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HAEMODIALYSIS
PERITONEAL DIALYSIS
TRANSPLANTATION
illi
illi
lla
lla
USRDS 2006
IRR 2012 Penyakit Dasar PGT
12%
Hipertensi
12% 35%
DM
15% pielonefritis
26% glomerulonefrotis
lain-lain
IRR,2013
19% Hipertensi
31%
10% DM
Glomerulopati
14%
26% Pielonefritis
INDONESIAN lain-lain
RENAL REGISTRY
INDONESIAN
RENAL REGISTRY
What Kidneys Do
OR
Damaged kidneys
do not remove wastes
do not remove extra water
from the blood as well as they should.
What Else About CKD?
CKD is a silent condition.
In the early stages, there are no symptoms.
CKD develops so slowly that people don't
realize they're sick until the disease is
advanced and they are rushed to the hospital
for life-saving dialysis.
Stages 1 & 2
Normal eGFR ≥ 60 ml/m
Kidney damage for more than 3 months as
manifested by
Abnormalities in the tissue of the kidney (biopsy) or
Markers of kidney damage including
Abnormalities in the composition of urine or
Changes seen by radiological images (x-ray, CT scan, ultrasound etc.)
Risks associated
Progression
Heart disease
Stages 3, 4 & 5
Kidney damage getting worse
eGFR getting progressively lower
Risks associated
Progressive kidney disease (dialysis)
Increased cardiovascular risk
Myocardial infarction (heart attack)
Stroke
Sudden death
The strategic framework for preventing CKD
• Primary prevention
• Secondary prevention
• Tertiary prevention
CKD Prevention
CKD
RRT
Risk 1 2 3
Normal 4 5 Dialysis
factors
Transplant
Hypertension
Diabetes
Obesity
Cardiovascular disease
Tobaccco smokers
Aged over 50 years
A family history of kidney disease
Secondary prevention
Early detection and effective intervention in
the early stages of kidney damage are
essential to prevent or delay the deveopment
of ckd
American)
Comparing eGFR and Creatinine
• Normoalbuminuria
• Mikroalbuminuria
• Makroalbuminuria
• Bermanfaat untuk skrining pasien diabetes, Hipertensi
Benefit
Detection
To assist in early detection of CKD by recognising people
who are at increased risk
Kidney Health Check:
• blood pressure
• urine dipstick for proteinuria
• estimated glomerular filtration rate (eGFR)
What is the role of the practice nurse in CKD?
Management
To assist in the management of CKD by
•Treatment to slow or prevent progression of kidney failure
•Assess and manage symptoms (e.g. anaemia, nausea/vomiting)
•Monitor for nephrotoxic medications (e.g. NSAIDs)
•Promote self-management strategies (lifestyle modification)
•Screen and manage diabetes and hypertension