Renal failure characterized by acute kidney failure

Renal Failure

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Renal Failure
Renal failure is characterized by acute kidney failure, where the kidney fails to perform its basic functions. The risk of renal failure is aggravated by chronic conditions such as diabetes and blood pressure. As a result, renal failure has become a common illness in the recent past because of increased diabetes and blood pressure cases. According to Broers et al. (2020), renal failure is attributed to poor nutrition. Therefore, this illness can be remedied by nutritional interventions. This project focuses on the role of nutrition in the prevention of the disease, alteration in health, etiology, the recommended diet, treatment, nursing assessments and interventions, and patient education to overcome barriers to the recommended diet.
Identification of the Alteration in Health
Renal failure comes with a wide range of alterations in health. Dennis et al. (2018) posit that the severity of kidney failure determines the alteration in health. Renal failure can be acute or chronic. Acute renal failure is characterized by obstruction of the renal blood vessels, obstruction of the glomerulonephritis, and inflammation of the blood vessels. This leads to the dysfunction of the kidneys. For example, after an accident that injures the kidney, it is impossible for the kidney to remove extra fluid from the body. Consequently, limbs swell because of excessive fluid retention in the body.
The urinary tract is blocked in chronic renal failure, such as chronic-post renal kidney failure. This leads to troubles in eliminating uric waste products from the body. Some of the symptoms of the alteration of health in chronic renal failure include pressure in the chest, shortness of breath, severe fatigue, persistent nausea, and comma.
Role of Nutrition in the Prevention of the Disease
Nutrition therapy can potentially lessen the burden of renal disease. There is worldwide recognition that poor diet is the major cause of kidney-related problems. Subsequently, regulating the diet can help prevent renal failure and its progression. For example, regulating protein and sodium intake helps control waste build-up in the kidney. This helps to prevent damage to the kidney.
Etiology
Type 1 and type 2 diabetes are the leading cause of renal failure. Excess blood sugar level damages the kidney because of the disrupted flow of blood to the kidney. High blood sugar levels clog the renal arteries, thus denying the kidney a sufficient supply of nutrients. Besides, high blood pressure is another well-documented cause of kidney failure. High blood pressure narrows blood vessels, thus constraining blood flow to the kidneys.
The other causes of renal failure include kidney stones, tumors, autoimmunity, and abnormalities in the urinary tract. Furthermore, sexually transmitted diseases such as cystitis and syphilis contribute to kidney failure. Moreover, excess intake of proteins such as creatine and albumin contributes to the damage of the kidney and can progress to total renal failure due to the accumulation of toxins.
Progression
The progression of renal disease occurs in five stages: first, second, third, fourth, and end-stage. These stages are determined by the eGFR test, urine test results, and the performance of the kidney. Persson and Rossing (2018) state that the performance of the kidney worsens progressively from the first stage to the last. The patient has a normal eGFR of 90 and above in the first stage. This value reduces to 60 in the second stage, 30 in the third stage, 15 in the fourth stage, and less than 15 in the fifth stage.
The kidney has mild damage during first stage renal damage, and the kidney operates normally. The kidney continues to damage mildly during the second stage but maintains almost normal functioning. The kidneys are moderately damaged in the third stage, and performance deteriorates in the first phase. The kidneys are severely damaged in stage three’s second phase but still perform some simple functions. Things worsen in stage four, where the kidneys are damaged close to zero functioning. In the last stage, when the bigger percentage of the kidney is damaged, the kidney stops functioning. Machines for dialysis support patients at this final stage.
Treatment
There are many treatment options for renal disease. The choice of the treatment method depends on the severity of the condition, affordability, availability, and patient preference. Dialysis is the most common treatment for renal failure. Dialysis involves using a machine to cleanse the body the same way the kidney operates. Dialysis is mainly performed at a dialysis center by a renal expert. In the recent past, people have started offering dialysis services at homes. Although dialysis has high effectiveness, it is a costly option.
The other treatment option is the performance of a kidney transplant. A kidney transplant is considered when all the other treatment options have failed. A healthy donor donates one of their kidneys to replace the receiver’s damaged kidney. The donor may be alive or dead. If the donor is alive, they donate one kidney, but a dead donor can donate both kidneys. Surgery is performed to replace the damaged kidney or kidneys. After the surgery, the patient must take supplementary medicines to leverage the performance of the new kidney.
Additionally, one can consider lifestyle changes to reduce the severity of the disease. Some lifestyle changes include a diet change, including quitting smoking, eating a balanced diet, regular exercise, reducing alcohol intake, losing weight, and avoiding OTC non-steroidal anti-inflammatory drugs such as ibuprofen. Lastly, the diseases can be treated by taking medicines to control conditions such as hypertension and bad high cholesterol.
Recommended Diet
Diet plays a significant role in the prevention and management of renal failure. The recommended diet for a patient with renal failure includes a high intake of fruits and vegetables and whole grains. Also, the patient should regulate sodium intake, sugar intake, protein intake, particularly red meats, and reduce fat intake. This diet helps improve blood flow to the kidney, thus optimizing the functions of the kidney.
According to Ko et al. (2017), a patient should reduce protein intake as one of the for preventing the contraction and progression of renal diseases. Low protein diets improve renal function and impede histologic damage (Bus et al., 2017). Besides, one should limit phosphorus intake to reduce the build-up of toxins in the kidney and impede hyperparathyroidism and acidosis. Excess phosphorus intake catalyzes the secretion of too much parathyroid hormone (PTH) (Bus et al., 2017). Accumulation of excess PTH and acids leads to damage to the kidneys.
Besides, one should consider diets that support their overall healthiness. Fruits and fresh vegetables should be taken daily. Also, fatty foods should be reduced or eliminated to maintain a healthy heart. Excess Sodium intake should be avoided to decrease the accumulation of sodium in the kidneys. According to Ko et al. (2017), the recommended daily sodium intake is < 2,300 mg.
Moreover, one should regulate the intake of alcohol. Adhering to a healthy diet regimen will help prevent diseases that elevate the risk of renal disease. For example, reduction of cholesterol intake prevents heart-related complications. Thus reducing the risk of damaging the kidney.
Type of Nursing Assessments
Successful management of renal failure is leveraged by effective dietary assessment. The primary nutritional assessments for renal failure include complete urinalysis, assessment of urine albumin- to creatine ratio (UACR), (CBC), and blood urea nitrogen (BUN) assessment. Secondary nutritional assessments include hepatitis serology, antinuclear antibody test (ANA), serum protein electrophoresis (SPEP), complement 3 (C3), and complement 4 (C4). Renal ultrasound and dilated retinal exam may be considered in patients with other complications that impede successful assessment.
Nursing Interventions
Some nursing interventions for the renal disease include fluid status and dietary management. Fluid status assessment is key in reaching normovolemia (normal blood volume) (Park et al., 2018). Maintaining a normal blood volume and flow for patients diagnosed with renal failure is key in preventing the progression of the disease. Having enough blood helps to maintain the supply of nutrients to the kidney. The nurse can encourage the patient to consume foods that boost the manufacture of blood.
Dietary management is central to the successful management of a renal disease. Nurses should ensure that the patient takes a low sodium, protein, and phosphorus diet. Also, the patient should limit the intake of foods rich in potassium and calcium. Furthermore, the patient should also increase the consumption of fresh fruits and fresh vegetables. Finally, the nurse should recommend a strict regimen for medication and rest.
Client Education
According to Sulaiman (2019), client education is imperative in managing renal failure. Client education enhances the patients’ adherence to recommended diet, lifestyle changes, and medication. Patients diagnosed with renal failure must be educated on managing the disease and preventing progression.
Firstly, the education program must include diet recommendations for the patient. As mentioned earlier, diet is central in altering the functioning of a damaged kidney. The patient must be taught to manage sodium intake, potassium intake, protein consumption, and phosphorus intake. Also, the patient is educated about the intake of fibers and how to control metabolism rate by monitoring calorie intake.
Secondly, the patient must be educated about home care strategies that may help to reduce the severity of symptoms and improve comfort. Examples of strategies to be included here are a rest plan, how to lose weight, strict adherence to medication appointments, controlling blood pressure, and management of diabetes. The nurse can also educate the patient about other dialysis and transplant interventions.
Lastly, patient education should include details about the follow-up care, such as the next clinical appointment and signs that . For example, signs such as trouble breathing, severe chest pain, and zero urine output require immediate medical attention. The patient should call 911 immediately if such signs occur.
Adherence
According to Mukakarangwa et al. (2018), adherence to recommended diet regimen reduces morbidity, mortality, and hospital stay. Nurses should simplify regimen characteristics and constantly evaluate adherence to overcome barriers that impede adherence to the recommended nutrition. Simplifying characteristics (vocabulary) used in the diet regimen helps the client understand the terms used, thus improving adherence to the diet. Evaluating adherence to the recommended diet helps identify patients who have not adhered to it and encourages them to do so. The evaluation results are used to improve patient education concerning the benefits of good nutrition. These strategies help bypass barriers that impede successful patient adherence to the recommended diet.
Conclusion
Renal failure is a serious condition attributed to the malfunction of the kidney. The disease progresses from stage one to stage five. Good nutrition is key in the successful management of the disease. Dialysis, kidney transplant, and medication are the most common treatment intervention for renal failure. Client education comprises diet regimen, rest, and adherence to medication appointments. Adherence to patient education can be improved by simplifying the regimen characteristics and constantly evaluating patients’ adherence to patient education.

References
Broers,N.J., Canaud,B., Dekker,M.J., Sande,F.M., Stuard,S., Wabel,P., & Kooman,J.P. (2020). Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end-stage kidney disease: What have we learned so far? Hemodialysis International, 24(2), 148-161. https://doi.org/10.1111/hdi.12812
Bus,P., Scharpfenecker,M., Van Der Wilk,P., Wolterbeek,R., Bruijn,J.A., & Baelde,H.J. (2017). The VEGF-A inhibitor sflt-1 improves renal function by reducing endothelial activation and inflammation in a mouse model of type 1 diabetes. Diabetologia, 60(9), 1813-1821. https://doi.org/10.1007/s00125-017-4322-3
Dennis,A.T., Hardy,L., & Leeton,L. (2018). The prone position in healthy pregnant women and women with preeclampsia a pilot study. BMC Pregnancy and Childbirth, 18(1). https://doi.org/10.1186/s12884-018-2073-x
Ko,G.J., Obi,Y., Tortorici,A.R., & Kalantar-Zadeh,K. (2017). Dietary protein intake and chronic kidney disease. Current Opinion in Clinical Nutrition & Metabolic Care, 20(1), 77-85. https://doi.org/10.1097/mco.0000000000000342
Park,J.H., Jo,Y., & Lee,J. (2018). Clinical usefulness of bioimpedance analysis for assessing volume status in patients receiving maintenance dialysis. The Korean Journal of Internal Medicine, 33(4), 660-669. https://doi.org/10.3904/kjim.2018.197
Persson,F., & Rossing,P. (2018). Diagnosis of diabetic kidney disease: State of the art and future perspective. Kidney International Supplements, 8(1), 2-7. https://doi.org/10.1016/j.kisu.2017.10.003
Sulaiman,M.K. (2019). Diabetic nephropathy: Recent advances in pathophysiology and challenges in dietary management. Diabetology & Metabolic Syndrome, 11(1).