Diabetes and Renal Failure

Diabetes and Renal Failure

Introduction

This is a research article about prevalence of renal failure and its early detection among patients who have long standing diabetes mellitus. End stage renal disease significantly increases the risk of death and requires expert health care. Although diabetes is the most predominant cause of chronic renal disease, maximum individuals with diabetes are not investigated based on national guidelines. Chronic kidney disease warrants improved detection using standardized criteria to improve outcomes. Proper screening of diabetic patients will lead to diagnosing early stages of chronic kidney disease (Go, Chertow, Fan, & McCulloh, 2004).  This gives an opportunity to treat and instruct patients about their chronic illness, and avert progress of disease to terminal stage renal failure. The writers aim of analysis was to progress the incidence of detecting long-lasting renal disorder in elders with diabetes.  The authors initial research   found that less than ten percent of those with stages 2 or 3 chronic kidney disease and less than fifty percent with stage 4 chronic kidney disease knew that they had renal impairment.

Literature review

As with diabetes, the possibility of chronic kidney disease and its gravity surges with age.  According to standard guidelines for kidney disease, following tests for those with diabetes are required yearly: urine microalbumin-to-creatinine ratio, estimated GFR, and serum creatinine (Hughes-Carter, Liu, & Hoebeke, 2018). However only 33% of people with diabetes over the age of 65 had annual recommended tests as per the national guidelines. The authors resolve of the study was to expand the occurrence of seizing the identification of chronic kidney disease in the aged people who have long standing high blood sugar issues and cannot afford to follow up regularly with their primary due to insurance problems.

Study design and sampling

This is a quantitative study used by the author which is appropriate for the concerned study. The author did provide a concise literature review about facts in older adults with diabetes. The author used a pre-post intervention design for this study. This type of an experimental design is a study design in which data are collected from participants both before and after introducing an intervention (Polit & Beck, 2017). The intervention contained three parts: 1) provide data about the current practice of screening for long standing renal problems 2) afford informative undertakings about practice guidelines for renal problems screening 3) encompass coordination tactics in their daily practice to expedite proper inspection.

Therefore, 45 percent of patients with diabetes were aged 55 years and older. The sample population chosen for the study appeared to be less for the purpose of the study (Hughes-Carter et al., 2018). The sample population had almost equal number of men and women thus eliminating the gender bias. Combined, 94 % of the population was either obese, overweight or extremely obese.

Data analysis and Presentation

The authors were able to map out pre and post intervention data and demonstrated statistical and clinical importance of improved capture rate of chronic kidney disease in the sample population. According to the authors, team work policies and educating the healthcare team about the practice guidelines and their implementation yielded the best prospect to improve catching chronic kidney disease diagnosis in the chosen facilities. Many on the research team comprehended the resolve of the study, hence generating early performance change and corruption of the pre-intervention data (Hughes-Carter et al., 2018). The limitations of the study were the three-month post intervention period. The authors suggest further studies to be considered with a longer post intervention period to allow catching the chronic kidney identification. Another limitation was the deficiency of information about the healthcare and the team’s approach regarding screening for chronic kidney disease.

Findings were structured well for readers to apprehend the study implications. Tables had correct headings and huge volume of data was collected. The article partially explained the statically significance but did provide information to support their conclusion.

Conclusion

The authors were successful in emphasizing the importance of screening for chronic kidney disease and early interventions in older adults with diabetes. Chronic kidney disease is a intricate diagnosis that requires clinical judgment and application of practical guidelines. Along with application of updated clinical guidelines the healthcare team should also lead structural change to expand patient results on a larger scale. Older adults have a high prevalence of diabetes, hence improving their screening rate of capturing early diagnosis of chronic kidney disease will perhaps thwart additional kidney dysfunction and anguish. Although practice guidelines exist for screening of chronic kidney disease, proper application of those is vital and indispensable to encourage health, chiefly in older population who carry a higher occurrence of the concerned disease.

It is apparent from this study that many older people who have diabetes are not given the prospect of timely diagnosis of chronic kidney disease. Many factors, including, non-implementation of clinical guidelines for screening of the disease, lack of education of the medical staff, underinsured population, are responsible for missing the diagnosis of chronic kidney disease in the older population with diabetes. It appears, therefore, that understanding these factors and the relationships between them could improve healthcare practice for older people with diabetes. At the same time, the author also concludes that due to certain weaknesses in the study, further research with longer intervention periods would be helpful to improve evidence-based practice for diagnosing early prolonged kidney sickness in the aging with diabetes.

References

  1. Go, A. S., Chertow, G. M., Fan, D., & McCulloh, C. E. (2004, September 23). Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. New England Journal of Medicine, 351, 1296-1305. http://dx.doi.org/10.1056/NEJMoa041031
  2. Hughes-Carter, D. L., Liu, C., & Hoebeke, R. E. (2018). Improved Screening and Diagnosis of Chronic Kidney Disease in the Older Adult with Diabetes. The Journal for Nurse Practitioners, 14, 626-632.
  3. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease [Supplemental material]. (2013). Kidney International Supplements, 3(1), 1-150. http://dx.doi.org/doi:10.1038/kisup.2012.73
  4. Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
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