TUGAS

REVIEW JURNAL
DI RUANG IGD RSUD ULIN BANJARMASIN
KHA-CARI Guideline: Early chronic kidney disease: Detection, prevention
and management

Disusun oleh:
Kelompok V(Lima)

1.
2.
3.
4.

Herlina Novia Ujianti

M. Robby Al Banjari
Deni Okvianti
Eka Septya Rahmi

5.
6.
7.
8.

Fitriyah
Lia Indria Wati
Muchammad Rony Pra
Riska Amalia

PROGRAM STUDI ILMU KEPERAWATAN

SEKOLAH TINGGI ILMU KESEHATAN SARI MULIA
BANJARMASIN
2016

LEMBAR PERSETUJUAN
PENULIS

: David W Johnson, dkk

TAHUN

: 2013

JUDUL

: KHA-CARI Guideline: Early chronic kidney disease:

Detection, prevention and management

JURNAL

: Asian Pacific Society of Nephrology

HALAMAN

: 340-350

Kelompok V(Lima)
Anggota Kelompok :

1.
2.
3.
4.
5.
6.
7.
8.

Herlina Novia Ujianti

M. Robby Al Banjari
Deni Okvianti
Eka Septya Rahmi
Fitriyah
Lia Indria Wati
Muchammad Rony Pra
Riska Amalia

Banjarmasin,.....Februari 2016
Menyetujui,
PEMBIMBING (CI)

PEMBIMBING (CT)

.........................................

No

Kriteria

...................................

Jawab

Pembenaran & Critical think

.
1

P
(Patient/Clinical
Problem)

Ya

I
(Intervention)

Ya

3
4

C
(Comparasion)
O
(Outcome)

This journal addresses issues relevant to the detec

management of early chronic kidney disease.
The objective of this guideline is to identify what
appreciable portion (>5%) of the community,
development of CKD and which are remediable or p
to detect early CKD and intervene at the earliest pos
PART I. DETECTION OF EARLY CHRONIC KID
HISTORY, RISK FACTORS, SCREENING, DIAGNO
- Symptoms, natural history and outcomes of early
- Risk factors for early chronic kidney disease
- Screening for early chronic kidney disease
- Diagnosis, classification and staging of chronic k
- When to refer for specialist renal care
PART II: PRIMARY PREVENTION OF EARLY CH
LIFESTYLE FACTORS, BLOOD PRESSURE, DIAB
EDUCATION, MULTIDISCIPLINARY CARE AND PR
- Primary prevention of chronic kidney disease: mo
- Primary prevention of chronic kidney disease: blo
- Primary prevention of chronic kidney disease: m
reduce the risk of progression to CKD
- Education Strategies
- Multidisciplinary or multifaceted renal care in ear
- Pregnancy and early chronic kidney disease
PART III: MANAGEMENT OF EARLY CHR
MODIFICATION OF LIFESTYLE AND NUTRITION I
THERAPIES
(ANTI-HYPERTENSIVES,
HYPOGLYCAEMICS, ANTI-PLATELET, URIC A
VITAMIN D).
- Modification of lifestyle and nutrition interventio
chronic kidney disease
- Medical therapies to reduce chronic kidney
cardiovascular risk: anti-hypertensive agents
- Medical therapies to reduce chronic kidney
cardiovascular risk: lipid lowering therapy
- Medical therapies to reduce chronic kidney
cardiovascular risk: glycaemic control
- Medical therapies to reduce chronic kidney
cardiovascular risk: anti-platelet therapy
- Medical therapies to reduce chronic kidney
cardiovascular risk: uric acid-lowering agents
- Vitamin D therapy (supplementation) in early chr

Tidak
Ya

CKD is associated with increased risks of death fro

events and progression to end-stage kidney disease
A large proportion of patients with early CKD experi
life and sleep disturbance. However, these symp
patients with other medical problems.

The following risk factors are associated with an a

CKD:
- Obesity
- Hypertension
- Diabetes mellitus
- Cigarette smoking
- Established CVD
- Age > 60 years
- Aboriginal and Torres Strait Islander peoples
- Maori and Pacific peoples
- Family history of stage 5 CKD or hereditary kidne
- disease in a first or second degree relative
- Severe socioeconomic disadvantage
The screening in those with additional CKD risk fact
(obesity, cigarette smoking, Aboriginal and Torres S
history of stage 5 CKD or hereditary kidney diseas
relative and severe socioeconomic disadvantage)
CKD be diagnosed in all individuals on at least two
least 3 months, irrespective of the underlying cause
an estimated or measured GFR <60 mL/min per 1.
kidney damage (albuminuria, proteinuria, haematuria
causes, or structural abnormalities on kidney imaging
Once a referral has been made and a plan jointly ag
take place at the patients General Practitioner surg
clinic. If this is the case, we recommend that crite
referral should be specified
The maintenance of a stable (within 5%), healthy we
lower risk of developing CKD
The patients achieve standard BP targets <140/90
morbidity outcomes
The patients with diabetes mellitus aim to achiev
mmol/mol*
The comprehensive and structured CKD educa
hypertension, diabetes, obesity and smoking and o
delay CKD progression
An individualized, structured care plan with
medications and interventions targeting cardi
modification, for all patients with early CKD
A women with early CKD who have normal or near> 60 mL/min per 1.73 m2) and who wish to fall pregn
provided their blood pressure is well controlled
The patients with progressive CKD have individualiz
an appropriately qualified dietitian
The patients with early CKD (stage 13) should b
(with or without ezetimibe) to reduce the risk of
patients with early (stage 13) CKD because of type
aim to achieve a HbA1c target of approximately 7.0%
The aspirin therapy should not be routinely recomme

primary prevention of CVD in patients with early (sta

The use of uric acid lowering agents (such as
feboxostat) should not be routinely recommended in
3) CKD who have asymptomatic hyperuricaemia
A daily oral intake (total) of vitamin D for patients
exposed to direct sunlight for at least 12 h
recommendations
- 1950 years 5 mg (200 IU)
- 5170 years 10 mg (400 IU)
- >70 years 15 mg (600 IU)
- (where 1 mg = 40 IU)