Utilizing the information you have gathered over the last four weeks regarding the specific illness group you identified, this week, you will create a plan of care for your chronic illness group.
In a Microsoft Word document of 5-6 pages formatted in APA style, (this page requirement includes the holistic care plan). Include the following in your plan:
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- Provide a brief introduction describing the chronically ill group you selected and rationale for selecting this illness and the participants.
Clearly identify the Healthy People 2020 topic chosen and why this topic was selected.
- Develop a holistic plan of care including patient, family and friends acceptance of the diagnosis, coping and impact on plan of care.
- Summarize the information gathered in each week (Weeks 1–4) over 2 to 3 pages. This is should not to be copied and pasted from previous assignments.
- Create a care plan for your chronic illness group organized using the following headings:
Nursing Diagnoses (at least 3 related to topic and interview results)
Assessment Data (objective and subjective)
Interview Results
Desired Outcomes
Evaluation Criteria
Actions and Interventions
Evaluation of Patient Outcomes
- Identify strategies for the family or caregiver in the care plan and provide your rationale on how they will work.
Support your responses with examples and information from library resources, textbook and lectures.
Running head: ILLNESS AND DISEASE MANAGEMENT
ILLNESS AND DISEASE MANAGEMENT
Betsy Quinones
February 20, 2021
NSG4055- Illness And Disease Management across a Lifespan
Professor Amber Mccall
Chronic Kidney Disease Care Plan
Description
Chronic kidney disease describes the gradual loss of kidney function. The role of the kidney is to filter excess fluids and wastes from the blood. The advanced stage of chronic kidney disease results in the build-up of high levels of waste in the blood that may lead to complications such as anemia, high blood pressure, poor nutritional health, bone weakness, and nerve damage. Chronic kidney disease occurrence is interrelated with other conditions such as high blood pressure, blood vessel and heart diseases, diabetes, and other disorders.
The rationale of selecting the condition
Among the United States population, more than 1 in 7 adults may have chronic kidney disease. According to the Healthy People 2030 report, the prevalence of this condition is highest among low-income and minority ethnic groups. Establishing awareness of this condition is very important since most people with chronic kidney disease do not know they have it. People with CKD have a high chance of developing stroke and heart disease that leads to early death, therefore, a lot of focus has recently been placed on the diagnosis, prevention, and treatment of chronic kidney disease.
Good public awareness of CKD is important to help manage risk factors like high blood pressure and diabetes and to develop strategies of early screening and diagnosis and diagnosis of high-risk groups so that they can get the necessary treatment. About 10 % of the global population is affected by CKD and millions of people die each year due to poor or lack of management or treatment of this condition. The mortality and morbidity associated with this condition is a massive loss in the global economy due to reduced productive medical expenses.
Questionnaire of acquiring information for creating a care plan
1. Does the patient have a family history of cardiovascular disease or diabetes?
2. What is the patient’s level of awareness about CKD?
3. What is the degree of kidney damage, and are there any complications that have been developed?
4. When did the patient start experiencing symptoms?
5. Does the patient have hypertension or postural changes?
6. Does the patient experience any chest pain? If yes, what are the location, nature of radiation, and severity?
7. What does the laboratory result reveal about the patient’s fluid and electrolyte balance?
8. Is the patient undergoing dialysis? If yes, then for how long?
9. What is/are the possible cause of the patient’s CKD?
10. Which type of treatments or drugs is the patient receiving currently, and what is the response?
11. Are the patient’s caregivers adequately aware of the evidence-based management practices of CKD?
12. What are the results obtained from evaluating heart sounds, peripheral pulses, vascular congestion, capillary refill, and temperature measurement?
13. What is the level of the patient’s activity intolerance?
14. How has the patient’s condition affected his/her thought processes?
15. What is the level of pain experienced by the patient?
Morbidity and comorbidity of chronic kidney disease.
Chronic kidney disease is a debilitating disease that affects various organs and organ systems in the body and is related to an increased risk of cardiovascular mortality and morbidity. The three most common comorbidities of chronic kidney disease include diabetes, hypertension, and hyperlipidemia. About 41.9% of patients with CKD are multi-morbid and can present with more than one comorbid condition.
The other comorbid conditions associated with CKD include; malignancies, liver disease, gout, cerebrovascular disease, ischemic heart disease, congestive heart failure, gout, tuberculosis, and anemia. Studies have revealed that smoking, age, and proteinuria are highly associated with the increased risk of multi-morbidity. Comorbidities in CKD patients should be treated to lower the burden of the disease and to slow down the deterioration of renal function.
Diabetes and hypertension can be considered to be concordant comorbidities that cause CKD while heart failure and coronary disease are often accompanied by CKD. There is, however, a limit that is known about the burden of mental health and discordant conditions. In 2017, it was estimated that CKD caused 1.2 million deaths and was the leading cause of mortality worldwide. CKD was also estimated to have caused 35.8 million disability-adjusted life years. It has been established that old age, low educational status, and smoking are the greatest risk of multi-morbidity. Determining the number of comorbidities in patients ensures there are simple, valid, and readily applicable methods for predicting renal outcomes in patients.
Impact of chronic kidney disease on patient morbidity to the overall national health.
CKD impacts the life of a patient in so many ways. This condition promotes an additional risk of cardiovascular disease and death. Management of chronic kidney failure and the associated conditions may become very expensive to the patients and their families. The condition in its advanced stage causes patient disability leading to patient dependency, loss of social, and economic function. CKD being a complex condition may affect a patient’s access to medical or health insurance due to insurers’ fear of increased cost.
CKD may subject the patient to uncomfortable situations i.e. having to use multiple pharmacological drugs to manage CKD and its comorbid conditions such as diabetes and hypertension as well as dialysis. As far as the overall national health is concerned, the impact is largely socioeconomic. The association of this condition with morbidity and comorbidities hence causing disability and social and economic impairment. Studies conducted by a total of 37 studies estimated that societal and healthcare costs of CKD ranged from $1600 to $25037 for patients with stages 1-3 of CKD. The high cost diverted to CKD and associated conditions paralyzes other national issues hence causing an imbalance in national programs and development.
Healthy People 2020 goals and objectives
The healthy people 2020 goals and objects include:
· Elimination of disparities among kidney disease patients
· A reduction in the kidney disease burden
· Longer lives and improved quality of life for people with CKD
Conclusion
Chronic kidney disease is costly to manage and many times patients become non compliant because they may not have insurance, the copayment, and/or a ride to the dialysis center. Many times patients also get fed up and tired with getting dialysis. With the care plan questions provided and the Healthy People 2020 goals I hope to be able to better manage patients with chronic kidney disease.
References
Carney, E. F. (2020). The impact of chronic kidney disease on global health. Nature Reviews Nephrology. Retrieved from
https://www.nature.com/articles/s41581-020-0268-7#:~:text=In%202017%2C%20CKD%20resulted%20in,%25%20of%20all%2Dcause%20mortality
.
Foundation, N. K. (n.d.). Chronic Kidney Disease (CKD) Symptoms and causes. National Kidney Foundation. Retrieved from https://www.kidney.org/atoz/content/about-chronic-kidney-disease
Foundation, N. K. (n.d.). Global Facts: About Kidney Disease. National Kidney Foundation. Retrieved from
https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease#:~:text=10%25%20of%20the%20population%20worldwide,have%20access%20to%20affordable%20treatment
.
Staff, M. C. (n.d.). Chronic kidney disease. Mayo Clinic. Retrieved from
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521
Wen-Chin Lee, Y.-T. L.-C.-Y.-H.-T.-C.-Y.-T. (2018). The Number of Comorbidities Predicts Renal Outcomes in Patients with Stage 3–5 Chronic Kidney Disease. J Clin Med. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306906/#:~:text=The%20three%20most%20common%20comorbidities,prevalence%20of%20hypertension%20approached%2090%25
.
CKD INTERVIEW 2
Illness and Disease Management CKD Interview
Betsy Quinones
February 27, 2021
NSG4055- Illness And Disease Management across a Lifespan
Professor Amber Mccall
Illness and Disease Management CKD Interview
Introduction
Mr. X has a medical diagnosis of stage 3 chronic kidney disease. According to the interview, he has a little bit of an understanding of his condition, though his level of awareness is low. He pointed out that the condition has changed his relationship with family and friends. The quality of life of individuals is closely related to the quality of life of those around them (Golics, 2019). In this journal, Golics further went and published that most chronic illnesses have the same impact on the family. In this case, chronic kidney disease has disrupted the psychological, emotional, and normal functioning of the family and some friends of Mr. X. Even the study advocates for a family-centered approach to care the disruptions brought about by the disease process negatively affect the wellbeing of the patient.
According to the stages of grief, Mr. X is at the level of acceptance same to the family. This stage means the patient has understood and accepted what the condition means to his life. The family members and friends have also reached the acceptance stage and are with him in his hard moments. Acceptance is not necessarily an uplifting stage of grief, it may mean that there may be more good days than bad but there may be still bad – and that is ok (Holland, 2018).
Coping mechanisms
Dealing with chronic illnesses requires coping skills to avoid sinking into depression. As for Mr. X, the main coping skill is lowering expectations of the awaited outcome. For example, if his blood has been taken for waste analysis before dialysis when the results come, he has trained himself not to expect much to avoid disappointments if otherwise. In addition to lower expectations, Mr. X also asks for help if need be, especially financial support. Change of source of stress and distance from the source of help has also been practiced by Mr. X to cope with stress. Finally, maintaining emotional composure has also been deployed by the patient to avoid stress (Coping skills and strategies, 2017).
Treatment of CKD
The treatment for Mr. X is partly symptomatic and largely therapeutic. For example, on occasions where the hemoglobin levels are low, he is given ferrous sulfate tablets or iron injections to control anemia. Diuretics such as furosemide are given to the patient to control edema. He is put on antihypertensive drugs to control his blood pressure which is the suspected root course of his condition. He also attends two sessions of hemodialysis each week to eliminate wastes from the blood (Medication, 2019).
Support aspects
The support aspect of chronic kidney disease is social, emotional, and psychological. The patient requires family and friends to offer social and emotional support to provide the patient with strength and the will to take treatment accordingly. Given that the condition comes with a lot of stressors, psychological support by a trained psychologist would be necessary to ensure the mental health of the patient is in good condition.
In conclusion, the following information will be necessary indirect development of a care plan for a group of patients with chronic kidney disease because the disease process is similar and that the complications of the condition are the same and may only vary from patient to patient. The treatment of complications with vitamin D and antihypertensive will be the same across board and dialysis too (Section 10: The role of social, cultural, psychological, and family relationship factors in the etiology of disease and illness, 2018).
References
Fishbane, S., & Spinowitz, B. (2018). Update on anemia in ESRD and earlier stages of CKD: core curriculum 2018. American Journal of Kidney Diseases, 71(3), 423-435.
Golics, C. J., Basra, M. K. A., Finlay, A. Y., & Salek, S. (2013). The impact of the disease on family members: a critical aspect of medical care. Journal of the Royal Society of Medicine, 106(10), 399-407.
Holland, K. (2018, September 25). What You Should Know About the Stages of Grief. Healthline. https://www.healthline.com/health/stages-of-grief
Medication. (2019). Kidney Care UK. https://www.kidneycareuk.org/about-kidney-health/treatments/medication/
Section 10: The role of social, cultural, psychological, and family relationship factors in the etiology of disease and illness. (2018, February 21). Health Knowledge. https://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4a-concepts-health-illness/section7/activity4/answers
Stressors: Coping Skills and Strategies. (2017). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/6392-stress-coping-with-lifes-stressors
Zhang, L., Zhang, P., Wang, F., Zuo, L., Zhou, Y., Shi, Y., … & Wang, H. (2018). Prevalence and factors associated with CKD: a population study from Beijing. American Journal of Kidney Diseases, 51(3), 373-384.
Appendix
1. Does the patient have a family history of cardiovascular disease or diabetes?
Yes, cardiovascular disease from the father of Mr. X.
2. What is the patient’s level of awareness about CKD?
Low level.
3. What is the degree of kidney damage, and are there any complications that have been developed?
Stage 3B moderate CKD, complications are anemia, gout, and fluid buildup.
4. When did the patient start experiencing symptoms?
2 years before diagnosis.
5. Does the patient have hypertension or postural changes?
Yes.
6. Does the patient experience any chest pain? If yes, what are the location, nature of radiation, and severity?
Chest pains and discomfort are usually felt on the left side, the pain is moderate.
7. What does the laboratory result reveal about the patient’s fluid and electrolyte balance?
GFR 30-59
8. Is the patient undergoing dialysis? If yes, then for how long?
Yes, twice per week
9. What is/are the possible cause of the patient’s CKD?
Hypertension
10. Which type of treatments or drugs is the patient receiving currently, and what is the response?
High blood pressure medications, medications to treat anemia, medication to relieve swelling, medication to lower cholesterol, and a low protein diet.
11. Are the patient’s caregivers adequately aware of the evidence-based management practices of CKD?
Yes.
12. What are the results obtained from evaluating heart sounds, peripheral pulses, vascular congestion, capillary refill, and temperature measurement?
Temp 37 C, capillary refill of 4seconds, a peripheral pulse of 85bpm,
13. What is the level of the patient’s activity intolerance?
Insufficient physiological energy to complete required daily activities.
14. What is the level of pain experienced by the patient?
Moderate pain.
Illness and Disease Management Chronic Kidney Disease
Betsy Quinones
February 27, 2021
NSG4055- Illness And Disease Management across a Lifespan
Professor Amber Mccall
Illness and Disease Management Chronic Kidney Disease
From the interview, Mr. X has stage 3 chronic kidney disease, which is a slow loss of kidney function. In this case, there is a buildup of dangerous amounts of fluids, wastes, and electrolytes in the body because the kidney cannot eliminate them (Green & Boulware, 2016). It is a disease that is common among the elderly populace as can be seen in Mr. X’s case. However, any person can get the disease at any age. Many people have little information regarding certain health conditions and this is the case with Mr. X who has a low level of awareness. Despite chronic kidney disease have several adverse consequences, many people with the condition remain uninformed of their disease. The awareness of chronic kidney disease remains way too low despite the attempts to upsurge awareness through the distribution of guidelines for clinical practice and free screening for people at high risk.
In his condition, Mr. X requires family and friends more than before as it is something he cannot manage alone. However, these people who should stand with him are affected psychologically and emotionally by his condition. Mr. X together with the family has accepted his condition and is ready to walk with him through the process of treatment. Kidney disease has no cure, but stage three means that an individual still has a chance to prevent further advancement of kidney failure. In this case, the most important support Mr. X needs is emotional, psychological, and social support, which he needs at the moment to help him recover quickly. This support should be followed with medications and lifestyle changes (Taylor, 2016).
Nursing interventions for chronic kidney disease are not to treat the disease, but to prevent extreme complications and for supportive care. The nurse assesses Mr. X’s hemoglobin level, assess his fluid status, his nutritional status, nutritional dietary patterns, hyperkalemia signs, assess the responses and reactions of Mr. X and his family regarding his condition and the treatment, and assess comprehension of the cause of the kidney failure, the consequences, and treatment (Lopez-Vargas, 2016). The nurse would assess Mr. X’s fluid status to identify the possible sources of imbalance, assessing his nutritional status and nutritional dietary patterns would make the nurse implement a dietary program for Mr. X that will ensure he has proper nutritional intake within the treatment regimen’s limits. The nurse also administers diuretics to remove excess body fluids to control edema and antihypertensive drugs to manage his blood pressure.
Implementing Healthy People 2020 objectives to increase wellness
Healthy people, 2020 is a well-known health plan that is aimed at health promotion and preventing diseases to promote a healthy nation. It is an extensive set of objectives focused on exterminating disparities and improving health over the years to come. Increasing life expectancy, life quality, and advancing healthcare service delivery is the general objective of healthy people 2020. Healthy people, 2020 can be utilized to identify the root cause of chronic kidney disease affecting Mr. X and others within the community and the goals that are set to fix the problem, thus improving their well-being.
It would be appropriate to implement the healthy people 2020 objectives by engaging in one-on-one health awareness with Mr. X’s family and friends and the general community by increasing their knowledge of the risk factors of chronic kidney disease, how healthy lifestyle, frequent medical checkups, and earlier treatments of the condition improve health, quality of life, productivity, and wellness. Educating the community and close family and friends about the significance of living healthy can help in the prevention of future cases of kidney diseases and other infections that are common (Taylor, 2016).
Additionally, positively influencing the behavioral patterns of the general public at an early stage will aid in determining the current health of the public and it can help in reducing their risk for developing many chronic diseases even as they grow old. Finally, the healthy people 2020 objectives can be implemented to promote wellness through the formation of social and physical environments, which promotes excellent health for everybody and through achieving health fairness, eradication of disparities, and improving the health of everybody.
The role of Nursing as an advocate for Mr. X diagnosis and treatment acceptance
Nurses play vital roles in advocating for patients to accept disease diagnosis and treatment by helping them make informed decisions concerning their health. Nurses take patients through the entire process of disease diagnosis to treatment by helping the patients navigate a multiplex health system, translate medical terms, and help the patients make ethical decisions (Potter, 2017). Nurses as advocates support the best interest of the patient while respecting the important role of the family. In Mr. X’s case, the nursing’s role is to help him understand his condition and accept that it cannot be cured.
Mr. X has accepted his condition and has made ethical decisions to avoid any kind of stressors that might deteriorate his health and begin his medications after explaining to him that they are only meant to prevent further damage to his kidneys. A nurse has to educate the patients on ways of managing their chronic conditions to help in improving the quality of their day-to-day life and this is very important for Mr. X as the nurse can teach him how to take his diuretics and antihypertensive medications.
The effect of the environment on the health of a patient
The environment has a significant impact on the health outcomes of a patient, particularly the most vulnerable populations. Several environmental factors such as air pollution, poor sanitation, drinking contaminated water, poor infrastructures, unequal access to health, and poverty negatively impact the health of a patient. Poor sanitation is associated with numerous infectious and nutritional outcomes that have a significant effect on the health and well-being of a patient (Dueñas, 2016). Additionally, poor infrastructure and lack of access to healthcare services deny patients their right to healthcare making their health deteriorate. The social environment plays a critical role in the risk of chronic kidney disease, its progression, and the inception of complications. Individuals with good infrastructures, proper sanitation, and easy access to healthcare services have proper disease progression and they receive treatment on time, hence improving their health.
Conclusion
To conclude, chronic kidney disease is an incurable disease that only requires management to prevent further kidney damage. Nurses play a vital role in advocating and providing interventions that will help improve the health of these patients. Moreover, the environment is a contributing factor to the disease prognosis of these patients as many people with chronic kidney diseases come from socially deprived areas. Despite this, it is important to ensure that everybody in the community receives equal care to improve wellbeing by implementing the Healthy People 2020 objectives.
References
Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment, and the health care system. Journal of pain research, 9, 457.
Green, J. A., & Boulware, L. E. (2016). Patient education and support during CKD transitions: when the possible becomes probable. Advances in chronic kidney disease, 23(4), 231-239.
Lopez-Vargas, P. A., Tong, A., Howell, M., & Craig, J. C. (2016). Educational interventions for patients with CKD: a systematic review. American Journal of Kidney Diseases, 68(3), 353-370.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2017). Fundamentals of nursing (9 th
Edition).
Taylor, F., Gutteridge, R., & Willis, C. (2016). Peer support for CKD patients and carers:
overcoming barriers and facilitating access. Health Expectations, 19(3), 617-630.
Chronic Kidney Disease
Betsy Quinones
March 9, 2021
NSG4055- Illness And Disease Management across a Lifespan
Professor Amber Mccall
Chronic Kidney Disease
Chronic kidney disease is mainly caused by diabetes and high blood pressure. Chronic kidney disease group is supported by a number of resources in Tampa, FL. These resources are categorized into community resources and national resources. The community and national resources that relate to this disease group are; resource guides for chronic kidney disease. Under this we have the national kidney foundation which is a health organization that aims at kidney disease prevention, supporting people having kidney disease, and transplantation organs increase and availing (Romagnani et al., 2017). There is also the American Association of Kidney that targets to help people and families affected by kidney disease how to deal with emotional, physical and the social effects of the disease. Another resource is Life Options Rehabilitation Program that is focused on helping people with kidney disease live long by offering encouragement and educational materials freely as well as emphasizing on the need to do exercise so as to stay active. Other resources are; kidney smart, dialysis finder, renal support network, transplant living, kidney disease information, dialysis facility, home dialysis central, ukidney and directory of resources.
It’s very costly to set up a dialysis center. It could cost $2 million to $3million to build a dialysis center. Those on dialysis have between 15% to 20% mortality rates after treatment for one year unlike persons who receive transplants that have 80% mortality rate after 5 years. Life expectancy is averagely 5-10 years for patients on dialysis according to the National Kidney Foundation. Patients who refuse to undergo dialysis ultimately die because of other causes and with some kidney functioning many die. It is the responsibility of the nurses to support and counsel them and help them relent their decision.
Transplant living states the benefits of dialysis, facts and the risks associated with it. Transplanted Kidney will not function forever, it is only made to lengthen the life time of a person that is having chronic kidney disease. Transplant of the kidney can help a person to live longer than expected. Kidney transplant is better than life-time dialysis. A living kidney donated can function between eight to twelve years whereas the donor kidney functions for twelve to twenty years.
Kidney disease information resource. It gives more information to the chronic kidney disease patients about the disease and how to manage their conditions. It states that kidney disease is caused by diabetes and high blood pressure. The condition occurs when the kidneys are damaged and are unable to filter blood as they should. The only treatments for kidney failure are transplant and dialysis. The first sign of kidney problem is urine output decrease. Retention of fluid which causes swelling of feet, legs and ankles. The other sign could be shortness of breath. In Tampa dialysis centres offer out-patient dialysis services and in-center hemodialysis. Other services that they offer include nutrition counselling for those that need guidance from kidney disorders expertise and dietitians. Hemodialysis costs more than $500 for patients that are not covered by the health insurance (Neuen et al., 2017).
The cost for the reimburse medicare dialysis by 2018 was $83.12 for adults. The medicare pays 80% of the facilities’ cost above the threshold. The limiting charge on medicare fee schedule charges more than the approved medicare amount although there is a limit called the limiting charge. The provider can only charge you not more than 15% over the amount paid to the participating participants. Rates for FMAP vary by state based criteria such as per capita income. The federal share is averagely 57% although it ranges from 50% to 75% in wealthier and lower per capita income states respectively.
Patients diagnosed with kidney disease may be eligible for social disability benefits. If one stays out of work for more than a year they may be eligible for help. Patients of chronic kidney disease with peritoneal dialysis or hemodialysis that is expected to last or has lasted for at least one year are eligible for the benefits of disability. People having chronic kidney disease with transplant of kidney are also eligible for disability benefits.
Transportation can be a factor affecting regular dialysis treatments especially for the old individuals. County offers transportation services for dialysis patients. There are specific care services for patients who are not able to access transportation for appointment of medication and this done at no charge. This is an alternative solution for medical transportation. In normal cases, coverage for medicare does not cover the transportation cost for appointment of medication except in the case where the recipient of the medicare in an emergency requires an ambulance to transport him or her.
The integration of these resources into the care plan is evident in the case where through the Life Options Rehabilitation program the persons with kidney disease are encouraged and given education materials. Another way in which these resources are integrated into the health care plan is through helping families and persons who are vulnerable to fight their physical and emotional effects. Renal support network, a non-profit organization is also integrated into the plan in that it works to benefit chronic disease individuals.
Populations vulnerable to chronic kidney disease are either advantaged or disadvantaged by seeking these resources. Some of the advantages of seeking these resources are: The patients acquire knowledge of kidney disease and how to manage their condition so as to live longer. The vulnerable populations gain an understanding that if the kidney is successfully transplanted, one can reduce the death risk and improve his or her life quality. The vulnerable populations understand the nutrition and diet practices they should embrace .These resources reduce the time taken to visit heath care facilities for dialysis. The disadvantages of these resources to the vulnerable population are; the vulnerable population are afraid in the understanding that transplant is the only option in the end-stage and that in case of transplant failure they are subject to death. Most of them get shocked and may die if there is no face to face counselling over the matter concerning their condition. Another disadvantage is three times a week travel to the dialysis centre may be required (Webster et al., 2017). At times patients may not be able to see the schedule of their treatment. In case of hemodialysis, there is a requirement of needles for fistula. The other disadvantage of these resources to the vulnerable population is that they require ample space for storage. Another disadvantage of having these resources is that one must schedule dialysis into his routine daily in the seven days of the week. Patients with failure of kidney and awaiting transplant get their blood connected to the machine, the disadvantage is that these machines are very expensive.
References
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. The lancet, 389(10075), 1238-1252.
Romagnani, P., Remuzzi, G., Glassock, R., Levin, A., Jager, K. J., Tonelli, M., … & Anders, H. J. (2017). Chronic kidney disease. Nature reviews Disease primers, 3(1), 1-24.
Neuen, B. L., Chadban, S. J., Demaio, A. R., Johnson, D. W., & Perkovic, V. (2017). Chronic kidney disease and the global NCDs agenda.
