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Causes of Anemia in Chronic Kidney Disease

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 A common complication of chronic kidney disease(CKD) is anemia.  Anemia in CKD is typically normocytic, normochromic, and hypoproliferative.  The most known cause is the decreased production of Erythropoietin by the damaged kidney.  Aside from EPO deficiency, what else contributes to the anemia of CKD? Numerous studies suggest that circulating uremic-induced inhibitors of erythropoiesis contribute to the anemia.  Shortened red blood cell survival also contributes, as demonstrated by radioisotope labeling studies.   Nutritional deficiencies, such as folate and vitamin B 12 , due to anorexia or dialysis losses are currently  not common with the routine use of supplementation in hemodialysis patients. CKD patients have increased iron losses, estimated at 1–3 g per year in hemodialysis patients, due to chronic bleeding from uremia-associated platelet dysfunction, frequent phlebotomy, and blood trapping in the dialysis apparatus. CKD patients also have impaired dietary iron absorption. In
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Cardiovascular Disease Prevention

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 Cardiovascular disease including stroke and coronary heart disease are major cause of mortality and morbidity. Many risk factors are identified which include modifiable and non modifiable factors. Modifiable risk factors control like reduction in smoking, lipid profile control an and control of hypertension has a very good effect on cardiovascular status. Abdominal aortic aneurysm screening:  Males should get one time ultrasound for abdominal aortic aneurysm if your age is 65-75 years and you have ever smoked. Aspirin use:   You should initiate lose dose aspirin use for primary prevention of cardiovascular disease at age 50-59 unless you are at risk of bleeding. Blood pressure screening:  If you are 18 years old or older , you should start screeing for high blood pressure, preferably outside of clinical setting. Lipid levels screening and Statins use: Lipids level screening and Statins( lipid lowering drugs) use should be started if age is 40-75 years and have one or more cardiovascul
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DIET RECOMMENDATIONS IN CHRONIC KIDNEY DISEASE

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When you have chronic kidney disease, diet is an important part of  your treatment. As a renal patient, you may be dependent on dialysis  to remove water and waste from you body. Proper diet can delay the progression of chronic renal failure so that the need of dialysis is  delayed. For patient on dialysis a proper diet can reduce that the  need of dialysis is delayed. For patient on dialysis a proper diet can  reduce the amount of water and waste products produced and  stored in the body and thus can reduce the number of times per week  the dialysis required. How much Protein Should one Take? Your doctor may recommend that you follow a diet that has  controlled amount of protein. The may help decrease the amount of  waste in your blood and may delay further damage to your kidneys.  People on dialysis are encouraged to eat mainly animal protein  foods.  This includes meat, poultry, fish, cheese and eggs;  In general the protein from egg and milk is better tolerated than  protein from o
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Visual Infusion Phlebitis ( VIP ) score

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An important cause of morbidity in hospitals is cannula sepsis and thrombophlebitis due to Staphylococcal infection. Staphyloccci form biofilm on plastic  and ca be a cause of bacteremia. To monitor IV cannulae Visual Infusion Phlebitis (VIP) score is commonly used. Removal of cannula and treatment with flucloxacillin or glycopeptide ( in case of MRSA )  are required if there is any vlue of spreading infection. Dvcvxxvzredcddff
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