NAME/NIM : SUCI MAHRESTU/F1F115022

CKD (CHRONIC KIDNEY DISEASE) AND ANEMIA

International Journal of Pharmacy Teaching & Practices, Vol5, issue3, Supplement I, 1020-1552.

1. Introduction Identification
Background :
Chronic renal failure is kidney damage that occurs for more than 3 months, based on
pathologic abnormalities or markers of kidney damage such as proteinuria3. In chronic renal failure,
the decline of kidney function occurs slowly3. The process of decline in renal function can continue
for months or years until the kidney can not function at all (end stage renal disease)3.
In the early stages of chronic renal failure. Perhaps, we can not find the clinical symptoms
because the kidneys are still able to adapt its functions3. In advanced stages, chronic kidney failure
can cause anemia with symptoms of weakness, fatigue, lethargy and shortness of breath. In the
accumulation of body fluids, it causes more swelling of the whole body3. Some patients show the
symptom that caused by the uremic condition (the level of urea in blood is increase) that is nausea,
vomiting and altered mental status (encephalopathy), with electrolyte imbalance. Renal ultrasound
examination can be helpful in diagnosing chronic renal failure3.

Problem identification :
Major cause of CKD (Chronic Kidney Disease) in the United States 1995-1999 is DM Type
1 (7%), diabetes mellitus type 2 (37%), hypertension and large vessel disease 27%, 10%
glomerulonephritis, interstitial nephritis 4%, cysts and other congenital diseases 3%, systemic disease
(lupus and vasculitis) 2%, 2% neoplasms. Based on Indonesian Society of Nephrology (Pernefri) of
2000, the most common cause of kidney failure are glomerulonephritis, diabetes mellitus,
hypertension, obstruction and infection4.

Objective :
The factors of chronic renal failure risk is with the patients of diabetes mellitus or
hypertension, obesity or smoking, age over 50 years, and individuals with a history of diabetes
mellitus, hypertension, and kidney disease in the family5. The preventing action toward the chronic
kidney disease should have been done at the early stadium of chronic kidney disease 5. Various
preventing action have prove its benefit to prevent kidney disease and cardiovascular, namely the
treatment of hypertension (the lower the blood pressure the smaller the risk of decline in kidney
function), blood sugar control, blood lipids, anemia, smoking surcease, increased physical activity
and weight control5.