Shame, silence and resistance: How my narratives of academia and kidney disease entwine

2019 ◽  
Vol 29 (2) ◽  
pp. 269-285 ◽  
Author(s):  
Rose Richards

As an academic with a chronic illness, it has taken me a while to understand shame’s impact on my academic identity and choices. In this article, through a process of narrative recuperation, I consider the challenges and contradictions of living as an academic with chronic kidney disease, an incurable and often debilitating illness that, for the most part, is invisible to others. By means of evocative autoethnography, I trace the trajectory of silencing shame I experienced around my condition in academia and I show how and why this changed over a number of years. My aim in doing this is to uncover subjugated knowledge of what it takes to live as a chronically ill academic and to be an advocate for other academics living with chronic illness. I theorise my study using Garland-Thomson, Shildrick and Leder, all of whom have worked with the othering effect of shame on the nonconforming body. These theorists have described ways of resisting shame and, partly thanks to them, I was able to find ways of fighting back and recovering. My intention in sharing these illness narratives is to speak back to a dominant discourse that favours invulnerability and a masculinised, disembodied way of being academic.

2021 ◽  
Vol 9 (T4) ◽  
pp. 106-110
Author(s):  
Susanti Susanti ◽  
Difran Nobel Bistara

BACKGROUND: Chronic kidney disease (CKD) is a chronic illness with complex disease which could lead to other underlying diseases such as diabetes mellitus (DM), hypertension, and dyslipidemia. Urban population must manage their illness due to their occupation. Coaching support is an advanced method to help individuals manage their illnesses, especially chronic illness. Symptoms and complaints in early-stage renal disorders tend to be mild, making it difficult to diagnose only by clinical examination. Impaired kidney function can lead to progressive kidney damage. AIM: This study aimed was to analyze the effect of coaching support in maintaining kidney function in patients with CKD. METHODS: This research used quasi-experiment with pre-test and post-test with control group design. Respondents in this study were 40 CKD patients which were taken by consecutive sampling technique and divided into two groups, namely, control group and treatment group. Data were collected using blood urea nitrogen and creatinine values observation sheet. Coaching support was divided into four steps of therapy, identify the disturbance, identify based on experience, use a family support system, and evaluating the results. Data were analyzed using paired t-test and independent t-test with a significance of p < 0.05. RESULTS: This study found that there was a significant difference in kidney function between the control group and the treatment group (p = 0.000). Coaching support interventions were effective on kidney function in patients with CKD. The implementation of coaching support went well because respondents and families were proactive. CONCLUSION: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Christian Schnedl ◽  
Astrid Fahrleitner-Pammer ◽  
Peter Pietschmann ◽  
Karin Amrein

FGF23 is a bone-derived phosphaturic hormone that may become a useful biomarker for the identification of high-risk patients in chronic but also acute disease. It rises early in chronic kidney disease and is strongly and independently associated with excess morbidity and mortality. Emerging data suggest that FGF23 is also elevated in different scenarios of acute illness. In this review, we give an overview on the role of this interesting disease marker and potential and proven interventional strategies and discuss a blueprint for future research.


2015 ◽  
Vol 131 ◽  
pp. 31-39 ◽  
Author(s):  
Gavin Daker-White ◽  
Anne Rogers ◽  
Anne Kennedy ◽  
Thomas Blakeman ◽  
Christian Blickem ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Georges Tarris ◽  
Alexis de Rougemont ◽  
Marie-Anaïs Estienney ◽  
Julien Journet ◽  
Anne-Cécile Lariotte ◽  
...  

Abstract Background The recent COVID-19 pandemic has raised concerns about patient diagnosis and follow-up of chronically ill patients. Patients suffering from chronic illnesses, concomitantly infected by SARS-CoV-2, globally tend to have a worse prognosis and poor outcomes. Renal tropism and acute kidney injury following SARS-CoV-2 infection has recently been described in the literature, with elevated mortality rates. Furthermore, patients with pre-existing chronic kidney disease, infected by SARS-CoV-2, should be monitored carefully. Here, we report the case of a 69-year-old patient with splenic marginal zone lymphoma, suffering from longstanding chronic kidney disease following SARS-CoV-2 infection. Case presentation A 69-year-old male patient previously diagnosed with pulmonary embolism and splenic marginal zone lymphoma (Splenomegaly, Matutes 2/5, CD5 negative and CD23 positive), was admitted to the hospital with shortness of breath, fever and asthenia. A nasopharyngeal swab test was performed in addition to a CT-scan, which confirmed SARS-CoV-2 infection. Blood creatinine increased following SARS-CoV-2 infection at 130 μmol/l, with usual values at 95 μmol/l. The patient was discharged at home with rest and symptomatic medical treatment (paracetamol and hydration), then readmitted to the hospital in August 2020. A kidney biopsy was therefore conducted as blood creatinine levels were abnormally elevated. Immunodetection performed in a renal biopsy specimen confirmed co-localization of SARS-CoV2 nucleocapsid and protease 3C proteins with ACE2, Lewis x and sialyl-Lewis x antigens in proximal convoluted tubules and podocytes. Co-localization of structural and non-structural viral proteins clearly demonstrated viral replication in proximal convoluted tubules in this chronically ill patient. Additionally, we observed the co-localization of sialyl-Lewis x and ACE2 receptors in the same proximal convoluted tubules. Reverse Transcriptase-Polymerase Chain Reaction test performed on the kidney biopsy was negative, with very low Ct levels (above 40). The patient was finally readmitted to the haematology department for initiation of chemotherapy, including CHOP protocol and Rituximab. Conclusions Our case emphasizes on the importance of monitoring kidney function in immunosuppressed patients and patients suffering from cancer following SARS-CoV-2 infection, through histological screening. Further studies will be required to decipher the mechanisms underlying chronic kidney disease and the putative role of sialyl-Lewis x and HBGA during SARS-CoV-2 infection.


2021 ◽  
pp. 781-788
Author(s):  
Sirimalla Shivaprasad ◽  
Uday Venkat Mateti ◽  
Pradeep Shenoy ◽  
Chakrakodi Shashidhara Shastry ◽  
Sreedhar Dharmagadda

Medication therapy management (MTM) was first implemented and introduced for chronically ill patients and those taking multiple prescription drugs. The MTM has five steps, namely medication therapy review (MTR), personal medication record (PMR), medication-related action plan (MAP), intervention or referral, and finally, documentation. After receiving MTM services, patients will gain knowledge on medicines, which may decrease non-adherence to treatment and increase its efficacy. Studies have shown the positive impact of MTM on geriatric, pediatric, and chronically ill patients and those on polypharmacy. MTM services may improve medication adherence, decrease healthcare costs, and improve the quality of life (QoL) of patients with chronic kidney disease (CKD) by addressing various issues like anaemia, metabolic acidosis, protein management, fluid management, electrolyte management, dosage adjustment based on eGFR, vaccination, and medication-related problems and intervening with the education about the disease, drugs, and lifestyle modifications.


Blood ◽  
2019 ◽  
Vol 133 (1) ◽  
pp. 40-50 ◽  
Author(s):  
Guenter Weiss ◽  
Tomas Ganz ◽  
Lawrence T. Goodnough

Abstract Anemia of inflammation (AI), also known as anemia of chronic disease (ACD), is regarded as the most frequent anemia in hospitalized and chronically ill patients. It is prevalent in patients with diseases that cause prolonged immune activation, including infection, autoimmune diseases, and cancer. More recently, the list has grown to include chronic kidney disease, congestive heart failure, chronic pulmonary diseases, and obesity. Inflammation-inducible cytokines and the master regulator of iron homeostasis, hepcidin, block intestinal iron absorption and cause iron retention in reticuloendothelial cells, resulting in iron-restricted erythropoiesis. In addition, shortened erythrocyte half-life, suppressed erythropoietin response to anemia, and inhibition of erythroid cell differentiation by inflammatory mediators further contribute to AI in a disease-specific pattern. Although the diagnosis of AI is a diagnosis of exclusion and is supported by characteristic alterations in iron homeostasis, hypoferremia, and hyperferritinemia, the diagnosis of AI patients with coexisting iron deficiency is more difficult. In addition to treatment of the disease underlying AI, the combination of iron therapy and erythropoiesis-stimulating agents can improve anemia in many patients. In the future, emerging therapeutics that antagonize hepcidin function and redistribute endogenous iron for erythropoiesis may offer additional options. However, based on experience with anemia treatment in chronic kidney disease, critical illness, and cancer, finding the appropriate indications for the specific treatment of AI will require improved understanding and a balanced consideration of the contribution of anemia to each patient’s morbidity and the impact of anemia treatment on the patient’s prognosis in a variety of disease settings.


Sign in / Sign up

Export Citation Format

Share Document