[Early Management of Renal Anaemia in Predialysis Patients and Its Impact on Their Progress of Renal Failure]

by

Contents

CHAPTER 1: INTRODUCTION1

1.1 Introduction of the Literature Review1

1.2 My Clinical Background1

1.3 Background of the Literature Review2

1.4 Aims and Objectives4

1.5 Future Questions4

1.6 Rationale5

1.7 Significance of the Study5

CHAPTER 3: METHODOLOGY7

3.1 Review Method7

3.2 Study Design7

3.3 Literature Search8

3.4 Secondary Data9

3.5 Types and Sources of Secondary Data10

3.6 Suitability of Data for the Project11

3.7 Authentication and Credibility11

3.8 Qualitative Data12

3.9 Justifying the Future Question12

REFERENCES14

CHAPTER 1: INTRODUCTION

1.1 Introduction of the Literature Review

This review focuses on early management of renal anaemia in pre-dialysis patients and its impact on left ventricular hypertrophy progression of renal failure and quality of life and comprises of the following chapters:

Introduction

Literature Review

Methodology

Discussion

Conclusion

1.2 My Clinical Background

At my place of work in the renal ward, acute and chronic kidney disease patients including pre-dialysis patients get admitted, for many different reasons, including diagnostic investigations and therapeutic intervention. I am a senior staff nurse and a member of the kidney care team linked to the renal ward, where we give advice and explanations about renal failure in general and renal anaemia in specific to patients and their family members and sometimes to patients. Also, I am a ward coordinator and facilitate the ward management on a daily basis. I sometimes give guidance and support to the junior doctors when needed, concerning the management of renal anaemia in chronic kidney disease patients including pre-dialysis patients. Junior doctors routinely change every four months and a new group of junior doctors comes to work on the ward. Also, as a Mentor to student nurses, I teach about renal failure and management of renal anaemia. I also act as a preceptor for newly qualified nurses.

1.3 Background of the Literature Review

The accepted definition of chronic kidney disease is based on a combination of kidney damage greater than or equal to 3 months in duration (usually quantified by measuring albuminuria or protein in the urine) and decreased kidney function as measured through glomerular filtration rate (GFR) (Hallan, & Vikse, 2008, p.286). There are five stages of chronic disease:

Stage 1 - GFR > 9OmLImin per 173 m2 (normal GFR) and persistent albuminuria

Stage 2- GFR between 60 and 89 mLImin per 1.73 m2 and persistent albuminuria

Stage 3 - GFR between 30 and 59 mLlmin per 1.73 m2

Stage 4 - GFR between 15 and 29 mUmin per 173 m2

Stage 5 - GFR < 15 mLlmin per 1.73 m2 or end stage renal disease

Kidney failure is the last stage of CKD and is often caused by diseases that attack the nephrons, the functional unit of the kidney that filters blood, causing them to lose the ability to filter waste. Acute damage to nephrons can happen quickly if due to injury or poisons. Most kidney disease, though, damages the nephrons slowly and without symptoms (Kielstein, & Zoccali, 2008, p.609). This gradual loss of kidney function is called Chronic Kidney Disease (CKD) or chronic renal insufficiency. Individuals with CKD can progress to permanent kidney failure leading to end-stage renal disease ...