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  • Bimbingan Chronic Kidney Disease

    Загружено:

    Muhammad Haris Firdaus
    59 просмотров15 страниц
    1. The document defines chronic kidney disease (CKD) as either kidney damage lasting at least 3 months as shown by abnormalities in structure/function tests or a glomerular filtration rate (GFR) below 60 mL/min/1.73m2 for at least 3 months. 2. Common causes of CKD include diabetes (40%), hypertension (25%), glomerulonephritis (15%), and polycystic kidney disease (4%). 3. Early detection of CKD is important through screening high-risk patients with diabetes, hypertension, or family history and testing urine, serum creatinine, blood pressure, and ultrasound imaging.

    Исходное описание:

    Presentasi diagnosis gagal ginjal kronis, kriteria, manajemen sebagai dokter umum, renal replacement therapy

    Оригинальное название

    Bimbingan chronic kidney disease

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    1. The document defines chronic kidney disease (CKD) as either kidney damage lasting at least 3 months as shown by abnormalities in structure/function tests or a glomerular filtration rate (GFR) below 60 mL/min/1.73m2 for at least 3 months. 2. Common causes of CKD include diabetes (40%), hypertension (25%), glomerulonephritis (15%), and polycystic kidney disease (4%). 3. Early detection of CKD is important through screening high-risk patients with diabetes, hypertension, or family history and testing urine, serum creatinine, blood pressure, and ultrasound imaging.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PPT, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    59 просмотров15 страниц

    Bimbingan Chronic Kidney Disease

    Загружено:

    Muhammad Haris Firdaus
    1. The document defines chronic kidney disease (CKD) as either kidney damage lasting at least 3 months as shown by abnormalities in structure/function tests or a glomerular filtration rate (GFR) below 60 mL/min/1.73m2 for at least 3 months. 2. Common causes of CKD include diabetes (40%), hypertension (25%), glomerulonephritis (15%), and polycystic kidney disease (4%). 3. Early detection of CKD is important through screening high-risk patients with diabetes, hypertension, or family history and testing urine, serum creatinine, blood pressure, and ultrasound imaging.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PPT, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 15

    criteria

    1. Kidney damage for 3 months, as defined by structural or


    functional abnormalities of the kidney, with or without
    decreased GFR, manifest by either :
    Pathological abnormalities; or
    Markers of kidney damage, including

    Abnormalities in the composition of the blood or


    urine, or abnormalities in imaging tests
    2. GFR < 60 mL/min/1.73 m2 for 3 mounths, with or without
    kidney damage

    History

    Long-standing history suggests


    CKD

    Renal osteodystrophy Ro evidence of osteitis fibrosa


    cystica or osteomalacia suggests
    CKD
    Renal size (length)
    -small (<9 cm)
    CKD
    -normal
    AKI
    -enlarged(>12 cm)
    Diabetec nephropathy
    Amyloidosis
    Obstructive uropathy
    HIV
    PKD
    Renal biopsy
    Histologic diagnosis

    Etiology of CKD which makes patient must do


    renal replacement therapy
    (transplant,HD,CAPD)
    Disease

    Diabetes mellitus
    Hypertension
    Glomerulonephritis
    Polycystic kidney disease
    Urologic
    Unknown & miscellaneous

    40
    25
    15
    4
    6
    10

    Rationale : early detection, early intervention,


    reduced associated complications
    Whom ? Diabetes, hypertension, autoimmune
    diseases, urinary tract infection or obstruction,
    heart failure, cirrhosis, family of ESRD, family of
    nephropathy (DM,HT,glomerulonephritis)
    How?
    - standart urine dipstick (spot urine): proteinuria
    hematuria, lekosituria
    - serum creatinine
    - blood pressure
    - ultrasound
    imaging(obstruction,stones,infection,PKD)
    - serum electrolytes
    - urinary concentration

    AJKD 2002: 39(2)

    AJKD 2002: 39(2)

    Anemia
    Hipertensi
    Overload
    Uremia

    syndrome

    Manifestasi
    Klinik Uremia

    Otak : - letargi, malaise


    - bingung
    - koma
    - kejang
    Konjungtiva : - kemerahan
    - kalsifikasi
    - perubahan fundus karena hipertensi

    Wajah : - pucat
    - warna keabu-abuan
    - uraemic frost
    Tekanan vena jugularis :
    - tinggi atau rendah
    Jantung : - pembesaran jantung
    - perikarditis
    Tekanan darah : - meningkat
    - turun saat berdiri

    Mulut : - napas uremik

    Dada : - hiperventilasi karena asidosis


    - edema paru, efusi
    Abdomen : - ginjal & kandung kemih teraba
    - bruits ginjal

    Lengan & tangan :


    - lecet
    - bekas garukan
    - lekonikia
    - tremor
    - flap
    - myoclonic jerks
    Urin : - simptom penyakit ginjal
    - poliuri, frekuensi, nokturi

    Genital : - impotensi
    - libido menurun
    - amenore, mandul

    Perifer : - edema tungkai


    - neuropati perifer
    - deformitas tulang pd anak
    - peningkatan penyakit vaskuler

    1. Anemia
    - Fe
    - asam folat
    - eritropoetin
    - transfusi
    2. Gatal
    - diet rendah protein
    - difenhidramin
    3. Mual
    - diet rendah protein
    4.
    Hiperuricemia : alupurinol
    5.
    Hiperkalemi : glukose dan insulin,diit
    rendah kalium,cation exchange resin
    6.
    Asidosis : nabic infus dan tablet
    7.
    Overload syndrome : balans cairan, diuretik

    Hemodialisis (HD)
    Chronic ambulatory peritoneal dialysis
    (CAPD)
    Kidney transplant

    When creatinine clearance <30 ml/min/1.73m2


    Patients at risk of rapid progression
    In whom doubt exists as to their diagnosis and
    prognosis

    Klirens kreatinin < 15 ml/m (DM)


    Klirens Kreatinin < 10 ml/men (non DM)
    Sindroma Uremik
    Hiperkalemia
    Asidosis Metabolik
    Kelebihan Cairan (overload)

    Thank you

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