University of Cebu – Banilad

College of Nursing
Cebu City

A Resource Unit of End Stage Renal Disease

Submitted by:

Tio, Marko Antonio

Trazo, Mary Cris
Uy, Reginald Sebastian
Verdadero, Dinah Laura
Villacarillo, Arjane
Watin, Marianne

Submitted to:

Barlutch L. Centillas, R.N., M.A.N.

Clinical Instructor

August 31, 2018

General Objectives: After forty-five minutes of lecture and discussion, the patients and SOs will be able to gain basic knowledge, beginning skills and develop a
positive attitude on the topic of End Stage Renal Disease

Objectives Content Time Allotment Methodology Resources Evaluation

 After forty-five Prayer 1 minute ➢ Lecture/Discussion ➢ Laptop After one hour of
minutes of ➢ Speaker lecture/discussion,
lecture/discussion, the Preconditioning Activity 2 minutes ➢ Microphone the students were
patients and SOs will ➢ DLP able to:
be able to: ➢ Projector
Kidney failure – also known as
end-stage kidney disease, is a 2 minutes
Understand Burn medical condition in which the Express
Injury kidneys no longer function. understanding about
The role of the nurse in the kidney disease
interdisciplinary treatment team
includes provision of holistic
evidenced based care during all
the phases of burn injury
recovery to optimize patient 5 minutes
outcomes.

Learn preventive Prevention

measures ● Advise to follow a low-
salt, low-fat diet
● Emphasize the
importance of exercise
at least 30 minutes on
most days of the week .
● Educate about the perils
of smoking and
drinking alcholic
beverages
State the different
10 minutes severity factors
Have knowledge of SEVERITY FACTORS
the severity factors
 Objectives Content Time Allotment Methodology Resources Evaluation
● Diabetes – Diabetes is
the #1 cause of kidney
failure. A special diet,
exercise and medicines
can help manage
diabetes and prevent
complications, but
some people with
diabetes may still
develop kidney disease,
even with good medical
care.
● HYPERTENSION
– High blood pressure
is the #2 cause of
kidney failure. High
blood pressure can be
both a cause of kidney
disease, and a symptom
of it because healthy
kidneys help regulate
your blood pressure.
Keeping your blood
pressure under control Understand the
Know the can help prevent kidney pathophysiology
pathophysiology of disease, or help keep it 10 minutes kidney-disease
kidney-disease. from getting worse.

● AGE
– Being over age 60
increases your risk for
kidney disease.
PATHOPHYSIOLOGY
Firstly, the rate of renal blood
flow of approximately 400
ml/100g of tissue per minute is
much greater than that observed
in other well perfused vascular
beds such as heart, liver and
brain. As a consequence, renal
tissue might be exposed to a
significant quantity of any
potentially harmful circulating
agents or substances. Secondly,
glomerular filtration is
dependent on rather high intra-
and transglomerular pressure
(even under physiologic
conditions), rendering the
glomerular capillaries
vulnerable to hemodynamic
injury, in contrast to other
capillary beds. In line with this,
Brenner and coworkers
identified glomerular
hypertension and hyperfiltration
as major contributors to the
progression of chronic renal
disease. Thirdly, glomerular
filtration membrane has
negatively charged molecules
which serve as a barrier
retarding anionic
macromolecules. With
disruption in this electrostatic
barrier, as is the case in many
forms of glomerular injury,
plasma protein gains access to
the glomerular filtrate.
Fourthly, the sequential
organization of nephron’s
microvasculature (glomerular
convolute and the peritubular
capillary network) and the
downstream position of the
tubuli with respect to glomeruli,
not only maintains the
glomerulo-tubular balance but
also facilitates the spreading of
glomerular injury to
tubulointerstitial compartment
in disease, exposing tubular
epithelial cells to abnormal
ultrafiltrate. As peritubular
vasculature underlies
glomerular circulation, some
mediators of glomerular
inflammatory reaction may
overflow into the peritubular
circulation contributing to the
interstitial inflammatory
reaction frequently recorded in
glomerular disease. Moreover,
any decrease in preglomerular
or glomerular perfusion leads to
decrease in peritubular blood
flow, which, depending on the
degree of hypoxia, entails
tubulointerstitial injury and
tissue remodeling. Thus, the
concept of the nephron as a
functional unit applies not only
to renal physiology, but also to
the pathophysiology of renal
diseases. In the fifth place, the
glomerulus itself should also be
regarded as a functional unit
with each of its individual
constituents, i.e. endothothelial,
mesangial, visceral and parietal
epithelial cells - podocytes, and
their extracellular matrix
representing an integral part of
the normal function. Damage to
one will in part affect the other
through different mechanisms,
direct cell-cell connections
(e.g., gap junctions), soluble
mediators such as chemokines,
cytokines, growth factors, and
changes in matrix and basement
membrane composition.
The main causes of renal injury
are based on immunologic
reactions (initiated by immune
complexes or immune cells),
tissue hypoxia and ischaemia,
exogenic agents like drugs,
endogenous substances like
glucose or paraproteins and
others, and genetic defects.
Irrespective of the underlying
cause glomerulosclerosis and
tubulointerstitial fibrosis are
common to CKD.
 Objectives Content Time Allotment Methodology Resources Evaluation

Determine the
different phases of
Burn Injury
Management

15 minutes
Identify the phases
of Burn Injury
Management

Objectives Time Allotment Methodology Resources Evaluation

 ●

Objectives Time Allotment Methodology Resources Evaluation

Objectives Time Allotment Methodology Resources Evaluation

Bibliography

http://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/stages-of-chronic-kidney-disease/