ckd

Chronic kidney disease, is also known as chronic renal failure, chronic renal disease, or chronic kidney failure. It often goes undetected and undiagnosed until the disease is well advanced, with kidney function down to 25 percent of normal.

As kidney failure advances and the organ's function is severely impaired, dangerous levels of waste and fluid can rapidly build up in the body. Treatment is aimed at stopping or slowing down the progression of the disease - this is usually done by controlling its underlying cause.

Chronic kidney disease is a slow and progressive loss of kidney function over a period of several years. Eventually, a person will develop permanent kidney failure and irreversible

Etiology 1. ISK 2. Glomerulonephritis 3. Penyakit vaskuler hipertensif (nefroskelrosis, stenosis arteri renalis) 4. Penyakit kongenital dan herediter 5. Penyakit metabolik (DM, hiperparatiroirisme) 6. Nefropati obstruktif (batu saluran kemih) 4. Penyakit kongenital dan herediter – penyakit ginjal polikistik, asidosis tubulus ginjal Secara garis besar, penyebab gagal ginjal dapat di kategorikan infeksi yang berulang dan nefron yang memburuk. Obstruksi saluran kronik destruksi pembuluh darah akibat diabetes dan hipertensi yang lama, scar pada jaringan dan trauma langsung pada ginjal

Manifestasi klinis Gejala dini: lethargi, skait kepala, kelelahan fisik dan mental, bb berkurang, mudah tersinggung, depresi Gejala lanjut: anoreksia, mual muntah, nafas dangkal atau sesak nafas, odem, pruritis

Hipertensi – akibat retensi cairan dan natrium dari aktivitas sistem RAAS Gagal jantung kongenstif dan odem pulmoner (akibat cairan berlebihan) Gangguan Integumen – pucat akibat anemia, gatal-gatal akibat toksik Gangguan cairan elektrolit dan keseimbangan asam dan basa Sistem hematologi – anemia akibat berkurangnya produksi eritropoetin

stages Stage 1 - GFR normal. However, evidence of kidney disease has been detected. Stage 2 - GFR is lower than 90 milliliters, and evidence of kidney disease has been detected. Stage 3 - GFR rate is lower than 60 milliliters, regardless of whether evidence of kidney disease has been detected. Stage 4 - GRF rate is lower than 30 milliliters, regardless of whether evidence of kidney disease has been detected. Stage 5 - GFR rate is lower than 15 milliliters. Renal failure has occurred.

Diagnostic test Blood test - If levels of urea and creatinine are persistently high, the doctor will most likely diagnose end-stage kidney disease. Urine test - presence of blood or protein in the urine. Kidney scans - MRI, CT scan or Utz. Blockages in the urine flow. Reveal size and shape of the kidneys - in advanced stages of kidney disease the kidneys are smaller and have an uneven shape. Blood test - a blood test may be ordered to determine whether waste substances are being adequately filtered out. If levels of urea and creatinine are persistently high, the doctor will most likely diagnose end-stage kidney disease. Urine test - a urine test helps find out whether there is either blood or protein in the urine. Kidney scans - kidney scans may include a magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, or an ultrasound scan. The aim is to determine whether there are any blockages in the urine flow. These scans can also reveal the size and shape of the kidneys - in advanced stages of kidney disease the kidneys are smaller and have an uneven shape. Kidney biopsy - a small sample of kidney tissue is extracted and examined for cell damage. An analysis of kidney tissue makes it easier to make a precise diagnosis of kidney disease. Chest X-ray - the aim here is to check for pulmonary edema (fluid retained in the lungs). Glomerular filtration rate (GFR) - GFR is a test that measures the glomerular filtration rate - it compares the levels of waste products in the patient's blood and urine. GFR measures how many milliliters of waste the kidneys can filter per minute. The kidneys of healthy individuals can typically filter over 90 ml per minute

Kidney biopsy - a small sample of kidney tissue is extracted and examined for cell damage. An analysis of kidney tissue makes it easier to make a precise diagnosis of kidney disease. Chest X-ray check for pulmonary edema (fluid retained in the lungs). Glomerular filtration rate (GFR) - compares the levels of waste products in the patient's blood and urine. GFR measures how many milliliters of waste the kidneys can filter per minute. The kidneys of healthy individuals can typically filter over 90 ml per minute

pathophysiology

AsKEP Gangguan keseimbangan cairan dan elektrolit berhubungan dengan retensi Na dan H2O di tandai dengan edema DS: DO: Goal: Mempertahankan berat tubuh ideal tanpa kelebihan cairan dengan kriteria hasil: tidak ada edema, keseimbangan antara input dan output

Intervensi: a. Kaji status cairan dengan menimbang BB perhari, keseimbangan masukan dan haluaran, turgor kulit tanda- tanda vital b. Batasi masukan cairan R: Pembatasan cairan akn menentukan BB ideal, haluaran urin, dan respon terhadap terapi c. Jelaskan pada pasien dan keluarga tentang pembatasan cairan R: Pemahaman meningkatkan kerjasama pasien dan keluarga dalam pembatasan cairan d. Anjurkan pasien / ajari pasien untuk mencatat penggunaan cairan terutama pemasukan dan haluaran R: Untuk mengetahui keseimbangan input dan output