Chronic Kidney Disease:Clinical Presentation, Diagnosis, and Treatment

Chronic Kidney Disease (CKD)
Name
Institutional Affiliation
Chronic Kidney Disease
Introduction
CKD is a global health problem responsible for kidney failure or loss, cardiovascular disease, and higher mortality rates (Thomas, Kanso, & John R. Sedor, 2009). A significant portion of the United States population suffers from CKD. The disease ranks as one of the top ten leading causes of death. Hence, families, health institutions and related organizations and the government have directed significant financial engagement to alleviate the effects of the CKD. Chronic Kidney Disease is a broad terminology for heterogeneous diseases that alter the normal structure and functioning of the kidney as discussed by Daugirdas (2012). The disease is defined and classified as kidney damage or glomerular filtration rate (GFR) less than 60mL/min/1.73m2. In the earlier stages of the disease, patients are typically asymptomatic. Thus, treatment may be delayed if the first signs of manifestation are not detected. The purpose of this paper is to look into clinical presentation, diagnosis, and treatment of CKD. The paper also details on the role of patient factors in regard to diagnosis and treatment of CKD.
Clinical Presentation of CKD
In the early stages (stage one and two) of the disease, there are usually no symptoms. Blood and urine tests help reveal detectable manifestation of the disease. According to the Mayo Clinic (2008), clinical presentation of illness depends on the severity of renal dysfunction and relatable disorder. As levels of severity progress, signs and symptoms of the disease become more pronounced. Depending on the stage and underlying disease, CKD patients may show different signs and symptoms. Consequently, signs and symptoms appearing on stage three of the disease can be observed in stage four, in other patients. (Wong, Warady, & Srivastava, 2012) Polyuria is one the earliest presentation. Reduced renal concentration tends to accompany a significant decline in GFR. Proteinuria, discharge of urinary proteins observed for more than a month is an indication of CKD. In children, slower growth rate is typical. General symptoms of CKD include body weakness, fatigue, back pains, hypertension, anorexia, and vomiting. Systemic disease like Wegner's granulomatosis may result in systemic symptoms (Thomas, Kanso, & John R. Sedor, 2009).
Diagnosis of CKD
CKD detection is conducted on every individual reporting kidney failure for more than three months. Initial evaluation of patients is a crucial step towards attaining responsive treatment and management of the disease. CKD in most scenarios is a silent disease that will rather show signs that may point out to several diseases (Scottish Intercollegiate Guidelines Network, 2008). Initial diagnosis should focus on differentiating acute kidney disease or mechanical damage from CKD. Medical records from the past may be useful to accomplish proper diagnosis. Further, history of the patients will aid to reveal the possible cause or subjective conditions leading to CKD (Hartmann, Czock, & Keller, 2010). Considering family history and the element of hereditary renal dysfunction intervenes at this stage. Further, diagnosis related history should find current diseases and appropriate medication as mentioned by Daugirdas (2012). Such a holistic diagnosis attempts to eliminate risk factors that may lead to deterioration and progression of the disease, notes Arici (2014).
Physical examination tests are usually conducted with the objective of determining end organ damage of diseases which cause CKD (Arora & Batuman, 2016). Pulse test while patients are lying and standing are part of the physical examination. Funduscopic examination for hypertension and changes in diabetes are necessary. This form of eye examination helps reveal the microvascular damage present in the kidney. Secondary diagnosis observes the progress of the disease. Monitoring of the serum creatinine levels is part of the observation. Physical examinations conducted about the diagnosis of creatinine levels include heart sound testing. Laboratory tests to determine creatinine production levels to determine re...