Chronic Kidney Disease Analysis

Chronic kidney disease (CKD) often presents with a "subtle" clinical presentation (Buttaro, Tybulski, Polgar Bailey, & Sandberg-Cook, 2013, p. 766). Therefore, clinicians need to be aware of the risk factors for CKD and screen patients who present with such factors that place them at risk for this condition. This paper will review the clinical presentation, diagnosis, patient history, physical exam, and diagnostics associated with the recognition of CKD. Treatment options will be discussed with attention to the influence of patient factors on diagnosis and treatment.
Clinical Presentation
The clinical presentation of CKD will vary based on many factors such as the severity and presence of other system involvement. According to Buttaro et al. (2013), CKD is a "reduction in kidney function that has been present for
Significant historical risk factors include the presence of "liver disease, diabetes mellitus (DM), and vascular disease" (Buttaro et al., 2013). Past management of comorbidities such as DM and HTN is contributory. What have been the trends of control related to DM or HTN? Chronic HTN and elevated A1C create an environment for further deterioration of the cardiovascular system. A family history of end-stage kidney disease is another significant factor (National Institute for Health and Care Excellence [NICE], 2015). These findings collectively can build a case for the development of CKD and its progression.
Physical exam findings will include identification of any "pathologic processes caused by primary diseases" such as DM and HTN (Buttaro et al., 2013). These findings could include signs associated with retinal changes (arteriovenous nicking), edema (jugular venous distension and ascites), weight changes, and hemodynamic outcomes from volume overload (heart failure, renal bruit, and pulmonary edema) (Buttaro et al.,