CE: Continuing Education ArticlePATIENT MANAGEMENT IN CKD STAGES 1 TO 3

How young people cope with chronic kidney disease: literature review

BACKGROUND

Chronic kidney disease (CKD) is a complex, long-term condition occurring in all age groups. It has been reported that the incidence of renal replacement therapy in young people is 7-8 per million population. Notwithstanding those individuals who may receive a donor kidney, many individuals may be disenfranchised by perceptions of helplessness and feelings of powerlessness against a backdrop of diminished health outlook, consequently impacting on capacity for effective coping.

AIM

The aim of this review is to explore how young people cope with CKD.

METHODS

Three hundred and thirty-seven abstracts were identified. Sixty-three papers were cross-examined using a Critical Appraisal Skills Checklist Tool.

RESULTS

Young people face various demands; these may be episodic or ongoing, depending on health and circumstance. The themes this review uncovers are: 'Lack of a Coping Definition'; 'Coping Strategies in Young People'; and 'Barriers to the Understanding of Coping in Young People'.

CONCLUSION

More qualitative research is vital to retrieve 'real-life' perceptions from young people coping with kidney disease to identify how care should be made more explicit for them.

Competencies for practice in renal care: a national Delphi study

The aim of this study was to describe essential competencies relevant for professional renal nursing in Sweden. A Delphi study with four rounds was conducted from November 2008 to April 2009. A national sample of renal nurses was used to achieve consensus about the core competencies required. The 43 competencies were reviewed for face validity by external experts representing general nursing, renal nursing, stakeholders and nephrologists. The core competencies were categorised in nine areas according to their structure; nursing and medical science, information and teaching, examinations and therapies, promoting health and preventing ill health, palliative care, safety and quality, care environment, research and development and management and cooperation in the patient care pathway. Altogether these categories represent a national description of competence in renal nursing.

Managing anaemia of chronic kidney disease

Chronic kidney disease (CKD) is a multi-faceted disease which has a number of associated complications. Anaemia is one of the most common complications that develops early in the course of the disease process. It is associated with increased mortality, increased hospitalization rates, and reduced quality of life. Low haemoglobin levels may increase risk for progression of CKD, cardiovascular morbidity and mortality. This article aims to address the importance of early recognition and management of anaemia in CKD, and the role of the health professional in this regard. Issues that will be discussed include causes, screening, guidelines, current research and recommended treatments of anaemia in CKD, along with recommendations for future practice in this pivotal area of renal care.

The role of the nurse in the management of acute kidney injury

Acute kidney injury can occur with patients within the hospital and within the community setting. The term acute kidney injury replaces the previous recognized term acute renal failure in the literature and uses two internationally recognized classification systems. The causes of acute kidney injury remain the same, pre renal failure, intra renal (intrinsic), or post renal failure. The nursing care of acute kidney injury is challenging and multifaceted as the patient can be critically ill and requires constant monitoring. It is therefore vital that nurses understand what acute kidney injury is, and the management of it in order to deliver holistic care to the patient concerned.