Kidney failure is a progressive health condition, and it occurs in five distinct stages – 1, 2, 3A and 3B, 4, and 5, with ESRD being the final phase. In stage 1, the glomerular filtration rate (GFR), measured in ml/min/1.73m2, is ≥90, and while the kidney functions normally, the initial signs of kidney disease start presenting. In stage 2, the GFR is between 60 and 89 with slightly impaired kidney function. In stages 3A and 3B, the GFR is 45-59 and 30-44, respectively, and kidney functioning is reduced significantly. In stage 4, the GFR is between 15 and 29 with extremely reduced kidney function. In the last phase, stage 5, the GFR is less than 15, and at this point, a patient is said to have ESRD or renal failure (DiMaria et al., 2017). The contributing factors to ESRD include family history, hypertension, diabetes, polycystic kidney disease (PKD), Alport syndrome, interstitial nephritis, pyelonephritis, and some autoimmune diseases, including lupus.
Mr. C. has several ESRD risk factors, such as diabetes, hypertension, and CVD. Therefore, to prevent the progression of ESRD, he should control his blood glucose to address the diabetes issue, maintain healthy blood pressure through keeping a low-fat and low-salt diet, exercise frequently, observe healthy weight, avoid smoking, and limit alcohol intake. The patient should be educated on how to achieve the aforementioned aspects of his health. He should be informed on how to maintain a healthy diet low in carbohydrates, salt, and fat. Additionally, the patient needs a realistic and executable workout plan to ensure that he is physically active. The education program should focus specifically on addressing the obesity problem because it is the major predisposing factor in his case.
ESRD patients could access information on this condition from the Centers for Disease Control and Prevention – Chronic Kidney Disease; Renal Disease Networks; Home Dialysis Central; Mayo Clinic – Chronic Kidney Disease; and Polycystic Kidney Disease. The management of ESRD requires an interdisciplinary approach with physicians, nephrologists, patients, and family members working together to address the problem. Social workers also play an important role in helping patients with ESRD to manage and cope with the condition. Some devices, such as portable hemodialysis devices including wearable ultrafiltration and artificial kidney, could be useful to ESRD patients (Castro et al., 2018). Transportation for these patients is available through public means, taxis, the subway, and private cars. With enough support from all the involved parties, ESRD patients could return to work based on the nature of their occupation.
Castro, A. C., Neri, M., Nayak Karopadi, A., Lorenzin, A., Marchionna, N., & Ronco, C. (2018). Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions. Clinical kidney journal, 12(2), 300–307.
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