Chapter 28: Care of the Adult with a Urinary/Renal Condition

June Mason is a white, 54-year-old female who was diagnosed with type 2 diabetes 12 years ago, she has a BMI of 30 and lives a sedentary life, June has always struggled to maintain her blood glucose levels and often records post prandial blood glucose levels of above 15 mmol/L. Over the years, June has also been reluctant to visit her GP and have regular renal profile blood tests to assess her renal function. June is now feeling lethargic, has lost her appetite and is losing weight, has a tendency to swollen ankles, is having difficulty sleeping and feels itchy, a visit to her GP and a renal profile blood test reveals eGFR of 9 ml/min. This result is later confirmed when she is referred to the regional renal unit and undergoes a further series of diagnostic tests.

Question

Using the resources in the chapter and those signposted online:

  • List the tests that would be performed to confirm a diagnosis of chronic kidney disease (CKD).
  • Classify the stage of CKD that June is now presenting with.
  • With reference to the MPT, think about what June’s care and management should include to prepare her for dialysis treatment. Does this differ in any way to the care planned for the patient KD (as presented in the book chapter)?
  • Reflect and think about what June could have done to reduce the risks of developing CKD as a result of her type 2 diabetes.

Answer

Suggested responses may include:

  1. Reference to the range of tests contained within the chapter.
  2. Reference to the eGFR tool contained within the chapter: 
    https://ukidney.com/nephrology-resources/egfr-calculator
  3. Reference to the classification table for CKD within the chapter.
  4. Reference to the MPT information contained within the chapter.
  5. Maintain a healthy diet, which includes fruit and vegetables, reduce sugar intake, regular exercise, maintain hydration but avoid sugary drinks, lose weight, avoid smoking, remain within the recommended limits for the consumption of alcohol, attend regular screening appointments.