BOOK
Kidney Disease, An Issue of Physician Assistant Clinics, E-Book
(2016)
Additional Information
Book Details
Abstract
Physician Assistant Clinics aims to provide an authoritative and continuously updated clinical information resource that covers all of the relevant PA specialties. Our clinical review articles address the key points, diagnosis, prognosis, clinical management, and complications of disease and techniques, evidence, and controversies in the field. Information for quick reference, as well as in-depth coverage of a topic, is a hallmark of the Clinics’ series. This issue of Physician assistant Clinics, guest edited by Kim Zuber, PA-C and Jane S. Davis, DNP, CRNP, brings together expert PAs, NPs, and MDs to give PAs deep insights into the latest advancements in renal disease and show how they are applicable in practice. Articles in this issue include: Will the Real Kidney Patient Please Stand Up?; Introduction of the Kidney Patient; The Surgical Kidney Patient; CardioRenal: The Pump and the Filter; Dosing the Kidney Patient; ABCs of the ICU; Pediatrics: Forgotten Stepchild of Nephrology; Acute Kidney Injury (AKI); Outpatient Management of the CKD Patient; Nephrolithiasis: The Rolling Stones; Transplant and the New Protocols; Health Disparities in Kidney Disease; and Diet and the Kidney.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Did you know you could earn15 AMA Category 1 CME creditsby reading this issue | Cover inside | ||
| Kidney Disease | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITORS | v | ||
| AUTHORS | v | ||
| Contents | vii | ||
| Foreword: Not Just Another Physician Assistant Journal\r | vii | ||
| Preface: From Alphabet Soup to Manuscript\r | vii | ||
| Will the Real Kidney Patient Please Stand up?\r | vii | ||
| Introduction to Kidney Patients\r | vii | ||
| Management of the Chronic Kidney Disease Patient\r | vii | ||
| Risky Business: Lessons from Medication Misadventures in Chronic Kidney Disease\r | viii | ||
| Food for Thought: Diet and the Kidney\r | viii | ||
| Before Crossing the Red Line: Surgery and Chronic Kidney Disease\r | viii | ||
| Cardiorenal Disease: The Pump and the Filter\r | viii | ||
| Rolling Stones: The Evaluation, Prevention, and Medical Management of Nephrolithiasis\r | viii | ||
| Acute Kidney Injury: The Ugly Truth\r | ix | ||
| ABCs of the Intensive Care Unit\r | ix | ||
| Pediatrics: The Forgotten Stepchild of Nephrology\r | ix | ||
| Health Disparities in Chronic Kidney Disease: The Role of Social Factors\r | ix | ||
| Kidney Transplant for the Twenty-First Century\r | x | ||
| PHYSICIAN ASSISTANT\rCLINICS\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| April 2016 | xi | ||
| July 2016 | xi | ||
| October 2016 | xi | ||
| Foreword: Not Just Another Physician Assistant Journal\r | xiii | ||
| SUPPLEMENTARY DATA | xiv | ||
| Preface:\rhabet Soup to Manuscript | xv | ||
| Will the Real Kidney Patient Please Stand up? | 1 | ||
| Key points | 1 | ||
| NATIONAL KIDNEY FOUNDATION FACTOIDS10 | 10 | ||
| REFERENCES | 10 | ||
| Introduction to Kidney Patients | 13 | ||
| Key points | 13 | ||
| CASE STUDY 1 | 14 | ||
| History of Present Illness | 14 | ||
| Social History | 15 | ||
| Past Medical History | 15 | ||
| Family History | 15 | ||
| Physical Examination | 15 | ||
| Vitals | 15 | ||
| General | 15 | ||
| Heent | 15 | ||
| Neck | 15 | ||
| Heart | 15 | ||
| Lungs | 15 | ||
| Abdomen | 16 | ||
| Genitalia/rectum | 16 | ||
| Extremities | 16 | ||
| Differential Diagnosis | 16 | ||
| Laboratory Evaluation | 16 | ||
| Radiology Evaluation | 17 | ||
| Renal ultrasound | 17 | ||
| Discussion | 17 | ||
| CASE STUDY 2 | 19 | ||
| History of Present Illness | 19 | ||
| Social History | 19 | ||
| Past Medical History | 19 | ||
| Family History | 19 | ||
| Physical Examination | 19 | ||
| Vitals | 19 | ||
| General | 19 | ||
| Heent | 19 | ||
| Neck | 19 | ||
| Heart | 19 | ||
| Lungs | 20 | ||
| Abdomen | 20 | ||
| Extremities | 20 | ||
| Differential Diagnosis | 20 | ||
| Laboratory Evaluation | 20 | ||
| Radiology Evaluation | 21 | ||
| Renal ultrasound | 21 | ||
| Discussion | 21 | ||
| Nephrology evaluation | 21 | ||
| CASE STUDY 3 | 23 | ||
| History of Present Illness | 23 | ||
| Social History | 23 | ||
| Past Medical History | 23 | ||
| Family History | 23 | ||
| Physical Examination | 23 | ||
| Vitals | 23 | ||
| General | 23 | ||
| Heent | 23 | ||
| Neck | 24 | ||
| Heart | 24 | ||
| Lungs | 24 | ||
| Abdomen | 24 | ||
| Extremities | 24 | ||
| Differential Diagnosis | 24 | ||
| Laboratory Evaluation | 24 | ||
| Radiology Evaluation | 25 | ||
| Renal ultrasound | 25 | ||
| Discussion | 25 | ||
| Nephrology Evaluation | 26 | ||
| CASE STUDY 4 | 27 | ||
| History of Present Illness | 27 | ||
| Social History | 27 | ||
| Past Medical History | 27 | ||
| Family History | 27 | ||
| Physical Examination | 27 | ||
| Vitals | 27 | ||
| General | 27 | ||
| Heent | 27 | ||
| Neck | 28 | ||
| Heart | 28 | ||
| Lungs | 28 | ||
| Abdomen | 28 | ||
| Extremities | 28 | ||
| Differential Diagnosis | 28 | ||
| Laboratory Evaluation | 28 | ||
| Discussion | 29 | ||
| Nephrology Evaluation | 29 | ||
| CASE STUDY 5 | 31 | ||
| History of Present Illness | 31 | ||
| Social History | 31 | ||
| Past Medical History | 32 | ||
| Medications | 32 | ||
| Family History | 32 | ||
| Physical Examination | 32 | ||
| Vitals | 32 | ||
| General | 32 | ||
| Heent | 32 | ||
| Neck | 32 | ||
| Heart | 32 | ||
| Lungs | 32 | ||
| Abdomen | 32 | ||
| Genitalia/rectum | 32 | ||
| Extremities | 32 | ||
| Differential Diagnosis | 32 | ||
| Laboratory Evaluation | 33 | ||
| Radiology Evaluation | 34 | ||
| Kidney, ureter, and bladder | 34 | ||
| Discussion | 34 | ||
| Nephrology Evaluation | 36 | ||
| INITIAL RECOMMENDATIONS | 36 | ||
| TREATMENTS INITIATED | 37 | ||
| CASE STUDY 6 | 37 | ||
| History of Present Illness | 37 | ||
| Social History | 37 | ||
| Past Medical History | 37 | ||
| Family History | 37 | ||
| Physical Examination | 37 | ||
| Vitals | 37 | ||
| General | 38 | ||
| Heent | 38 | ||
| Neck | 38 | ||
| Heart | 38 | ||
| Lungs | 38 | ||
| Abdomen | 38 | ||
| Extremities | 38 | ||
| Differential Diagnosis | 38 | ||
| Laboratory Evaluation | 38 | ||
| Radiology Evaluation | 39 | ||
| DISCUSSION | 39 | ||
| Treatment | 40 | ||
| SUMMARY | 40 | ||
| REFERENCES | 40 | ||
| Management of the Chronic Kidney Disease Patient | 43 | ||
| Key points | 43 | ||
| STEP 1: IDENTIFY PATIENTS AT RISK | 44 | ||
| STEP 2: DIAGNOSIS | 44 | ||
| STEP 3: PREDICTING PROGRESSION OF CHRONIC KIDNEY DISEASE—ALBUMINURIA | 47 | ||
| STEP 4: TREATMENT STRATEGIES | 48 | ||
| Treatment of Hypertension | 48 | ||
| Reduction of Albuminuria | 49 | ||
| Minimizing Risk of Cardiovascular Disease | 49 | ||
| Glycemic Control | 51 | ||
| SUMMARY | 51 | ||
| REFERENCES | 51 | ||
| Risky Business | 55 | ||
| Key points | 55 | ||
| INTRODUCTION | 55 | ||
| CONTENT | 56 | ||
| Antimicrobials and Antivirals | 56 | ||
| Case 1: Valacyclovir | 56 | ||
| Case 2: Levofloxacin | 58 | ||
| Case 3: Sulfamethoxazole/trimethoprim | 59 | ||
| Hypoglycemic Agents | 60 | ||
| Case 1: Glyburide and metformin | 60 | ||
| Analgesics | 61 | ||
| Case 1: Meperidine | 61 | ||
| Case 2: Morphine | 62 | ||
| Case 3: Gabapentin | 63 | ||
| ANTICOAGULATION | 64 | ||
| Anticoagulation Case | 64 | ||
| ANGIOTENSIN-CONVERTING ENZYME INHIBITORS, DIURETICS, AND NONSTEROIDAL ANTI-INFLAMMATORY DRUGS | 65 | ||
| The Case of the “Triple Whammy” and Acute Kidney Injury | 65 | ||
| SUMMARY | 72 | ||
| REFERENCES | 72 | ||
| Food for Thought | 77 | ||
| Key points | 77 | ||
| MODIFICATION OF DIET IN RENAL DISEASE STUDY | 77 | ||
| PROTEIN | 78 | ||
| SODIUM | 79 | ||
| POTASSIUM | 79 | ||
| PHOSPHORUS | 81 | ||
| VITAMIN D | 83 | ||
| CALCIUM | 83 | ||
| VITAMINS AND ANTIOXIDANTS | 89 | ||
| BICARBONATE | 96 | ||
| FLUIDS | 96 | ||
| FIBER | 97 | ||
| PROBIOTICS | 97 | ||
| HERBALS | 97 | ||
| SUMMARY | 97 | ||
| REFERENCES | 98 | ||
| Before Crossing the Red Line | 101 | ||
| Key points | 101 | ||
| THE SURGICAL CHRONIC KIDNEY DISEASE PATIENT | 101 | ||
| The Scene: Operating Theater Circa 1830 | 101 | ||
| SURGERY AND THE CHRONIC KIDNEY DISEASE PATIENT | 102 | ||
| FOCUS ON THE STORY | 102 | ||
| PREOPERATIVE EVALUATION WITH OBJECTIVE TESTS AND ALGORITHMS | 104 | ||
| OPTIMIZING MEDICAL MANAGEMENT | 105 | ||
| ENTER ANESTHESIA | 105 | ||
| Postoperative Care | 106 | ||
| Pain Management | 107 | ||
| The Reality of the Situation | 107 | ||
| Go with the Flow | 107 | ||
| Preprocedure Outpatient Care for the Kidney Patient | 107 | ||
| Hyperkalemia | 108 | ||
| Increased bleeding possibility | 108 | ||
| Anemia | 108 | ||
| Hypertension | 108 | ||
| Hypoglycemia | 108 | ||
| Hyperglycemia | 109 | ||
| Contrast-Enhanced Study | 109 | ||
| Creatinine Clearance | 109 | ||
| Preprocedure Antibiotics | 109 | ||
| Dental Visits | 111 | ||
| SUMMARY | 112 | ||
| REFERENCES | 112 | ||
| Cardiorenal Disease | 115 | ||
| Key points | 115 | ||
| DEFINITION | 115 | ||
| PREVALENCE | 116 | ||
| A COMPLEX PHYSIOLOGY | 116 | ||
| TYPE 1 CARDIORENAL SYNDROME | 118 | ||
| Acute Heart Failure Leading to Acute Kidney Injury | 118 | ||
| TYPE II CARDIORENAL SYNDROME | 120 | ||
| TYPE III CARDIORENAL SYNDROME | 120 | ||
| TYPE IV CARDIORENAL SYNDROME | 120 | ||
| TYPE V CARDIORENAL SYNDROME | 121 | ||
| BIOMARKERS AND CARDIORENAL SYNDROME | 121 | ||
| SUMMARY | 124 | ||
| REFERENCES | 124 | ||
| Rolling Stones | 127 | ||
| Key points | 127 | ||
| INTRODUCTION | 127 | ||
| EPIDEMIOLOGY | 128 | ||
| Incidence and Prevalence Rates in the United States | 128 | ||
| Prevalence of Specific Types of Kidney Stones | 129 | ||
| RISK FACTORS FOR NEPHROLITHIASIS | 129 | ||
| Ambient Temperature | 129 | ||
| Geographic | 130 | ||
| Seasonal | 130 | ||
| Occupational | 130 | ||
| Genetic Factors | 131 | ||
| Family clustering | 131 | ||
| Ethnic differences | 131 | ||
| Twin studies | 131 | ||
| Dietary Factors | 131 | ||
| Fluid intake | 132 | ||
| Calcium | 132 | ||
| Oxalate | 132 | ||
| Fructose | 132 | ||
| Sodium | 133 | ||
| Protein | 134 | ||
| Citrate | 134 | ||
| Vitamins C and D | 134 | ||
| Systemic Disorders | 135 | ||
| Bariatric surgery | 135 | ||
| The obesity–metabolic syndrome–diabetes spectrum | 135 | ||
| Urinary Factors | 135 | ||
| CLINICAL PRESENTATION OF ACUTE RENAL COLIC | 137 | ||
| MEDICAL MANAGEMENT OF ACUTE RENAL COLIC | 137 | ||
| Plain Radiography | 137 | ||
| Unenhanced Helical Computed Tomography Scan | 137 | ||
| Ultrasound | 137 | ||
| DIAGNOSTIC EVALUATION | 138 | ||
| PREVENTION OF RECURRENT STONES | 141 | ||
| Fluid Intake | 141 | ||
| Dietary Management | 141 | ||
| Pharmacologic Management | 143 | ||
| Thiazide diuretics | 143 | ||
| Potassium citrate | 143 | ||
| Allopurinol | 143 | ||
| Acetohydroxamic acid | 143 | ||
| Antibiotics | 143 | ||
| SUMMARY | 144 | ||
| REFERENCES | 144 | ||
| Acute Kidney Injury | 149 | ||
| Key points | 149 | ||
| ACUTE KIDNEY INJURY: THE UGLY TRUTH | 149 | ||
| MORBIDITY AND MORTALITY OF ACUTE KIDNEY INJURY | 151 | ||
| CAUSE OF ACUTE KIDNEY INJURY | 151 | ||
| DIAGNOSIS OF ACUTE KIDNEY INJURY | 153 | ||
| KIDNEY IMAGING AND BIOPSY | 154 | ||
| TREATMENT OF ACUTE KIDNEY INJURY | 154 | ||
| RENAL REPLACEMENT THERAPY | 155 | ||
| THE FUTURE OF ACUTE KIDNEY INJURY | 157 | ||
| SUMMARY | 157 | ||
| REFERENCES | 158 | ||
| ABCs of the Intensive Care Unit | 161 | ||
| Key points | 161 | ||
| INTRODUCTION | 161 | ||
| ACUTE KIDNEY INJURY | 162 | ||
| ACUTE KIDNEY INJURY RISK AND OUTCOMES | 163 | ||
| TREATMENT OF ACUTE KIDNEY INJURY IN CRITICAL CARE PATIENTS | 166 | ||
| Peritoneal Dialysis | 167 | ||
| Hemotherapies | 167 | ||
| Continuous Versus Intermittent | 169 | ||
| Complications | 170 | ||
| Fluid Management in Critical Care Patients | 171 | ||
| Anticoagulation | 171 | ||
| SUMMARY | 172 | ||
| REFERENCES | 172 | ||
| Pediatrics | 175 | ||
| Key points | 175 | ||
| INTRODUCTION | 175 | ||
| DEFINITION | 175 | ||
| EPIDEMIOLOGY | 176 | ||
| CAUSE | 176 | ||
| COMPLICATIONS | 177 | ||
| Hematologic | 177 | ||
| Cardiovascular | 177 | ||
| Growth and Nutrition | 179 | ||
| Bone and Mineral Disorders | 180 | ||
| PATHOGENESIS/PROGRESSION | 180 | ||
| IMMUNIZATIONS | 181 | ||
| QUALITY OF LIFE | 182 | ||
| TRANSITION | 183 | ||
| SUMMARY | 183 | ||
| REFERENCES | 183 | ||
| Health Disparities in Chronic Kidney Disease | 187 | ||
| Key points | 187 | ||
| INTRODUCTION | 187 | ||
| CHRONIC KIDNEY DISEASE IN BLACK AMERICANS | 187 | ||
| CHRONIC KIDNEY DISEASE IN HISPANIC AMERICANS | 188 | ||
| SOURCES OF DISPARITIES IN CHRONIC KIDNEY DISEASE | 188 | ||
| Genetics | 188 | ||
| Disparities in Chronic Kidney Disease Risk Factors | 189 | ||
| Diabetes | 189 | ||
| Hypertension | 189 | ||
| Social Determinants of Health | 191 | ||
| Economic stability | 191 | ||
| Poverty | 192 | ||
| Unemployment | 192 | ||
| Food insecurity | 192 | ||
| Housing instability | 192 | ||
| Neighborhood and built environment | 192 | ||
| Access to healthy foods | 192 | ||
| Quality of housing and environmental conditions | 193 | ||
| Health and health care | 193 | ||
| Access to health care/primary care | 193 | ||
| Health literacy | 193 | ||
| Social and community context | 193 | ||
| Social cohesion | 193 | ||
| Perceptions of discrimination | 194 | ||
| Incarceration | 194 | ||
| Education | 194 | ||
| Early childhood education and development | 194 | ||
| High school graduation/higher education | 194 | ||
| Language and literacy | 195 | ||
| Implicit Bias Among Clinicians | 195 | ||
| Interaction of Social and Biologic Factors | 195 | ||
| ADDRESSING DISPARITIES IN THE CLINICAL SETTING | 195 | ||
| Understanding That Social Determinants of Health May Affect Individual Patient Ability to Self-Manage | 196 | ||
| Promoting an Integrated, Collaborative Approach to Chronic Kidney Disease Care | 196 | ||
| Being Aware of and Countering Implicit Biases | 196 | ||
| SUMMARY | 196 | ||
| ACKNOWLEDGMENTS | 196 | ||
| REFERENCES | 196 | ||
| Kidney Transplant for the Twenty-First Century | 205 | ||
| Key points | 205 | ||
| HISTORY OF KIDNEY TRANSPLANTATION | 205 | ||
| PRETRANSPLANT EVALUATION | 206 | ||
| KIDNEY TRANSPLANT PROCEDURE | 209 | ||
| IMMUNOSUPPRESSION | 210 | ||
| LONG-TERM MANAGEMENT OF THE KIDNEY TRANSPLANT PATIENT | 211 | ||
| INFECTION RISK | 213 | ||
| CARDIOVASCULAR DISEASE | 213 | ||
| DIABETES | 213 | ||
| HYPERTENSION | 214 | ||
| DYSLIPIDEMIA | 214 | ||
| IMMUNIZATIONS | 214 | ||
| OBESITY | 215 | ||
| CANCER | 215 | ||
| BONE AND MINERAL DISEASE | 215 | ||
| FERTILITY | 216 | ||
| THE FUTURE OF TRANSPLANTATION | 216 | ||
| REFERENCES | 217 |