Chronic Kidney Disease (CKD) Evaluation and Management

EVALUATION and MANAGEMENT
What should we do if we have patient with Chronic Kidney Disease? Today, Mbah Dukun Bagong, modern shaman from medical and health information explains how to treat and give therapy for patient with chronic Kidney Disease (CKD). If someone has been established, there is an increased risk for Chronic Kidney Disease (CKD), but not yet exposed to CKD, it needs to be evaluated as below:

How to know and diagnose CHRONIC KIDNEY DISEASE

CLINICAL MANIFESTATIONS

CKD patients with blood urea of less than 150 mg%, usually without any complaints or symptoms and are often found by chance on routine examination. Clinical picture more evident when the blood urea more than 200 mg%. At the initial level of CKD with a GFR less than 25% of normal, clinical picture is very minimal, only albuminuria, hyperuricaemia, and hypertension.

Pathophysiology of CHRONIC KIDNEY DISEASE

PATHOPHYSIOLOGY
Pathophysiology of CKD at first depending on the underlying disease, but in the later development process that occurs more or less the same, a chronic progressive in the long run will cause a decrease in renal mass. In line with the decrease of renal mass, as a compensation mechanism that is still better then the nephron hyperfiltration therefore will experience an increase in glomerular capillary pressure and flow, and subsequent hypertrophy. Structural and functional hypertrophy of residual nephrons is still good is happening due to the influence of vasoactive molecules, cytokines and growth factor, and eventually will happen sclerosis process. Renin-action activities intravenous Angiostensin also played a role in the occurrence of hiperfilltrasi-hypertrophy and sclerosis.

CHRONIC KIDNEY DISEASE

DEFINITION
Chronic kidney disease is kidney damage or a decrease in renal physiology, more or equal to three months prior to diagnosis. As per the recommendations of the NKF-DOQI (The National Kidney Foundation Disease Outcomes Quality Initiative) (2002):

How to Diagnose and Treatment Encephalopathy Hepaticum

DIAGNOSIS
Diagnosis is made on the basis of anamnesis history physical examination and laboratory disease.
1. history
→ History of liver disease
→ History of the possibility of trigger factors.
→ Is there a neuropsychiatric disorder: changes in Hepatic Encelopathy behavior, personality, intelligence, speech and so on.

HEPATIC ENCEPHALOPATHY ( Hepatic Coma)

DEFINITION

Hepatic encephalopathy or  Hepatic Coma is a complex of a central nervous system disorders that were found suffering from liver failure. The disorder is characterized by memory impairment and personality changes.

Hepatic encephalopathy (portal system encephalopathy, hepatic coma) is a disorder in which brain function decline due to toxic substances in the blood, which would normally be discarded by the liver.

PANCREATIC CARCINOMA (Pancreatic Cancer)

 Yesterday, Steve Jobs, founder Apple inc, was died. who had killed him? he was killed by cancer. what kind of this cancer?. It's called Pancreatic Carcinoma. Today, Mbah Dukun Bagong, modern shaman from medical and health information will explain about this cancer.

Pancoast Tumor

 DEFINITION
Pancoast tumors are primary tumors in the lung apex position in one lung, left or right. Known also as a superior sulcus lung tumors, found by Henry Pancoast, a radiologist, in 1932.
Pancoast tumor originating from the upper limit of the lung. The tumor will form an abnormal tissue in the lung apex, which will be more apparent invade the chest wall and surrounding structures, as compared with the structure of the lung itself.

Nasopharyngeal Carcinoma Therapy

Hello Mbah Dukun Bagong, modern shaman comes again. today mbah dukun will explains about how to therapy the cancer of nasopharyngeal, following last post. There are 2 therapies for this disease. what are they? okey check it out

 

Nasopharyngeal Carcinoma (Nasopharyngeal Cancer)

Be carefull if you smoke ciggaret and eat saltfish too much, because they make deadly disease called Nasopharyngeal Carcinoma or Nasopharyngeal Cancer. Today Mbah Dukun Bagong, Indonesian Modern Shaman special author from Medical and Health Information explains about this cancer. wish it is so usefull for us.

TYPHOID FEVER

DEFINITIONS
Typhoid fever is an acute infectious disease caused by gram-negative bacteria Salmonella typhi. During an infection, the germs multiply in phagocytic cells mononuclear and continuously released into the bloodstream.

RABIES

DEFINITION: 

An acute infectious disease of warm-blooded animals characterized by involvement of the nervous system resulting in death.

Medical Treatment of Acute Cholecystitis

Treatment and Therapy

a.  Common actions

Bed rest, intravenous fluid administration, pain relief with petidin (demerol) and buscopa low-fat diet.  There are several factors that cause the occurrence of gallbladder disease, including obesity, high fat consumption, particularly the increasing trigleserida dyslipidemia associated with high intake of fat and sugar, weight loss quick reply.

Nutritional intervention needs to be done to prevent gallbladder disease: weight control, limiting fat intake to <30? Ri total calorie and fat intake no more than 30 grams / day, limiting the consumption of pure sugar (white sugar and other sweet food), avoid  weight reduction program drastically.  The principles of diet on gallbladder disease:

Acute Cholecystitis

Definition

Acute cholecystitis is an acute inflammatory process of the gallbladder accompanied with right upper abdominal pain, tenderness, and fever and is usually triggered by obstruction of the cystic duct.  The most common cause of acute cholecystitis is a continuous obstruction of the cystic duct by gall stones causing acute inflammation of the gallbladder.

MEDICAL THERAPY for DHF

Two days ago, a medical student came to Mbah Dukun. She asked about DHF. How to treat DHF?

there's no specific therapy for DHF, just support therapy.

DEFINITION

DHF or DENGUE HEMORRHAGIC FEVER is acute infection which caused by dengue virus with clinical manifestasions are fever, myalgia, athralgia  be accompanied by leukopenia, rash, lymphodenopathy, thrombocytopenia and diatesis haemorrhagic, also haemoconcentration (increasing hematocryt). in Indonesia it called "DEMAM BERDARAH"

Idiopathic thrombocytopenic purpura

DEFINITION

Patient asks to mbah dukun: "Mbah, my name is Painem, im from Belgia, i have a problem. my son's legs frequently bruising, red spots appear, these has been about 6 months, intermittent, sometimes accompanied by fever, DHF-like disease. Would you tell me what is that?

Mbah Dukun anwers:

ITP, primary immune thrombocytopenia (also called immune (idiopathic) thrombocytopenic purpura), is an autoimmune disease. In autoimmune diseases, the body mounts an immune attack toward one or more seemingly normal organ systems. In ITP, platelets are the target. They are marked as foreign by the immune system and eliminated in the spleen and sometimes, the liver. In addition to increased platelet destruction, some people with ITP also have impaired platelet production.

CARDIORENAL SYNDROME

DEFINTION
There is no definite definition of the notion Cardiorenal Syndrome (CRS). The National Heart, Lung, and Blood Institute defines the circumstances in which therapy to relieve symptoms of congestive heart failure is limited by the decline in kidney function. More broadly described as a state of moderate or high renal dysfunction, which appears in heart failure patients during therapy. Some say the CRS is the linkage of heart and kidney with the burden of excess fluid in which patients become resistant to diuretic therapy.

NEPHROTIC SYNDROME Part 2

COMPLICATIONS

Patient asks to Mbah Dukun : "Mbah, what are complications of NS?"

Mbah Dukun Bagong answers:



1. Nitrogen balance.

Massive proteinuria in the NS will cause a negative nitrogen balance. Decreased muscle mass is found but these symptoms are often found covered with new symptoms and edema anasarka looked after the edema disappeared. Loss of muscle mass by 10-20% of body mass (lean body mass) are not rare in NS.

Nephrotic syndrome Part 1

DEFINITION

Patient asks to Mbah Dukun: "Mbah, would you explain about Nephrotic Syndrome?"

Mbah Dukun Bagong answers: " Sure, ok read the text below"

Nephrotic syndrome (NS) is one of the clinical manifestations of glomerulonephritis (GN) are marked with anasarka edema, massive proteinuria ≥ 3.5 g / dl, hypercholesterolemia and lipiduria. At the beginning of the process or the mild NS stage, to make the diagnosis, not all symptoms must be found. Massive proteinuria is a typical sign of NS, but in severe NS accompanied low serum albumin concentration, excretion of protein in urine was also reduced. Proteinuria also contributes to various complications that occur in the NS. Not only Proteinuria,hypoalbuminemia, hiperlipidemia and lipiduria also found in NS. Nitrogen balance diorders, hypercoaguloability, disturbances of calcium and bone metabolism, and thyroid hormones are often found in NS. Generally, NS with normal renal function can heal itself and showed a good response to steroid therapy. However, for some cases develop into end stage renal disease or develop inti chronic.

Theraphy HIV AIDS

DEFINITION

Patient ask to Mbah Dukun: “Mbah! I have heard many people talk about AIDS, what is it?”

Mbah Dukun Bagong answers:

Acquired Immune Deficiency Syndrome (AIDS) is a collection of symptoms of disease or abbreviation for acquired imune deficiency syndrome caused by Human Immunodeficiency Virus (HIV).

HIV virus can be found in body fluids, especially in blood, semen, vaginal fluids, breast milk. The virus destroys the human immune system and may decrease or loss endurance, so easily affected by infectious diseases.