Explanatory Model of Chronic Kidney Disease from the Perspectives of Patients and Healthcare Providers: Case Study in Chaiyaphum Hospital, Thailand

Chronic kidney disease (CKD) is a condition in which there is a gradual decline in kidney function. This disease is progressive and usually irreversible. Indications for hospitalized CKD patients with severe complications and do not allow inpatient therapy. This study was aimed to describe the overview and management of chronic kidney disease inpatient in Royal Prima General Hospital Medan. The type of research used is research with a descriptive and retrospective case study design. This study is based on medical record data related to inpatient CKD patients' diagnostic and management features at the Royal Prima General Hospital Medan in 2020. The research subjects were all inpatients diagnosed with CKD, whereas 100 research subjects with complete medical records were included in this study. It was found that the highest age group was 57-65 years, as much as 37.0%, and men as much as 27%. The chief complaint was shortness of breath at 43% and additional complaints, the most of which were fever + low back pain + edema at 38%. On physical examination, most of the inspections were weak, 55%. Most palpation was sociable 57%. There was auscultation of four abdominal regions and normal positive bowel sounds (93%). Complete blood count + blood sugar level + electrolytes + urea + creatinine 70%, the most combination medication is NaCl 0.9% + Furosemide injection 31%. Based on the length of stay, the longest was 13-14 days (20%).

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MEDICATION BURDEN AND INAPPROPRIATE PRESCRIPTION RISK AMONG ELDERLY WITH ADVANCED CHRONIC KIDNEY DISEASE

10.21203/rs.2.10876/v1 ◽

2019 ◽

Author(s):

Clarisse Roux-Marson ◽

Jean-Baptiste Baranski ◽

Coraline Fafin ◽

Guillaume Extermann ◽

Cecile Vigneau ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Elderly Patients ◽

Healthcare Providers ◽

Antihypertensive Agents ◽

The Elderly ◽

Anticholinergic Drugs ◽

Cross Sectional ◽

French Study ◽

Sectional Analysis

Abstract Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were analyzed according to route of administration, therapeutic classification, and their potential inappropriateness for these patients, according to Beers' criteria. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 88% of patients had at least 1 medication classified as a RIM, and 21% of those were contraindicated drugs. At least 1 PIM was taken by 68.9%. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.

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Role of Ayurveda in the management of chronic kidney disease: A case study

Journal of Ayurveda Case Reports ◽

10.4103/jacr.jacr_4_20 ◽

2020 ◽

Vol 3 (1) ◽

pp. 14

Author(s):

Alka (Babbar) Kapoor ◽

PoonamGulati Dang

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease

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Strategies designed to increase the motivation for and adherence to dietary recommendations in patients with chronic kidney disease

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa177 ◽

2020 ◽

Cited By ~ 1

Author(s):

Raíssa Antunes Pereira ◽

Marle S Alvarenga ◽

Carla Maria Avesani ◽

Lilian Cuppari

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Healthcare Providers ◽

Poor Adherence ◽

Counseling Skills ◽

Dietary Recommendations ◽

Factors Associated ◽

The Poor ◽

Positive Results ◽

Counseling Approach

Abstract Chronic kidney disease (CKD) often requires several dietary adjustments to control the disease-related disturbances. This is challenging for both patients and healthcare providers, and particularly for dietitians, who deal closely with the poor adherence to dietary recommendations. Factors associated with poor adherence within the CKD scenario and the need for a shift in the paradigm have already been indicated in several studies; however, rarely are any different and/or potential strategies actually formulated in order to change this paradigm. In this review, we aimed to explore the concepts and factors surrounding adherence to dietary recommendations in CKD and further describe certain potential strategies for a nutritional counseling approach. Such strategies, while poorly explored within CKD, have shown positive results in other chronic disease scenarios. It is timely, therefore, for healthcare providers to acquire these new counseling skills; nevertheless, this would require a rethinking of the traditional attitudes and approaches in order to build a partnership, based on a nonjudgmental and compassionate style in order to guide behavior change. The reflections presented in this review may contribute towards enhancing motivation and the adherence to dietary recommendations in CKD patients.

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P-52 Delivering advance care planning in chronic kidney disease (CKD): The perspectives of healthcare providers

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2015-000978.182 ◽

2015 ◽

Vol 5 (Suppl 2) ◽

pp. A59.2-A59

Author(s):

Marcus Sellars ◽

A Tong ◽

William Silvester ◽

Carol Pollock ◽

Tim Luckett ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Advance Care Planning ◽

Healthcare Providers ◽

Care Planning ◽

Advance Care

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MANAGEMENT OF CHRONIC KIDNEY DISEASE THROUGH AYURVEDA – A CASE STUDY

10.36106/gjra/7800683 ◽

2020 ◽

pp. 14-15

Author(s):

Bhanu Pratap Singh ◽

Chhaju Ram Yadav

Keyword(s):

Chronic Kidney Disease ◽

Renal Transplantation ◽

Kidney Disease ◽

Alternative Therapy ◽

Herbal Drugs ◽

Adequate Treatment ◽

The World ◽

Prevention And Treatment ◽

Reduced Renal Function

Chronic kidney disease is progressive forms of renal disorders associated with reduced renal function having no well known etio-pathogenesis. The conventional approach of management includes dialysis and renal transplantation, which are involving the high costs and complexity so very few patients are able to obtain adequate treatment for kidney disorders because of financial limitation. Therefore, exploration of a safe and alternative therapy is needed, which proves to be helpful in reducing the requirement of dialysis and in postponing the renal transplantation. The use of herbal drugs for the prevention and treatment of various diseases is constantly developing throughout the world. The present case is totally treated through Ayurvedic approach and it seems to be effective and safe.

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Chronic Kidney Disease of Uncertain Etiology in Sri Lanka: Curing between Medicine and Traditional Culture

Social Sciences ◽

10.3390/socsci11010020 ◽

2022 ◽

Vol 11 (1) ◽

pp. 20

Author(s):

Chandani Liyanage

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Lifestyle Changes ◽

Ethnographic Study ◽

Unknown Etiology ◽

Analysis Model ◽

The Past ◽

Lay People

Chronic Kidney Disease of unknown origin (CKDu) has appeared across Sri Lanka’s North Central Province (NCP) since the 1990s as an epidemic, unexplained by conventional associated risk factors. During the past few decades, a large number of studies attempted to determine the unknown etiology of CKDu. Despite these investigations, no concrete conclusions were developed, though a number of contradictory hypotheses emerged. The present ethnographic study was carried out in two endemic areas, labelled as “CKDu hotspots”, and illuminates how curing takes place between biomedicine and traditional cultural practices. Our ethnographic study thoroughly scrutinized three decades of lived experience, lay-perceptions and local discourses on CKDu. We used a qualitative study design with a transcendental phenomenological approach and employed a mixture of ethnographic methods. Data collection techniques included participant observation, in-depth interviews, focus group discussions and key informant interviews. Data was analysed by using an interpretive thematic analysis model. Findings revealed that lay people have constructed a popular discourse on CKDu, and we explored their views on the origin, etiology and prevalence of CKDu in their locality over the past few decades. Patients’ narratives revealed that there were currently a number of gaps in service delivery. These were mainly due to distant relationships between healthcare providers and CKDu patients. Lay people in affected communities were marginalized throughout the investigation process to determine the unknown etiology, their involvement marginalized to merely acting as objects for scientific instigation. The affected communities strongly believed that CKDu was a recent phenomenon resulting from the mismanagement of the natural environment due to social and lifestyle changes. These findings highlight local dynamics of healthcare seeking behaviours which demand complementary medicine system, particularly given the number of limitations in the biomedical system. Empirical evidence generated from this study suggests a conceptual shift to an ethno-medical model to address CKDu. Improving cultural competency and communication skills among healthcare providers in public health are crucial in order to apply a “bio-psychosocial perspective” in healthcare delivery system and bridging the gap between hospital and the community.

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Eradication Of Combined Hepatitis B (HBV) And C (HCV) In Patients With Chronic Kidney Disease On Chronic Hemodialysis. A Case Study And Review Of Literatures

Nephrology & Renal Therapy ◽

10.24966/nrt-7313/100025 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1-5

Author(s):

Mohammed Al-Homrany ◽

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Hepatitis B ◽

Chronic Hemodialysis

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When Heart Failure Collides with Diabetes and Chronic Kidney Disease: Challenges and Opportunities

Cardiorenal Medicine ◽

10.1159/000520909 ◽

2021 ◽

Author(s):

Kris Vijay ◽

Brendon L. Neuen ◽

Edgar V. Lerma

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Clinical Evidence ◽

Metabolic Risk ◽

Downstream Effects ◽

Increased Risk ◽

Challenges And Opportunities ◽

Treatment Plans

Background: Heart failure (HF), diabetes mellitus (DM), and chronic kidney disease (CKD) are commonly occurring and interlinked conditions. Approximately 25% to 40% of patients with HF have DM, and approximately 40% to 50% of patients with HF have CKD. Both DM and CKD are associated with increased risk of incident HF. Further, 40% of people with DM develop CKD, making DM the leading cause of kidney failure globally. Importantly, 16% of patients with HF have both comorbid DM and CKD, and the combination of these 3 comorbidities is associated with substantially increased risk for hospitalization and mortality. Mechanisms that underlie the relationships between HF, DM, and CKD are complex but likely relate to shared cardiovascular and metabolic risk factors, as well as downstream effects on inflammation, oxidative stress, and neurohormonal pathways. Summary: This review outlines the epidemiology and links between HF, DM, and CKD, as well as current clinical evidence for the treatment of individuals with a combination of these comorbidities. A case study of a patient with concomitant HF, DM, and CKD is discussed to explore potential treatment approaches for patients in whom all 3 comorbidities exist. Key Messages: Treatment plans for patients with a combination of these 3 comorbidities should consider the available clinical evidence.

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