Chronic Kidney Disease

CHRONIC KIDNEY DISEASE: KNOW THE MAIN PHYSIOTHERAPEUTIC TREATMENTS

Chronic Kidney Disease

The kidneys are a pair of bean-shaped organs located in the upper-posterior part of the abdomen. Its main function is to filter the blood, eliminating toxins and excess salt and water from the bloodstream.

The proper functioning of the body depends a lot on the kidneys. Therefore, it is necessary to take special care to avoid possible kidney problems, which can lead to failure and the need for dialysis or hemodialysis.

Chronic kidney disease (CKD) is a slow, progressive and irreversible loss of renal structures that affect the glomerular, tubular and endocrine functions of the kidneys, leading to the body’s inability to maintain metabolic and electrolyte balance.

Characterized by the presence of functional and/or structural changes in the kidneys, for a period longer than three months, with a glomerular filtration rate (GFR) lower than 60 mL/min./1.73m.

CKD has been considered a public health problem worldwide due to its high rates of morbidity and mortality and its impact on physical and biopsychosocial aspects, drastically affecting the quality of life of patients, says the best nephrologist in Delhi.

With that in mind, nephrologist in Delhi prepared this article with the main types of treatment for Chronic Kidney Disease. Keep reading and learn more about them!

Treatment for Chronic Kidney Disease

Treatment for Chronic Kidney Disease aims to help the kidneys maintain homeostasis for as long as possible.

With the deterioration of renal function, dietary intervention is necessary with careful control of protein intake (allowed must be of high biological value – dairy, eggs, meat – to provide essential amino acids), fluid intake (quantity of fluid allowed is 500 to 600 ml more than the 24-hour urine output) to counteract fluid losses, sodium intake to counteract sodium losses, and a certain potassium and phosphate restriction.

At the same time, adequate caloric intake and vitamin supplementation must be ensured.

In general, dialysis in Delhi is started as a form of treatment for Chronic Kidney Disease when the patient cannot maintain the usual lifestyle with the conservative method.

Unfortunately, not all patients are candidates for dialysis or transplantation due to severe psychological problems, ischemia, vascular complications from diabetes and old age, says kidney specialist in Delhi.

Types of dialysis

There are two types of dialysis – hemodialysis (HD) and peritoneal dialysis (PD), both types involve the use of a fluid used to filter impurities in the blood, toxins and fluids passing from the blood through a semi-permeable membrane.

Physiological principles of dialysis

Dialysis is a process of treatment for Chronic Kidney Disease whereby the composition of solutes in a solution A is changed by exposing solution A to a second solution B through a semipermeable membrane.

Water molecules and low molecular weight solutes from the two solutions can pass through the pores of the membrane and therefore mix, while larger solutes (such as proteins) cannot pass through this semi-permeable membrane and thus the amounts of high molecular weight solutes on either side of the membrane will remain unmodified.

The transport of solutes will take place in two ways:

  • Diffusion: transport of solutes through a semi-permeable membrane, obeying the concentration gradient and the molecular weight of the solute;
  • Ultrafiltration: transport of water through the transmembrane pressure gradient with the passage of water from the higher side to the lower pressure.

Peritoneal dialysis

Peritoneal dialysis uses the peritoneum as a natural permeable membrane to balance water and solutes.

The technique is less physiologically stressful for the patient, does not require vascular access that can present numerous complications, it can be performed at home and, for this reason, allows patients greater flexibility in its performance.

Although, with so many advantages, the technique requires much more patient involvement than in a hemodialysis at dialysis centre in Delhi, it needs to be performed carefully and sterile maintenance is of great importance.

Peritoneal dialysis can be done manually or using an automatic device (periodic, overnight, or continuous), and in general, the dialysate is instilled through a catheter into the peritoneal space, remains for a period, and then drains. In the double bag technique, the patient drains the fluid instilled into the abdomen into one bag and then infuses fluid from another bag into the peritoneal cavity.

Quality of life of patients

Although the different dialysis methods of treatment for Chronic Kidney Disease are equivalent in issues related to patients’ rehabilitation and mortality, the quality of life needs to be evaluated.

In a study, it was possible to observe that PD was more favorable to a better quality of life for the patient, as it presents three significant variables (work, patient satisfaction and less contact with the team – less likely to experience situations of stress), while HD presented two significant variables (emotional and physical function).

However, it should be taken into account that the two significant items in HD are more relevant to the daily quality of life of the patient outside the clinic.

Conclusion

Kidney replacement therapies, hemodialysis and peritoneal dialysis, as a treatment for Chronic Kidney Disease represent, in most cases, a life expectancy for those who undergo it, since the disease is characterized as an irreversible process.

Conservative treatment (medicines, changes in diet and lifestyle) can be used to delay the worsening of renal function or stabilize its progression, reduce symptoms (malaise and fatigue, itching and dry skin, headache, loss of unintentional weight, loss of appetite and nausea), prevent complications and improve the quality of life of these patients.

Adapting to this new reality is not an easy process, nor is it a very smooth process, the health professionals involved in the patient’s treatment must understand and help the individual in all aspects, as well as his family, says the kidney doctor in Delhi.

 

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