Diabetes, Chronic Renal Disease, and End-Stage Renal Disease
Diabetes can result in mesangial expansion, structural glomerular changes (for instance, the thickening of glomerular membranes), and expansion of the afferent renal artery. The renal structural changes interfere with the kidney’s normal functioning, which can lead to the leakage of albumin from entering the urine (Batuman et al., 2019). High blood glucose levels can also lead to the build-up of material on the glomeruli, which subsequently increases blood pressure in the glomeruli. Systolic blood pressure leads to the progression of diabetic neuropathy to proteinuria (Batuman et al., 2019). It also reduces the rate of glomerular filtration, consequently leading to end-stage kidney diseases.
Treatment and Management of Chronic Renal Disease
The treatment goals involve stopping or delaying the progression of the disease. The underlying causes and symptom management are usually the main focus of treatment. Dialysis is contraindicated unless the patient’s glomerular filtration rate is 6 mL/min/1.73 m2. (Arora, 2020). Renal replacement therapy is recommended for severe metabolic acidosis, peripheral neuropathy, pericarditis, and encephalopathy. The recommended lifestyle includes diets with low proteins, salts, phosphates, sodium, and potassium. A physical aerobic exercise routine of at least 30 minutes 5 times a week is also recommended (Arora, 2020). However, physical exercise plans should be individualized, depending on the patient’s cardiovascular health.
Purpose of Dialysis and The Difference Between Hemodialysis and Peritoneal Dialysis
In hemodialysis, blood is moved to an artificial dialyzer, while in peritoneal dialysis, the patient’s blood is moved to mesenteric vessels. The dialysate in hemodialysis is unsterilized, while in PD, it is sterilized and transferred to the patient. Dialysis removes salts and wastes from the body to prevent their buildup (Orora, 2020). They act as complementary or substitute the kidney when the patient loses kidney function.
References
Arora, P. (2020). Chronic kidney disease treatment & management. Medscape. Web.
Batuman, V., Schmidt, R. J., & Soman, S. S. (2019). Diabetic nephropathy: Practice essentials, pathophysiology, & etiology. Medscape. Web.
Gilroy, R. K. (2019). Hepatitis A treatment & management: Approach considerations, supportive care, liver transplantation. Medscape. Web.
Jones, M. W., Genova, R., & O’Rourke, M. C. (2019). Acute cholecystitis. StatPearls Publishing. Web.
Workeneh, B. T. (2019). Acute kidney injury: Practice essentials, background, & pathophysiology. Medscape. Web.