brochure 01-02 ang -...

“ I.N.T.E.R.V.E.N.I.R. ̋Educational initiative

intended to inform patients and eliminate

the emergence of serious complications associated

with renal failure

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www.prevenirdevenir.com

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Original Idea and Project Lead:Roxanne Brouillard, Nurse Clinician, CNeph(C)

Provincial Revision Committee:Dr. Simon Falardeau, InternistDr. Daniel Garceau, Nephrologist

AuthorsNurse Clinicians:Diane DeschênesFrançois GagnonMarie Le CavalierLucie LégaréGinette Lemay

Educational Consultant:Hélène Gagné, Nurse Clinician

TABLE Of CONTENTs

Chronic Kidney failure Causes Complications Possible Symptoms Understanding My Blood Test Results Results Follow-UpArterial Hypertension Controlling My Hypertension My Blood Pressure Follow-Up Diabetes Controlling My Diabetes My Diabetes Follow-Up List of My Medications My Notes Additional Useful Resources

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CHRONIC KIDNEy DIsEAsEYour kidneys are vital to your health.They have a number of functions.These are the main ones:• Eliminating waste from the body • Eliminating excess water • Eliminating certain drugs • Regulating blood pressure • Regulating electrolytes (sodium, potassium, phosphate) • Regulating blood acidity • Secreting hormones

pms 187#noir pms 1795#

Couleurs logotype DEVENIR-PRÉVENIR

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sTAGE 1 sTAGE 2 sTAGE 3 sTAGE 4 sTAGE 5

eGfR60–89mL/min/1.73 m²Prevention



eGfR<15mL/min/1.73 m²Possible Dialysis

eGfR>90mL/min/1.73 m²

When the kidneys are not working properly, this is known as kidney failure.

Chronic kidney failure is a slow, insidious, and irreversible deterioration of kidney function.

It is broken down into 5 stages based on blood CREATININE levels.

Each stage represents the kidneys’ filtration capacity, known as the estimated glomerular filtration rate (eGFR), which is expressed in mL/min/1.73 m².

MY eGFR IS ________ mL/min/1.73 m².

This means I have stage ________ CKF.

These values are expressed in mL/min/1.73 m².



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CausesThe two main causes of chronic kidney failure in North America are DIABETES and HYPERTENSION.

ComplicationsAlthough the disease has few symptoms initially, complications can still develop gradually.

The main complications are:• High blood pressure• Anemia• Heart disease (infarction, stroke, etc.)• Bone disorders (abnormal calcium and phosphorus levels in the blood).



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Possible symptomsSymptoms of CKD are rare until 80% of kidney function has been lost. In other words, not usually until stage 4 CKD.

At that point, possible symptoms of CKD are:• High blood pressure• Fatigue• Decreased resistance on effort• Reduced appetite• Bad taste in the mouth• Swelling• Itching/rash• Cramps• Foamy urine

The rest of the brochure will tell you how you can manage your chronic kidney disease to control its progression and prevent complications.

Although chronic kidney failure is irreversible, with your involvement its progression can be slowed.



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UNDERsTANDING BLOOD TEsT REsULTs

Creatinine: Creatinine is a waste molecule produced by the muscles. It increases when the kidneys are not filtering properly.

eGfR: Calculation of the kidneys’ filtration capacity based on creatinine dosage and other elements (age, gender, etc.). Your kidneys are made up of millions of tiny filters. The eGFR indicates the functioning level of these filters. The poorer the kidney function, the lower the eGFR.

Urea: A waste substance produced by protein digestion.

Potassium: Normalizes heart and muscle function.

Phosphorus: A substance that is normally filtered by the kidneys. When kidney function decreases, the level of phosphorus in the blood increases. A high level can weaken bones.

Hemoglobin: The kidneys stimulate the production of red blood cells, which contain hemoglobin. Hemoglobin carries oxygen throughout the body. Anemia results if your levels are too low.

Iron: This mineral is essential to every cell in the body. It is necessary for the production of hemoglobin. If your body does not have enough iron, you may develop anemia.



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Albumin: This is a type of protein in the blood that is produced from the proteins and calories in your food. A low level of albumin can indicate that you are not eating enough protein-rich foods.

Glycated hemoglobin: This is your average blood-sugar level over a period of three months.

Total cholesterol: This substances is produced mainly by the liver and includes both good and bad cholesterol.

LDL cholesterol: Commonly known as “bad” cholesterol, this carries cholesterol from the liver to the cells. Too much LDL can leave deposits on blood-vessel walls and arteries.

HDL cholesterol: Commonly called “good” cholesterol, this carries used cholesterol back to the liver for removal.

Triglycerides: Store fat in the body. Consuming an excess of concentrated sweets, fat, and alcohol can result in higher triglyceride levels.

Cholesterol/HDL ratio: Total cholesterol divided by good cholesterol.



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BLOOD NORMAL TARGETTEsT LEVEL DATE DATE DATE DATE

550-110 µmol/lKeep your level stable

Keep your level stable

3.0-6.5 mmol/l

3.5-5 mmol/l

0.8-1.45 mmol/l

120-160 g/l (women) 140-180 g/l (men)

> 20 %

40-60 g/l

≤ 7.0%

< 4.8

< 2.0

Women > 1.0Men > 1.3

< 1.7

< 4.0

REsULTs fOLLOw-UP

< 4.0

Creatinine

eGfR

Urea

Potassium

Phosphorus

Hemoglobin

Ironsaturation

Albumin

Glycated hemoglobin (diabetes)

Cholesterol

LDLcholesterol

HDL cholesterol

Triglycerides

Chol/HDL ratio



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550-110 µmol/lKeep your level stable

Keep your level stable

3.0-6.5 mmol/l

3.5-5 mmol/l

0.8-1.45 mmol/l

120-160 g/l (women) 140-180 g/l (men)

> 20 %

40-60 g/l

≤ 7.0%

< 4.8

< 2.0

Women > 1.0Men > 1.3

< 1.7

< 4.0

REsULTs fOLLOw-UP

< 4.0

Creatinine

eGfR

Urea

Potassium

Phosphorus

Hemoglobin

Ironsaturation

Albumin

Glycated hemoglobin (diabetes)

Cholesterol

LDLcholesterol

HDL cholesterol

Triglycerides

Chol/HDL ratio



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HIGH BLOOD PREssUREBlood pressure must be controlled to slow the progression of chronic kidney failure and improve cardiovascular health.

Blood pressure is the force exerted on the walls of your arteries (blood vessels) as blood circulates through your body.

130 mmHg = Systolic pressure when the heart contracts

80 mmHg = Diastolic pressure when the heart is at rest

Source: Canadian Hypertension Education Program (CHEP) 2011

TARGET BP < 130 80

mmHg



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Controlling My High Blood Pressure• Reduce salt intake.• Take my blood pressure medication.• Exercise.• Maintain a healthy weight.• Manage stress.• Reduce alcohol consumption.• Quit smoking.• Measure my blood pressure at home.



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Is my blood pressure under control?

My target blood pressure is:

My action plan is:• Continue to measure and record my pressure.• Take my pressure record with me to my medical

appointments.• Maintain a healthy lifestyle: – Cut down on salt in foods. – Work to achieve a healthy weight. – Reduce stress. – Reduce alcohol consumption. – Quit smoking.

Tell my nurse, pharmacist, or physician about ANy change.



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DIABETEsTo slow the progression of chronic kidney failure and improve cardiovascular health, diabetes must be controlled.

Diabetes occurs when the pancreas can no longer efficiently control the amount of sugar in the blood. The result is high blood sugar (buildup of sugar in the blood), which damages small blood vessels throughout the body.

Target Blood sugar Levels

fasting Blood Blood sugar sugar 2 Hours after a Meal

4–7 mmol/L 5–10 mmol/L

Glycated hemoglobin (A1c)≤ 7%

Source: Canadian Diabetes Association (2008 Guidelines)



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My BLOOD PREssURE fOLLOw-UP

DATE TIME sysTOLIC DIAsTOLIC PULsE



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My BLOOD PREssURE fOLLOw-UP




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CONTROLLING My DIABETEs

• Eat a healthy diet.• Take my diabetes medication.• Exercise.• Maintain a healthy weight.• Manage stress.• Reduce alcohol consumption.• Measure my blood sugar.

Is my blood sugar under control? My target blood sugar:



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My action plan is:• Continue to measure and record my blood sugar.• Take my blood sugar record with me to my medical

appointments.• Analyse my diet and make any necessary changes.

– Schedule a meeting with my nutritionist.• Make lifestyle changes that may help to control my blood

sugar.

Tell my nurse, pharmacist, or physician about ANy change.



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DATE TIME BLOOD sUGAR REsULT

My DIABETEs fOLLOw-UP



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DATE TIME BLOOD sUGAR REsULT

My DIABETEs fOLLOw-UP



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LIsT Of My MEDICATIONs

fOR DIABETEs

Dosage(mg/tablet)

Time of Day

PrecautionsName of Medication

Date



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fOR HIGH BLOOD PREssURE

Dosage(mg/tablet)

Time of Day


Date



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fOR CHOLEsTEROL

Dosage(mg/tablet)

Time of Day


Date



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GENERAL

Dosage(mg/tablet)

Time of Day


Date



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My NOTEs



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My NOTEs



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Association générale des insuffisants rénaux: Toll-free telephone number: 1-888-852-9297 www.agir.qc.ca/

Diabète Québec: www.diabete.qc.ca/

Fondation des maladies du cœur: www.fmcoeur.qc.ca

Hypertension Canada: www.hypertension.ca

Kidney failure, high blood pressure, and diabetes; lifestyle changes: www.passeportsanté.net

Kidney Foundation of Canada: www.kidney.ca

Public Health Agency of Canada; information about diet: www.dietitians.ca

Public Health Agency of Canada; information about physical activity: www.phac-aspc.gc.ca

Société québécoise d’hypertension artérielle: www.hypertension.qc.ca

Spice It Up!: kidney-friendly ideas and recipes for chronic kidney failure: www.myspiceitup.ca

OTHER UsEfUL REsOURCEs



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