Incidence of Renal Failure in Selected Adopted Communities of Lyceum of the Philippines University Kidneys are responsible for many

functions in the body. Failure of one part to function could be very crucial for it could lead to the suppression of all the other parts of the human body. Thus, this case is called Renal Failure. Renal Failure is an acute deterioration in kidney function manifested as an inability to eliminate waste products and regulate fluid balance. The buildup of waste materials that accumulates affects multiple organ systems. (Robertson, 2006). Renal failure occurs in either an acute or chronic failure. The acute form most often occurs because of a sudden body insult, such as severe dehydration. On the other hand, the chronic form results from extensive kidney disease, such as hemolytic- uremic syndrome or glomerulonephritis (Reddy &Murra, 2009). Other causes of acute renal failure include prolonged anesthesia, hemorrhage, shock, severe diarrhea, or sudden traumatic injury. It can also occur in children who are placed on cardiopulmonary bypass while undergoing heart surgery, who receive common antibiotics (aminoglycosides, penicillin, cephalosporin, and sulfonamides), who swallow a poison such as arsenic (found in rat poison), or who are exposed to individual wastes such as mercury. All of these conditions appear to lead to renal ischemia, which ultimately leads to acute renal failure. (Pilliteri, A. 2010). Acute kidney failure is potentially life-threatening and may require intensive treatment. However, the kidneys usually start working again within several weeks to months after the underlying cause has been treated. The high mortality related to ARF has not changed for over 4 dead in spite of increasingly complex technologies to treat acute renal failure one could argue that today patients with acute renal failure often have associated multiple organ dysfunction syndrome (MODS) and have complex illness and comorbiditics compare with patients 40 years ago. In some cases, chronic renal failure or end-stage renal disease may develop. Death is most common when kidney failure is caused by surgery, trauma, or severe infection in someone with heart disease, lung disease, or recent stroke. Old age, infection, loss of blood from the intestinal tract, and progression of kidney failure also increase the risk of death. ( Acute renal failure occurs in 5 percent of hospitalized patients. Etiologically, this common condition can be categorized as prerenal, intrinsic or postrenal. Most patients have prerenal acute renal failure or acute tubular necrosis (a type of intrinsic acute renal failure that is usually caused by ischemia or toxins). (Am Fam Physician 2000;61:2077-88).

Incidence of Renal Failure


Every year, millions of people battle kidney disease. There are many different types of this disease, but the most common, which is increasing every year at a rate of six to eight percent, is chronic kidney disease. Kidney disease goes through several stages, with the final stage being end-stage kidney disease (ESKD), also referred to as end-stage renal disease (ESRD). According to the World Health Organization, an ageing population, and increasing rates of type 2 diabetes and hypertension are driving the increase of ESRD. Currently, there are over 1.4 million people on life-saving dialysis (mostly in high-income countries), and the number is growing by about eight percent every year. (Capicchiano) Renal or kidney failure remains among the top 10 causes of morbidity and mortality in the country. Nephrologists and medical experts who were trained in the diagnosis and management of kidney disease, the renal failure at its final stage is on the ninth spot out of the top 10 causes of death in the country. Renal failure (formerly called renal insufficiency or chronic renal insufficiency) is a situation in which the kidneys fail to function adequately. ( 2c5b3534baa6&topic=19469.msg330200#msg330200) Each year an estimated 120 Filipinos per million populations (PMP) develop kidney failure. This means that about 10,000 Filipinos need to replace their kidney function each year. According to the Philippine Renal Disease Registry Annual Report in 2008, the leading cause of kidney failure in the Philippines is diabetes (41%) followed by an inflammation of the kidney (24%) and high blood pressure (22%). Patients were predominantly male (57%) with a mean age of 53 years. The best way to replace kidney function though is to transplant another kidney into the patient through a surgical procedure. Only another kidney can completely replace kidneys shrunken because of disease. Dialysis only provides about 15% of kidney function. It is enough to sustain life, but needs to be performed regularly, and for life. Acute kidney failure is a common problem. It affects approximately 5% of all hospitalized patients and up to 30% of patients admitted to Intensive Care areas. The mortality rate for AKF approaches 50% making it one of the leading causes of inpatient death. (Phipps, 2007) Nationwide, there are 8,708 patients who started their therapy in 2009, according to the Philippine Renal Registry in connection with the Department of Health (DOH). (2010)

and postoperative conditions.2000) The survival rate for acute renal failure has not improved. For example.Incidence of Renal Failure 3 The researchers foresee that the results of the study would extend its benefits not only to the researchers but also to the respondents in giving them precise information about renal failure. family income. the mortality rate can range from 7 percent to as high as 80 percent. Numerous underlying conditions can lead to prerenal failure. Objectives of the Study The researcher seeks to determine the demographic profile of the respondents in terms of age. medication and environment. the state of shock. In the pediatric population-age 19 and underthe annual rate is only 1 or 2 new cases in every 100. In children. the most common causes are hypovolemia secondary to gastrointestinal losses.000 develop kidney failure each year. In ARF the most common is prerenal particularly dehydration secondary to acute gastronephritis. (Fe del Mundo. slightly more than 30 people in every 100. etc. In the general population. and health related problems. lifestyle. primarily because affected patients are now older and have more comorbid conditions. in contrast chronic renal failure is more common among adolescents 11 to 15 years old. ocuupation. The main process in the development of pre-renal failure is hypoperfusion of the kidney. to propose a program on how to lessen or decrease the incidence of Renal Failure. In other words. The risk increases steadily with age. gender. ARF may occur after heart surgery .000 children. adults are about 20 times more likely to develop kidney failure than children. and lastly.Infection accounts for 75 percent of deaths in patients with acute renal failure. and cardiorespiratory complications are the second most common cause of death. secondary to reduced effective plasma volume or heart failure. Depending on the severity of renal failure. Pre-renal failure is the most common form of ARF in children. Related Literature on Objective 1 Age Among Filipino children. ARF is common below two years. it seeks to determine the factors contributing to the incidence of Renal Failure in terms of nutrition. The product of this research would help the community by contributing knowledge and expounding their ideas about renal failure that would help in decreasing the incidence of renal failure through the use of the proposed program of the researchers.

This is the most common cause of postrenal failure in boys. 2007) In the general population. Renal blood flow is decreased by 1% per year after age 30. As person ages.Incidence of Renal Failure 4 when the aorta is cross-clamped or following prolonged cardiopulmonary bypass time. the kidney undergoes structural and functional changes. trauma. The patient may have had frequent urinary tract infections. which leaks. Clearly. 2008) Aging is known to cause predictable increases in both systolic and diastolic BP.000 develop kidney failure each year.htm) According to Zaykoski (2010) Age and risk affect the chances of developing kidney failure. tubular reception and renal concentrating ability decline because the size and number of functioning nephrons When a child presents with the signs of azotemia and a sudden decrease in urine output. the history and physical examination can help determine the location and cause of obstruction. In the pediatric population-age 19 and underthe annual rate is only 1 or 2 new cases in every 100.000 children. Postrenal failure is a less frequent cause of ARF in children. Untreated hypertension accelerates the development of atherosclerosis. . (Lippincott. The physical examination may reveal a palpable suprapubic mass. dribbling). hematuria. an alteration in the urinary pattern (decrease in urine stream. underlying lesions. (Rosner. and presence of lower abdominal or flank pain secondary to renal enlargement and dilatation of the collecting reports that people age 65 or older have a higher risk of kidney disease than younger people. unless the patient has a single kidney.4shared. as well as longevity related to chronic kidney failure. MayoClinic. It presents as an abrupt decline in glomerular filtration rate (GFR) secondary to lower tract obstruction or bilateral upper tract obstructions. (http://www. the pediatrician must be alert to the possibility of renal obstruction. Renal function may decline by 50% or more by age 70. As a person ages. 2009). adults are about 20 times more likely to develop kidney failure than children. to kidney failure. slightly more than 30 people in every 100. 2008). such as in male newborns that have posterior urethral valves. This slow increase in blood pressure begins early in life and continuous through adulthood. (Phipps. (Goldman. The risk increases steadily with age. In other words.

and just apportion time for dialysis treatment. a tertiary government hospital providing services for kidney Thus. On top of all that. patients with kidney failure die. And individuals may need to limit their work hours.When a primary diagnosis is taken into account. or polycystic kidney disease. A study at the National Kidney and Transplant Institute (NKTI). 000 to P552. Part D prescription coverage is rarely adequate for the high costs of oral medications. have all been thought to play a part. along with diet and the presence of hypertension.2010).Incidence of Renal Failure Gender 5 According to Science Daily. Family Income Adequate dialysis costs from P25. While Medicare pays 80% of dialysis costs for most patients. Kidney disease often affects the male population with 59 percent and common age population is between 41 to 70 years old with most suffering from Type 2 diabetes or obesity-related diabetes (Yu. Gender influences the prevalence and progression rate of many renal diseases. such as polycystic kidney disease (PKD). affecting take . Plus. showed that half the patients who start dialysis are dead within a year. transportation to and from treatment may be difficult to arrange and financial burdens may exist. 000 to P46. Several lines of evidence indicate that there are sex differences in the incidence and severity of cardiovascular and renal disease. They require replacement of their kidney function to live. hypertensive nephropathy. Without dialysis or kidney transplantation. and clinical data are conflicting (American Heart Association). The physiology behind gender differences and renal disease is still uncertain. If one is able to afford this lifelong treatment then the patient will be well enough to return to his normal way of life. 000 per month or P300. Men are more prone to develop chronic kidney disease (CKD) and to progresses to end-stage renal disease than are women. in the case of diabetic renal disease. presumably because they could not afford sufficient dialysis. but the distinct characteristics of male and female kidney size. (http://www. when all-cause incidence rates are considered. However. diabetic males in the most productive years of their lives comprise the population who received treatment for kidney failure in 2007. However majority of Filipinos cannot afford this costly treatment for more than a year. and private health insurance or state medical assistance likely contributes funds. the sexual dimorphism favoring women is not as clear cut. individuals could have co-pays for secondary insurance. 000 annually. such as IgA or membranous nephropathy.abscbnnews. this assertion holds true for many causes of CKD.

phosphate fertilisers.kidneycoach. (http://www. (http://sofs. 800 to P3. breathing contaminated air in the workplace. passive smoking). tools.cfm) So What Are The Main Sources of Cadmium? Cigarette smoke (inc. Exposure to asbestos and/or cadmium (a type of metal used in the production of and other industrial processes) can increase the risk of developing kidney cancer. mercury and lead everyday from mercury in our fish. 6 Financial burdenincreases. pesticides. plumbing alloys. plastics. (http://en. cadmium in our air. and yellows. . (http://www. 2010). particularly if they use the pigments in dry form.hubpages. and lead in our pipes for example. Exposure to heavy metals such as lead and cadmium may also raise risk levels. batteries (nickel-cadmium). (Martchev. Artists who work with cadmium pigments. If the individual is single.wellsphere. ( Cadmium is also found in some industrial paints and may represent a hazard when sprayed. 500 while dialysis patients need to undergo dialysis two to three times a week (Yu. drinking water (galvanised pipes). shellfish. can easily accidentally ingest dangerous amounts. Fungicides. Occupation Incidence rates are also higher among steel plant coal oven workers. which are commonly used strong oranges. It may cause a lot of stress not only for the individual but also on the family. the individual has to endure a high level of stress. 4 We are exposed to heavy metals like cadmium. or in mixing their own paints. with no family support. ceramics. to accommodate appointments. reds.wikipedia. as treatment is expensive.Incidence of Renal Failure home Only 10 to 15 percent of people who suffer from kidney failure undergo dialysis because of financial constraints as one dialysis session costs between P1. electroplating (Electronics). Operations involving removal of cadmium paints by scraping or blasting may pose a significant Heavy metals from the environment can also accumulate in the kidneys and can damage them. evaporated milk. The family¶s economic resources are strained to the maximum extent possible. as with chalk pastels. 2008). photographic chemicals.

primarily the afferent and efferent arterioles and the glomerular capillaries are affected. suggesting that obesity should be considered a risk factor for the condition. Because of the extremely high prevalence if diabetes and hypertension as causes of chronic renal failure. neoplasms. interstitial nephritis. 2010) McCulloch (2006). and obstructive neuropathy. accounting for more than 30% and 20% of cases of ESRD respectively (2006). the microvasculature in the organ systems of the body. deposits of immunoglobulin and albumin and diffuse glomerulosclerosis. heart failure. 2006).63% in patients with type 2 diabetes mellitus. Anonas. Peacock WF. heart attack. and stroke. is damaged. Glomerular changes include thickening of the basement membrane.Central and Eastern Visayas Chapter bared that more than 50 percent of those who have kidney problems is due to diabetes and 25 percent attributed to hypertension alone. In a few years¶ time.. tubular atrophy and interstitial fibrosis also occur.(Rhoney D. 2010) Uncontrolled hypertension increases the risk of stroke. congenital malformation. hepatorenal syndrome. the causes of chronic renal failure are numerous. Other causes include glomerulonephritis (both primary and secondary systemic diseases). but diabetes mellitus and hypertension are by far the two most common. Renal failure is a major complication of diabetes with an incidence of 40% in patients with type 1 diabetes mellitus and 40% . kidney disease. such unhealthy lifestyle that goes with untreated hypertension will lead to organ damage.(Framelia V.Incidence of Renal Failure Health Problems 7 Nephrologist Dr. Late in diabetic neuropathy. Danny Yu and secretary of the Philippine Society of Nephrologists . According to the United States Renal Data System. (Lancaster. In diabetes. the long-range study found that the obese have up to a seven times greater risk of kidney failure than normal weight people. 2007). genetic disorders. myocardial infarction and kidney diseases. including the kidneys. an understanding of the renal pathophysiology specific to these entities and knowledge of interventions designed to slow down or even prevent progression to ESRD is imperative. The exact . (USRDS. and that kidney failure is yet another consequence of obesity. microangiophic etiologist such as scleroderma and atheroembolic disease. In the kidneys.

(D. a metallic taste in the mouth. Malignant nephrosclerosis. uremic pneumonitis. Often symptoms like blurred vision and a severe headache accompany this crisis situation. is primarily seen with chronic renal failure. Factors associated with renal failure that contribute to pulmonary infections include decreased pulmonary macrophage activity. acute glomerulonephritis. its incidence is greater in populations with a higher incidence with primary hypertension. 2006) Other gastrointestinal complications associated with renal failure primarily occur in chronic renal failure and include anorexia. tenacious sputum. nausea. but hyperglycemia is a major contributor. Pericarditis. "Our results confirm an accumulating body of clinical and experimental data implicating obesity as an important causative factor in kidney . especially in critically ill patients. and a depressed cough reflex. (D. such as diabetes mellitus. 2006) Cardiovascular system can cause or accelerate acute and chronic renal failure. pleuritic inflammation and pain. and eventually necrotic. (Lancaster. and acute pyelonephritis. (D. In addition. In benign nephrosclerosis. renal impairment occurs every many years. and pulmonary infections. The effect of systemic hypertension on the kidneys results in a condition known as nephrosclerosis.Holcombe. Common cardiovascular complications in acute and chronic renal failure include hypertension and hyperkalemia.Incidence of Renal Failure 8 pathophysiological mechanism for these structural alterations is unclear. diarrhea. 2007). cardiovascular complications can arise as a result of renal failure. sickle cell anemia. associated with malignant hypertension.Holcombe. (Lippincott Williams. constipation. Hypertensive nephrosclerosis can be benign or malignant. may contribute to the development of acute renal failure. Because hypertensive nephrosclerosis is directly caused by hypertension. God pastures syndrome. 2008). and fetor uremicus (the smell of urine and ammonia in the breath). another cardiovascular disease of renal disease. vomiting. Hypertensive nephrosclerosis involves the development of sclerotic lesions in the renal arterioles and glomerular cappilariesthar cause them to become thickened and narrowed. on the other hand are common in both acute and chronic renal failure. 2006) Certain systemic diseases. Pulmonary infections. 2006) Other pulmonary complications in renal failure include pleural effusions. Obesity is an important and potentially preventable risk factor for chronic renal failure (CRF).(Lancaster. associated with chronic mild or moderate hypertension. according to a study in the June Journal of the American Society of Nephrology. can lead to permanent renal failure rapidly if blood pressure is not immediately reduced. hypertension.Holcombe. systemic lupus erythematosus (SLE). and oral cavity alterations such as: stomatitis. a generalized immunocompromised state.

your target blood pressure should be below 130/80 mm Hg. up from 18 percent in 1980. your body fails to make enough insulin. High blood sugar levels causes problems in many parts of your body. The extra fluid in your blood vessels can build up and raise blood pressure even more. It also damages the countless small blood vessels and filtering units in your kidneys. you can be treated by your doctor to remove the stones or bread them down into small bits so they will pass. Obesity²defined as a BMI of 30 or higher²was a strong risk factor for CRF. lead author of the new study. This is due to the global increase in type 2 diabetes and obesity. For women. If you have had one stone. Subjects who met the definition of obesity at any age were three to four times more likely to develop CRF. Untreated high blood pressure can damage your kidneys. When you have diabetes.sciencedaily. Your kidneys contain countless small blood vessels and filtering units.Incidence of Renal Failure 9 disease. Sweden. kidney stones can lead to CKD. and is rapidly becoming the leading cause of CKD in developing countries. This damage can lead to heart attacks. Repeated urinary infections can lead to CKD. strokes and kidney failure. According to guidelines issued by the National Kidney Foundation. This can prevent the kidneys form removing waste products from the blood and extra fluids." comments Dr. Diabetes accounts for 45 percent of prevalent kidney failure. Insulin is a hormone that regulates the amount of sugar in your High blood pressure can reduce blood supply to the kidneys. which become damaged as a result of high sugar levels. you are at increased risk of having another one. Polycystic kidney disease is the most common inherited kidney disease. morbid obesity²BMI 35 or higher²was also a risk factor for CRF. (http://www. if you have kidney disease. Elisabeth Ejerblad of Uppsala University. Urinary tract infections cause symptoms such as pain and/or burning during urination and the need to .htm) According to the National Kidney Foundation's Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease 2007. If kidney stones are too large to pass. diabetes is the leading cause of CKD in developed countries. It causes cyst formation in the kidneys that grows over time and can cause serious kidney damage. If left untreated. Those who have developed one stone are at approximately 50 percent risk for developing another within five to seven years.

potassium. the immune system doesn't recognize the body's tissues and cells. phosphorus and sodium. the immune system can tell the difference between invading pathogens such as bacteria. viruses or cancer cells and the body's own cells and tissues. but it's believed that the immune response causes damage to the glomeruli and nephrons. Bacterial endocarditis. Although this disease affects men and women. acute poststreptococcal glomerulonephritis can cause permanent kidney damage. Glomerulonephritis is inflammation of the membrane that acts as a filter in the kidney. primarily in the kidneys. However. These antibodies get deposited in the filtering units of the kidney and cause damage. a heart infection. Streptococcal infections don't directly affect the kidney.Incidence of Renal Failure 10 urinate more frequently. (http://www. The renal diet restricts the intake of protein. Although rare. PKD. Alport's syndrome also affects hearing and vision.livestrong. is an inherited genetic disease that affects more than 12. which causes glomerulonephritis. and HIV infection can also lead to chronic renal failure. The Kidney and Urology Foundation of America explains how an acute streptococcal infection can cause glomerulonephritis. This disorders causes the formation of fluid-filled cysts. Normally. these cysts can form in many other organs. and they may cause fever and pain in your back. but the body's immune response to attack the invading streptococcal bacteria may overproduce antibodies. In patients .com/article/106137-causes-kidneydisease/#ixzz1fACr0RB8) Literature on objective 2 Nutrition Acording to Zaykoski (2010).livestrong. Chronic autoimmune disorders such as systemic lupus erythematous result in kidney damage because of circulating antibodies that cause inflammation in the glomeruli and nephrons. and immuneglobulinA (IgA) Polycystic kidney disease. inflammation of the glomeruli and kidney disease. The National Kidney Foundation reports that approximately 50 percent of PKD patients have kidney failure by the time they reach 60.5 million people worldwide. The exact mechanism of action is unclear. men have a greater incidence of chronic kidney disease. but they sometimes spread to the kidneys. In the case of an autoimmune disorder. the body literally attacks itself. These infections most often affect the bladder. Other autoimmune disorders that cause kidney disease are Goodpasture's syndrome. which directly targets the kidneys. (http://www.Alport's syndrome is another inherited condition that's a cause of kidney disease earlier in life. adhering to a renal diet can reduce the complications of end-stage renal failure and improve quality of life.

The less creatinine in the blood. Other kinds of sodas did not increase the risk for chronic kidney disease. which contains high protein content. citrus fruits is one such option. Excessive salt can also lead to high blood pressure. Because damaged kidneys cannot filter waste products. The protein rich food is difficult on kidneys. When your kidneys are functioning improperly. Food with high sodium content should also be avoided as it helps in more calcium formation in urine and can thus cause kidney stones. It is also recommended that the food. If you include plenty of citrus fruits in your diet then you can be saved from kidney stones. reducing sodium. reducing protein intake reduces the amount of creatinine consumed during protein metabolism. You should consume lots and fruits and vegetables to avoid kidney stones. On the other hand there are some foods which if consumed can decrease the chances of kidney stones. Retaining water can be very dangerous for people with kidney failure. as the ones which can cause kidney stones. and there are more amounts of waste products. Your body can get rid of toxins if you drink plenty of water. The important thing to know here is ± moderation. the diet also restricts the amount of fluid consumed on a daily basis. potassium and fluid intake reduces the workload of the kidneys and reduces the risk of complications. The high protein diet includes meat. Water is one wonderful option. Salt accumulation can cause edema or swelling of . phosphorus. a problem often associated with kidney failure. the less work the kidney has to do to filter wastes. you should drink plenty of water. which gets converted into kidney stones. Food with high sugar content should also not be taken as a sugary food helps in formation of kidney stones.kidney-stones. as they cannot get rid of extra fluid through urinating. your ability to balance salt levels in the body diminishes. Chronic high blood pressure can lead to worsening of kidney failure. eggs A new study linked drinking two or more cola drinks (either diet or regular) each day with an increased risk for chronic kidney disease. There are very small amount of nutrients extracted by our body from the dairy products. It is also seen that dairy products also cause formation of kidney stones. Since the kidneys also control fluid and mineral balances. not to have it.Incidence of Renal Failure 11 with advanced renal failure. Excessive salt intake makes a person retain water. Every food should be had in moderation until or unless advised by the doctor. It is seen if all these food items are avoided from the diet then the chances of having kidney stones decreases to a great extent. (http://www. This certainly does not mean that you should eliminate all these foods from your diet. should also be avoided. Although we have discussed certain food items in the above paragraphs.

pickles. pizza. bananas. a chemical compound that is stored in your kidneys and can cause kidney stones if it is not excreted. such as oranges. your physician may recommend that you adjust your fluid intake to improve your kidney condition. Eggs. lemons. For best results.aged women. bacon. the type of beverage might also play a role. beer consumption reduced. potato chips. pork. juices and soups. Salts also contain potassium. In patients with diseased kidneys. tomatoes. chocolate. wheat bran. However. whereas grapefruit juice promoted incident kidney stone disease. High-protein animal products are more harmful to your body than lower protein plant foods if you have kidney disease. Fluid accumulation can affect your heart by prompting it to pump large blood volumes. Some beverages. Your physician is likely to adjust your daily diet to allow only minimal amounts of these foods until your kidney health has improved. this toxic substance causes conditions such as muscle weakness. of water daily is a standard target. cheese. your body releases a chemical agent called uric acid after the protein is broken down. tomatoes. it can also worsen kidney disease. beef. peas and dried nuts should be avoided because of their high potassium level. tuna and dairy sources such as creams and cheese should be limited or restricted. This can cause increased weight gain and edema in parts of your body in response to excess fluid buildup. Although consuming at least 64 oz. your kidneys may fail to perform their normal functions. spinach. and apple juice increased the risk of kidney stones. all of which should be limited or restricted if you have or develop kidney disease Protein. a nutrient that has certain roles in muscle contractions. should also be avoided to lower or decrease fluid levels in your body. seek individualized advice from your doctor. Foods with added salts include soy sauce. grapes. in this cohort. In addition to the total amount of fluid consumed. Chocolate. These findings were also confirmed in men. helps your body maintain muscle strength and cellular functions. heart disorders and joint pain. for example stronger hopped beers such as European . ice creams. prunes. lettuce. When you consume protein-rich foods. an important nutrient. table salt. exerting unnecessary pressure on your heart. In a study of middle.Incidence of Renal Failure 12 the face. rhubarb. Altered potassium levels may cause arrhythmia or abnormal heart rhythm. Foods such as strawberries. especially those of the heart. coffee. tea and wine were independently protective. ham and canned goods. celery. tea. oranges. french fries. This can cause damage if you are suffering from kidney disease. however. beets. With the onset of disease. beans. Certain foods. feet and hands. nuts and most dry beans contain large amounts of oxalate.

which likely relates to its effects on urine flow. Smoking also causes kidney disease.ehow.davita. for anyone who can drink it safely. This can lead to dehydration. Drinking too much alcohol²even for a completely healthy person²can cause kidney disease. 2008) Exposure to any form of stress triggers activity within the hypothalamicpituitary-adrenal axis. might contain significant amounts of oxalate but their consumption also increases urinary flow and dilution. 2011). This can affect their functioning. moderation is the key. These hormones affect multiple physiological functions. In addition. (http://www. If you fail to replenish these fluids. The carbohydrate load from drinking can cause obesity. (http://www. The key aspect of stress response is adrenal release of norepinephrine. The more intense the physical activity. (Vamvakas. Lifestyle Psychological and sociological factors can affect the patient¶s health. This could increase the risk of diabetes and diabetic kidney disease.Incidence of Renal Failure 13 lagers. which likely explains their neutral or even beneficial effects in observational studies. epinephrine and cortisol. 2006). Both depression and anxiety may predispose patients to worsening of congestive heart failure. including those of kidneys. has repeatedly been shown to be protective in a dose. independent of the initial severity of .dependent fashion. the more fluids are lost through sweat. The reduction in blood flow inhibits the kidneys' ability to filter waste. It isn't until dehydration becomes severe that it can slow blood flow to the kidneys. (George. Drinking can interfere with the blood chemistries and increase the ability of the body to protect the kidneys. as opposed to tea consumption. A general recommendation for the consumption of alcoholic beverages to reduce the risk of stone disease cannot be given at the present time. coffee. One source found depression to be a fairly strong predictor of repeated hospital admission. causing a buildup of not only toxins but fluids. Exercise causes you to sweat.html) When it comes to drinking alcohol. it can ultimately lead to Drinking alcohol can cause the kidneys to increase urinary output. More than two drinks a day can cause a rise in blood pressure. Many people who drink are more likely to leading to what the American Urological Foundation calls pre-renal failure. (Lippincott.

with little margin for acting out or error. 2010) Kidney failure occurs after prolonged stress on the system due to heroin use. overprotection and the sick role may lead to learned dependency. depression and anger displaced onto the disease or treatment. bladder cancer and kidney cancer are more common in smokers. Increased authority from parents and professionals. magical thinking and denial can all contribute to poor treatment adherence. adolescents with chronic kidney disease must rely on drugs or machines for their health or survival. your medicines may not control your blood pressure well enough. Kidney disease is one of the less talked about consequences of . preoccupation with appearance. ( Bruce. Add to this a serious medical condition. Individuals who live alone or have minimal contact with friends. Peer pressure. The mental stress of anxiety and depression is associated with excess activation of the sympathetic nervous system (SNS). In addition. Another source states that CHF patients with severe depression are 4 times more likely to die within 2 years compared to those without depression. (Bell) Control Your Blood Pressure ² keep your blood pressure below 130/85 (adults) with weight loss and exercise. Smoking slows blood flow and can worsen existing heart. development of identity. aspirations and dreams for the future. In addition to the challenges faced by every teenager. Uncontrolled or poorly controlled high blood pressure is a leading cause of chronic kidney disease. a major risk factor for CKD and its progression to ESRD. Smoking can interfere with the medicines used to treat high blood pressure. and taking your blood pressure medication correctly.Incidence of Renal Failure 14 heart failure. a low sodium/low fat diet. Loss of a function kidney puts the heroin user at greater risk of serious illness or death. This increased activity in the SNS is strongly associated with increased mortality and morbidity in CHF. Smoking can also be a problem for people who already have kidney disease. leading to worsening heart failure. Adolescent risk taking. the target blood pressure is lower (125/75). A research has found anger and hostility to be positively correlated with hypertension. If you have high blood pressure and you smoke. blood vessel and kidney problems. Studies also show that depression and anxiety predispose to poor compliance with heart failure treatment plans. or acquaintances have been found to have higher rates of cardiovascular disease morbidity and mortality than persons who are integrated in social networks. There may be poor self-image. the joy of the moment. Missed treatments can lead to irreversible injury. or even death. reducing stress. For some patients. Controlling high blood pressure may delay the progression of kidney disease by slowing damage to the kidneys. relatives.

this may not improve (Brooks). a kidney inflammation that can lead to kidney failure. such as heroin or cocaine. The physician will monitor kidney function closely when prescribing any of these treatments to minimize the risk of kidney failure. (Naughton. Diuretics taken alone can cause dehydration which can lead to kidney failure. or acetaminophen (Tylenol®) have been linked to interstitial nephritis. several other medications can cause problems. A new study suggests that ordinary use of painkillers (e. . but remains a great risk for those who use the drug over months and Medication According to Zaykoski (2010). Motrin®). and intravascular contrast media.Incidence of Renal Failure 15 heroin use. one pill per day) is not harmful in men who are not at risk for kidney disease. Heavy use of painkillers containing ibuprofen (Advil®. prescription and over-the-counter medications are designed to treat the symptoms or underlying causes of many diseases and medical conditions. In patients who are at high risk for kidney problems. Patients who receive large amounts of dye or who suffer from dehydration can also develop kidney failure after a procedure. cardiovascular drugs such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). naproxen (Aleve®). some have severe side effects that can be life-threatening. can damage the kidneys. Allergic reactions to²or side effects of²antibiotics like penicillin and vancomycin may also cause nephritis and kidney damage. It is important to alert the physician to all of the medications a person is taking because a combination of drugs or procedures may cause problems when used together.michaelshouse. 2008). there is often an initial decrease in kidney function that stabilizes over a few days. diuretics.. (http://www. antidepressants. Use of certain nonprescription drugs. Patients who have other health problems such as diabetes combined with kidney disease may be at higher risk for kidney failure after a radiologic procedure that uses contrast dye. As with other medications and agents that can cause kidney failure. amphotericin B and acyclovir. and may lead to kidney failure and the need for dialysis. Some of the most common culprits are non-steroidal anti-inflammatory drugs (NSAIDs). While many are effective. Many medications are associated with acute kidney injury. specific antiviral medications and antifungal agents like amphotericin B can cause kidney problems and may need to be discontinued. but in patients with previous risk factors. antimicrobials such as aminoglycosides.g. One possible side effect of prescription and OTC medications is kidney failure. Antibiotics.

Drugs causing postrenal damage (urinary tract obstruction). Drugs that cause excessive gastrointestinal losses. cefixime. Analgesics: NSAIDs may cause acute renal failure due to hypoperfusion and interstitial nephritis. including penicillins. Nephrotoxic drugs. this is a problem only in patients with compromised renal perfusion. Discontinuation of the abused drugs often results in stabilisation or even improvement in renal function . This type of trauma can reduce the flow of blood to the kidneys and result in renal disease. amphotericin and ciclosporin. furosemide. Drugs that may cause interstitial nephritis include penicillins. Drugs causing prerenal damage. Drugs causing intrarenal damage. However. Care should be taken when an ACE inhibitor and NSAID are prescribed together as this combination may precipitate an acute deterioration in renal function.Cephalosporins: cephaloridine. even in short courses. acetazolamide or methotrexate may cause crystalluria and could therefore cause obstruction. captopril. High-dose sulphonamides. has been associated with direct renal toxicity and is no longer in clinical use. NSAIDs. gold. Physical trauma includes injuries sustained in auto accidents and during surgical procedures. have very rarely been reported to cause nephrotoxicity. can cause acute renal failure as a result of renal under perfusion. Other cephalosporins are much less likely to produce renal damage but third generation cephalosporins. There are a number of drugs that cause direct toxicity to the renal tubules (acute tubular necrosis). e. one of the first cephalosporins introduced. cephalosporins. either through diarrhea or vomiting. Intrarenal damage may result a direct toxic effect on the kidneys or hypersensitivity reactions. Most drugs that cause damage within the kidneys do so as a result of hypersensitivity reactions.Incidence of Renal Failure 16 Kidney trauma can occur as the result of an accident or overuse or abuse of over-the-counter and prescription drugs.g. Drugs that have been reported to cause glomerulonephritis include penicillamine. Ibuprofen and acetaminophen have been known to lead to kidney inflammation that can increase the risk for renal disease. phenytoin and some antibiotics. ACE inhibitors can also cause deterioration in renal function. aminoglycosides. Allergic reactions to antibiotics can also lead to inflammation of the kidneys and eventual kidney disease. as well as analgesic nephropathy (chronic interstitial nephritis and papillary necrosis). and alcohol may cause urinary tract obstruction due to retention of urine in the bladder.g. sulphonamides and rifampicin. particularly those with renal artery stenosis. NSAIDs and rifampicin.g. Analgesic nephropathy has been most commonly seen with combination analgesic products that contain aspirin and/or paracetamol. nticholinergics. e. thiazide diuretics. Other nephrotoxic drugs. sulphonamides. also cause volume depletion and may precipitate acute renal failure. Analgesic nephropathy is one of the few preventable causes of chronic renal failure. e. which involve either glomerular or interstitial damage. tricyclic antidepressants.

high-risk patients have conditions that result in increased vasoconstrictor activity. Analgesic nephropathy results from the daily use for many years of antipyretics such as phenacetin. dehydration). decline in renal function. Classic analgesic nephropathy is a slowly progressive interstitial nephritis characterized by small. usually in combination with caffeine or codeine. Progression is insidious. In most studies. Many consumers assume that. However. because dietary supplements are regulated as food and not as drugs. prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) results in the development of classic analgesic nephropathy. such as the aged and those with congestiveheart failure. N 5 years). No convincing evidence indicates that the habitual. as many 32 bloweydietary . All NSAIDs have the potential to induce an acute. they are harmless. Inhibition of renal prostaglandin production by NSAIDsresults in unopposed vasoconstrictor activity and a reduction in renal blood flowand renal function. most cases of acute renal failuremanifest in individuals at high risk. Nonetheless. and clinical findings in later stages are related to advanced renal failure. irregularly shaped kidneys with renal papillary necrosis. Lithium: serum levels of lithium consistently above the therapeutic range have been associated with development of a nephrogenic diabetes insipidus. cyclosporine).Typically. However. Early clinical symptoms of analgesic nephropathy include polyuria. volume depletion (eg. Other less common untoward effects of NSAIDs on thekidney include the nephroticsyndrome . orconcosmitant therapy with diuretics or other agents with nephrotoxic potential (eg.About 40% of Americans use dietary supplements. Nonsteroidal anti-inflammatory drugs. acetaminophen. Because of the requirement of prolonged analgesic consumption (ie. but a CT finding of irregular kidneys with papillary necrosis and calcifications is the most sensitive and specific method of diagnosing analgesic nephropathy. Over-the-counter analgesics. it is not likely that analgesic nephropathy will present during adolescence. Diagnosis can be made by ultrasound. Analgesic nephropathy. NSAIDs. including the newer cyclo-oxygenase 2 inhibitors . are associated with a wide variety ofadverse renal effects.but usually reversible. papillary necrosis. and practitioners should inquire about chronic analgesic use and provide counseling on the potential adverse renal effects. and microscopic hematuria. Although acute renalfailure can occur in healthy individuals. angiotensin II. analgesic abuse is defined as the daily consumption of analgesics for at least 5 years with a minimum of 3000 doses. andinterstitial nephritis. pre-existing renal disease. vasopressin) through the vasodilatationof the renal vasculature. and aspirin. the habitual use of analgesics may begin in adolescence.Incidence of Renal Failure 17 but continued abuse leads to further renal damage. sterile leukocyturia. Natural medicines and dietary supplements. and renal prostaglandins maintaineffective renal blood flow and glomerular filtration rate by attenuating the effectsof the vasoconstrictors (eg. natural does not necessarily mean safe.

and Fanconi syndrome. and anemia. if the manufacturer makes false or misleading claims.Incidence of Renal Failure 18 supplements contain compounds potentially toxic to humans and the human kidney. progression to end-stage renal disease is more rapid than that noted in other interstitial nephropathies. Other common clinical findings include renal failure. Recent events associated with dietary supplements containing ephedrine alkaloids and steroid precursors illustrate these safety and enforcement concerns. herb. and contains at least one of the following dietary ingredients: vitamin. According to the Dietary Supplement Health and Education Act of 1994. amino acid. the pathologic findings in Chinese herbs nephropathy bear a striking resemblance to those observed in the illdefined Balkan nephropathy. a rapidly progressive interstitial renal fibrosis was reported in a group of young women who ingested pills containing Chinese herbs while attending a slimming clinic in Brussels. Interestingly. glycosuria. aortic insufficiency. extensive interstitial fibrosis and tubular atrophy with preserved glomerular structures. Furthermore. The cardinal pathologic features of Chinese herbs nephropathy are an acellular. and peritoneal membrane. Extrarenal manifestations of Chinese herbs nephropathy include nephrotoxicity of drugs 33fibrosis of the salivary gland. The manufacturer must show the US Food and Drug Administration (FDA) that a new dietary supplement can reasonably be expected to be safe but is not required to have a premarket evaluation of safety and efficacy. is labeled as such. periureter. aseptic leukocyturia. suggesting that the latter might represent a chronic exposure to aristolochicacids. Subsequent investigation found that one of the prescribed Chinese herbs had been inadvertently replaced by other Chinese herbs containing the nephrotoxinaristolochic acid. mild to moderate hypertension. a dietary supplement is an oral product that is intended as a supplement to the diet. but once it is present. No premarket approval requirement exists for dietary supplements. A product is considered a new dietary supplement when the ingredient was notmarketed before October 15. Chinese herbs nephropathy. most patients present with tubular dysfunction manifested as lowmolecular-weight (tubular) proteinuria. The onset of renal failure is often delayed for several years after the exposure to Chinese herbs. enzyme. in contrast to the stringent requirements for new drugs. and the manufacturer has no obligation to provide evidence of product safety unless the product is considered a new dietary product.In 1993. or botanical product. Since the original description. Consistent with the predominant tubular interstitial damage. The FDA can bring enforcement action against an existing supplement if it presents an unreasonable or significant risk of harm. there have been several reports worldwide of nephropathy associated with the inadvertent adulteration of herbal remedies taken for a variety of conditions with herbs containing aristolochic acid. there are no postmarket adverse event reporting requirements for dietary supplements. or if the product is adulterated or misbranded. mineral. and a predisposition to . 1994 or the ingredient is currently not present in the food supply.

The cause is probably multifactorial and involves a direct vasoconstrictive effect of cocaine on the renal vasculature. and proteinuria. A report from an emergency department found that 24% of patients evaluated for cocainerelated issues had evidence of rhabdomyolysis in the form of a CPK greater than 1000 IU/L. Inhalants produce a euphoric high that resembles the effect of alcohol followed by drowsiness and disinhibition.nephrotoxicity of drugs 39Amphetamines. or nitrites. Cocaine is a stimulant extracted from the leaf of the Erythroxylon coca bush and available as a hydrochloride salt for intravenous or intranasal administration or as µµfreebase¶¶ for smoking. are the most common medical consequences of cocaine abuse. 3. MDMA. A variety of renal complications have been reported. altered systemic hemodynamics. renal tubular acidosis. the most commonly abused compound is toluene. The chronic inhalation of solvents has been associated with varied kidney abnormalities. Often the tubular abnormalities resolve with avoidance of the suspected solvent. and myoglobin-induced renal failure due to rhabdomyolysis. The delay in the development of renal damage for several years after exposure suggests that the mechanism by which aristolochic acids cause fibrosis and a predisposition to urothelial malignancies is related to DNA modifications rather than to a direct cytotoxic effect. gases. anti±glomerular basement membrane antibody±mediated glomerulonephritis is observed with gluesniffing. glue. A retrospective study of 39 patients admitted with cocaine intoxication and rhabdomyolysis found that 13 (33%) developed renal failure for which eight required dialysis [56].pyuria. A significant amount of inhalation can result in loss of consciousness.Incidence of Renal Failure 19 urothelial malignancies. and a variety of kidney toxic effects. Ecstasy (ie. and an autopsy study found an increased incidence of glomerular sclerosis. aerosols. Inhalants are generally classified as volatile solvents (eg. Chronic exposure to inhalants can produce neurologic. Inhalants are volatile substances that can be inhaled to induce a psychotropic response. and heart attacks. Acute renal failure is well described in patients presenting with acute cocaine intoxication. such as hypertension. cardiac arrhythmias. Although several chemical substances are found in abused solvents. Cardiovascular effects. The euphoric effect associated with cocaine is caused by an inhibition of dopamine reuptake in the neural cells. hepatic. periglomerular sclerosis. Cocaine use has been linked to renal infarction. 4-methylenedioxymethamphetamine) is a close . The tubular manifestations arising from solvent abuse probably result from the interference with intracellular metabolic processes involved with membrane transport. gasoline). and atherosclerotic changes in cocainerelated deaths. Rarely. including acute and chronic renal failure. urolithiasis. hematuria. paint thinners. Fanconi syndrome. hematologic.

families. The sustained physical exertion (eg. Ecstasy has been shown to stimulate the release of antidiuretic hormone.Incidence of Renal Failure 20 structural analogue of amphetamine with both stimulant and hallucinogenic effects in humans. (b) economic deprivation at the household level. depression. myoglobin Environment The economic and social standing of communities and families often provides access to important social. rhabdomyolysis. (Bruce. and acute renal failure. and communities because they can play a critical role in the formation and navigation of difficult social and economic environments where opportunities for upward mobility are scarce. and/or stress. However. . Several cases of acute renal failure have been reported in individualsingesting wild mushrooms with the intent of producing hallucinations. the study of the psychosocial aspect of nephrology is still relatively new and requires scientists to devote considerable attention to nontraditional risk factors such as anxiety. fulminate hyperthermia. Three important components of the distressing or unhealthy social environments are (a) poor residential conditions. and acuterenal failure from the muscle breakdown products (eg. and social support. the overdose of a variety ofdrugs has led to a prolonged coma. and material resources that help individuals care for themselves and others. particularly among adolescents who frequent µµrave¶¶ or µµtechno¶¶ parties. disseminated intravascular coagulation. 2010). The number of studies examining the relationship between psychosocial factors and kidney disease has grown in recent years. Toxicity includes convulsions. as a larger segment of the nephrologic community has become interested in identifying and addressing modifiable risk factors. rhabdomyolysis. and is used to prolong dancing time and mood enhancement.Inexperienced collectors inadvertently collected and ingested Cortinarius mushrooms or other nephrotoxic species. Finally. hepatic dysfunction. Acute renal failure has been associated with the intravenous administration of cannabis. dancing) associated with a high ambient temperature and inadequate fluid intake may result in severe hyperpyrexia. Some of the toxic effects probably result from the combination of direct drug effect and the environmental circumstances associated with the abuse of Ecstasy. anxiety. and cases ofhyponatremia and stupor have been reported with aggressive hydration. sex. Constant exposure to distressing environments can reinforce constraints on one¶s existence and lead to higher levels of anger. and acute renal failure. and socioeconomic status have important implications for individuals. referred to as psychonephrology. Ecstasy is a popular drug of abuse. Social scientists have noted that living in economically and socially challenging environments can be psychologically harmful. stress. may provide unique insights into the development and progression of kidney disease. emotional. and (c) social stressors such as racism or discrimination.We believe that this line of research. and urinary retention has been reported with cannabis ingestion. pressure-induced muscle necrosis. Race.

the nurse's function in the cure circle is limited to helping patients/families deal with the measures instituted by the physician. The core circle was shared with social workers. Theoretical Framework Hall believed patients should receive care ONLY from professional nurses. It has been well established that patients with sparse social networks and low levels of social support have an increased risk for death. The existing literature suggests that involvement in dense social networks and emotionally supportive relationships can be a protective factor against environmental threats to psychological and physiological health. However. The relationship between social relations and kidney disease has not been pursued extensively. racial/ethnic minorities and the poor) confront on a regular basis. the impact of social support has been assessed primarily in patient populations. Hall was not pleased with the concept of team nursing--she said that "any career that is defined around the work that has to be done. This suggests that future studies should examine the relationship between social support and the development and progression of CKD while also considering social and psychological challenges that at-risk individuals (eg. and how it is divided to get it done. Nursing involves interacting with a patient in a complex process of teaching and learning. These studies provide evidence that positive social support can be a protective factor for individuals dealing with time-consuming. and survival rates among patients undergoing hemodialysis. psychologists. It is not clear how social support interacts with environmental factors or other psychosocial factors to affect the health of individuals at risk for CKD or who are in the early stages of CKD. long-term therapy associated with ESRD. and they determined that social support is inversely related to morbidity and mortality risk. quality of life. (J Investig Med. or acquaintances have been found to have higher rates of cardiovascular disease morbidity and mortality than persons who are integrated in social networks. is a "trade" (rather than a profession). etc. relatives. care. A few studies have examined the relationship between social support and depression. This nurturing component also referred to . Care focuses on hands-on bodily care and the belief that a caring touch and thorough assessment is therapeutic. clergy. 57(4): 583± 589). Research has not determined the degree to which social support has implications for the development and progression of CKD.Incidence of Renal Failure 21 Classic social science asserts that social relationships affect an individual¶s well being. 2009 April. Individuals who live alone or have minimal contact with friends. and cure) but shares them to different degrees with other disciplines. compliance. She felt that the care circle was exclusive to nursing. Nursing functions in all three of the circles (core. For example.

Then the next box is the factors contributing to the incidence of Renal Failure in terms of nutrition. The goal is to help patients learn their roles in the healing process. family income and health related problems. maintain who they are. In Hall's theory. patient care was based on social sciences and shared with other parts of the community. It is also here that a nurse's role as a patient advocate comes into play. but also his life. such as psychologists and clergy. Hall believed this was an aspect of care that was exclusive to nurses. "core" refers to using therapeutic communication to help the patient understand not only his condition.Incidence of Renal Failure 22 as "mothering" the patient. she must advocate her plan of care for the best interest of the patient. Through these. lifestyle. was done with the goal of comforting the patient and helping them meets their needs. peer group and environment. . Conceptual Framework Demographic profile of the Respondents y y y y Age Gender Family income Health related problems Factors contributing to the incidence of Renal Failure y y y y Nutrition Lifestyle Medication Environment Proposed Program on how to lessen or decrease the incidence of Renal Failure Figure 1 Figure 1 shows the demographic profile of the respondents in terms of age. the function of the nurse is to assist the patient and her family in coping with treatment ordered by a physician. the researchers can propose program on lessening/decreasing the incidence of Renal Failure. gender. In this aspect. In this aspect. Patient care in this section is based on pathological science. and learn to use the nurse as a sounding board. Cure refers to nurses applying their medical knowledge of the disease to assist with a plan of care.

(Polit& Beck. Procedures The researchers started the research study from the time the titles was constructed together with its particular objectives. 2008). The researcher utilized purposive sampling which the researchers select participants based on personal judgement about which one will be most informative. It is concerned with describing the characteristics of the population as well as finding out the association of certain characteristics in the population. Participants The researchers selected 3 adopted communities of LPU Batangas. Study Locale The students will conduct study in selected adopted communities of Lyceum of the Philippines University Batangas. Then it was presented to the . It is a selfmade questionnaire that was made through the hard works and collaboration of the researchers and was also guided with the help of other experts. The descriptive method seeks what is rather than predicts relations to be found. The questions were easily comprehendible and were formulated in a way that the respondents can easily understand. The first part of the questionnaire comprises of the demographic profile of the respondent. 2008). The second part was about the factors contributing to the incidence of Renal Failure.Incidence of Renal Failure 23 Methods Research Design The researchers utilized the purposive sampling method in the research. Instruments The researchers used questionnaires as a data gathering tool. The researchers chose these particular adopted communities because of the accessibility and familiarity of the researchers. describe and document aspects of a situation as it naturally occurs. (Polit& Beck. This type of research tends to observe.

Receiving the endowment and approval from the Dean of the College of Nursing. From the approved title and objectives. And it was followed by the formation of questionnaires that was based from the literature of every objective. Afterwards it was again presented to the adviser and other chairperson for consultation and approval. the research study was then started entitled ³Incidence of Renal failure in Adopted communities of LPU Batangas´. allowed by the hospital administrators. . the research study was conducted.Incidence of Renal Failure 24 adviser for approval and validation. The participants were given consent to sign for cooperation in answering the questionnaires and it was treated with highest confidentiality.

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