Posts Tagged ‘Metabolic Wastes’

Assessing Your Hypertensive Patient for Renal Disease

Comments: 0September 2nd, 2010 by admin



Because your hypertensive patient has an increased risk of developing renal disease, monitor his laboratory results for the following.

Stage I: Diminished Renal Reserve

* reduced kidney function with no accumulation of metabolic wastes

* mild elevation in blood urea nitrogen (BUN) and creatinine levels

Stage II: Renal Insufficiency

* mild accumulation of metabolic wastes

* elevated BUN, creatinine, uric acid, and phosphorus levels

* anemia

* mild hyperkalemia

* reduced ability to concentrate urine

Stage III: End-stage Renal Disease

* excessive accumulation of metabolic wastes

* severely elevated BUN, creatinine, potassium, and phosphorus levels

* decreased sodium and calcium levels

* decreased hemoglobin level and hematocrit

* fluid retention

A physician uses renal ultrasonography, excretory urography, and renal arteriography to diagnose renal disease. Renal ultrasonography helps the physician visualize renal structures to evaluate the integrity of tissues and vessels. This procedure is safe for patients with renal insufficiency because it doesn’t use contrast media.

A physician uses excretory urography to identify the absence or presence of lesions, areas of restricted blood flow, and areas of vascular occlusion. He also may use renal arteriography to evaluate renal blood flow. Excretory urography and renal arteriography require the use of contrast media, placing your patient with renal insufficiency at risk for worsening kidney function.

Treatment for Peripheral Vascular Disease

The treatment of peripheral vascular disease may include drug therapy, surgery, or both. If your patient has peripheral artery occlusive disease, the physician may prescribe pentoxifylline, which is the only effective drug for treating the condition. Pentoxifylline increases erythrocyte flexibility and reduces blood viscosity, thus increasing the oxygenated blood supply to the ischemic muscle.

The physician may prescribe an antihypertensive drug to control your patient’s blood pressure. If your patient undergoes arterial bypass surgery for peripheral vascular disease, his physician also may prescribe aspirin and warfarin to maintain graft patency.

To treat peripheral vascular disease, a surgeon may perform patch graft angioplasty. In this procedure, the surgeon opens the occluded artery and removes the atherosclerotic plaque. Then he places a patch over the opening to widen the vessellumen.

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Diet For Kidney Failure – Are They Really Effective in Reducing the Progression of Kidney Diseases?

Comments: 0September 17th, 2009 by admin



As a nurse for many years now, a lot of people complain to me that their diet for kidney failure is so hard to follow. They tell me that this type of diet has too many restrictions and that it is so rigid and unforgiving.

My reply to the above statement is that maybe the asking patient didn’t consider other possibilities of the diet? Or maybe he or she was not able to research enough to realize that this diet is in fact easy to follow.

Before I start talking about the diet for kidney failure, I will first talk a little about the kidney. The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolytes in the body, controlling blood pressure, and stimulating the production of red blood cells.

Now, renal failure results when the kidneys cannot remove the body’s metabolic wastes or perform their regulatory functions. The substances normally eliminated in the urine accumulate in the body fluids. As a result of this impaired renal excretion, there are electrolyte and acid-base disturbances.

Renal failure is a systemic disease and is final common pathway of many different kidney and urinary tract diseases. Each year, the number of deaths from irreversible renal failure increases.

Kidney disease diet is an important consideration for those with impaired kidney function. Consultation with a dietitian may be helpful to understand what foods may or may not be appropriate. Various kidney disease recipes are available in the market right now.

Since the kidneys cannot easily remove excess water, salt, or potassium, they may need to be consumed in limited quantities. Foods high in potassium include bananas, apricots, and salt substitutes.

Phosphorus is a forgotten chemical that is associated with calcium metabolism and may be elevated in kidney failure. Too much phosphorus can leech calcium from the bones and cause osteoporosis and fractures. Foods with high phosphorus content include milk, cheese, nuts, and cola drinks.

This diet is usually done with other treatments for kidney failure. The two major treatments for kidney failure are dialysis and transplantation. The former has two kinds of procedures-hemodialysis (accessed via IV route) and peritoneal dialysis (done via the abdomen). The latter, on the other hand, involves a more complex pre-operation.

With a research based diet for kidney failure, renal recovery is almost guaranteed. It is, however, important to be started as immediately as possible to prevent long term damage.

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Posted in anemia