have no symptoms in the early stages of the condition development. Due to this reason, it is often undetected until it is advanced and requires more serious solutions. This fact made experts refer to the disorder as a “silent disease” (NIH, 2016). According to CDC, as many as 9 in 10 adults with CKD are not aware of their condition, and approximately 2 in 5 adults with severe forms do not know about it, as well (2021). The only way to detect CKD at the early stages is with the help of specific blood and urine tests, which include measurement of the creatinine level in the blood and protein in the urine. As the disease progresses, there may appear symptoms, indicating problems with kidneys. They may include poor appetite and weight loss, swollen limbs, difficulties with breathing, fatigue, blood in urine, insomnia, the itch of the skin, muscle cramps, headaches, and erectile dysfunction in men.
Evolution of the Disease
CKD is usually developed progressively through time and can lead to kidney failure in the end. There are five stages of the condition evolution:
- Damage with normal kidney function (estimated Glomerular Filtration Rate (GFR) equals or more than 90 mL/min per 1.73 m2) and persistent (more than three months) proteinuria.
- Damage with mild loss of kidney function (estimated GFR 60-89 mL/min per 1.73 m2) and persistent (more than three months) proteinuria.
- Mild-to-severe loss of kidney function (estimated GFR 30-59 mL/min per 1.73 m2).
- Severe loss of kidney function (estimated GFR 15-29 mL/min per 1.73 m2).
- Kidney failure, which requires urgent dialysis or transplant, is also called ESRD (estimated GFR <15 mL/min per 1.73 m2) (NIH, 2016).
Due to the fact that CKD is a disease characterized by progressive development, it is important to detect it as soon as possible. Considering the fact that the disease is usually hidden and shows no signs or symptoms, it is crucial that a person is careful about their health and takes a regular examination. In case CKD is detected in time, today, there are numerous ways for helping people with this condition, which help to evade the fatal outcome and to prevent kidneys from losing their function.
Treatment of Kidney Disease
There are no medications to cure patients with CKD, but treatment can help reduce symptoms and stop the disease from progressing. The measures, helpful in coping with the disorder signs, depending on the stage and may include lifestyle changes, medicine for associated problems, dialysis for replicating part of the kidney’s functions, and kidney transplant in advanced forms (NHS, 2019). There are actions available to any person to keep CKD from development. Among them are staying active and performing regular exercise, which helps to lose weight in case of obesity and have normal blood pressure and sugar levels. In case an individual has diabetes, it is critical to stay in the target blood sugar range as much as possible. If a person has one or more risk factors, there is a need for a regular examination for CKD. When an individual already has detected kidney disease, they should consult a dietician to create a healthy eating plan, take medications according to the instructions of the doctor, and quit smoking as it can worsen the condition.
For an advanced stage of the disease, there is an option of dialysis, which may be essential in cases when the kidneys eventually stop performing their function. This is a method of “removing waste products and excess fluid from the blood” (NHS, 2019). There are two types of dialysis: hemodialysis and peritoneal dialysis (NHS, 2019). Hemodialysis is usually performed three times a week and implies diverting blood into an external machine, where it is filtered and then being returned to the body. Peritoneal dialysis is done several times a day, and during it, fluid is pumped into a space inside the belly to “draw out waste products from the blood as they pass through vessels lining the inside of tummy” (NHS, 2019, para. 51). Treatment with dialysis usually requires to be done for the rest of the life. Another option for helping a patient with an advanced stage of CKD is a kidney transplant, involving serious surgery and the later necessity of taking medicines suppressing the immune system for a lifetime.
Chronic kidney disease is damage, interfering with the normal functioning of the organ, leading to such health conditions as strokes and heart attacks. The disorder is characterized by an absence of signs and symptoms, which often leads to late detection when its development and cannot be stopped from progressing by conservative treatment. Advanced forms of CKD demand such serious measures as dialysis or kidney transplant, while early stages require only the change of lifestyle and supportive medications for corresponding diseases. In case the disorder is not detected in time, it can become lethal. To prevent it from happening, a person needs to evaluate the risk factors, proved to influence the condition’s appearance, and perform regular examinations to detect possible problems in time to be able to stop them from developing.
Centers for Disease Control and Prevention. (2020). Chronic kidney disease basics. Web.
Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2021. Web.
Chironda, G., Bhengu, B., & Manwere, A. (2019). Models and theories of care applicable to predicting and improving adherence behaviours among chronic kidney disease (CKD) patients. Rwanda Journal of Medicine and Health Sciences, 2(1), 48-58. Web.
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Kidney Disease Statistics for the United States. Web.
NHS. (2019). Treatment. Chronic kidney disease. Web.