What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
Chronic Kidney Disease – Promoting Self-Management
This article will discuss the evidence for the self-management of long-term conditions, with a focus on chronic kidney disease (CKD). Self-management of CKD can include activities to control and manage blood pressure (BP); changes to diet such as reduced salt intake; smoking cessation; and understanding of the action and side-effects of prescribed medicines.
Postural Hypotension
As we aim for tighter and tighter blood pressure control to minimise the cardiovascular complications of diabetes,the risk of postural hypotension increases. In this article we discuss what postural hypotension is and how to identify it and confirm diagnosis. We also consider the main causes and the relationship between diabetic neuropathy and postural hypotension as well as prevention and treatment strategies.
Editorial
This spring is an important time for the prevention and management of cardiovascular disease in the UK. The new vascular risk assessment and management programme, now known as the NHS Health Check, starts in April. And it’s the fifth birthday of the British Journal of Primary Care Nursing! So close your eyes and make a wish, and we hope we can play some part in making it come true.
Impaired Glucose Tolerance: What it is and How to Manage it
The new national strategy for vascular risk assessment, now being referred to as NHS Health Check, will include testing for diabetes and impaired glucose tolerance (IGT). This follows a major evaluation of the evidence showing that it is more cost-effective to screen individuals for IGT than screening for diabetes alone, but only as part of the broader vascular risk assessment. This article examines the concepts of IGT and impaired fasting glucose (IFG) and offers practical advice as to how these conditions can be managed in primary care.
You have been Diagnosed with Impaired Glucose Regulation
Understanding the Potential of New Oral Anticoagulant Drugs
Although there are other oral anticoagulation agents available, warfarin is the drug used predominantly in the UK. Warfarin has been in clinical use for over 50 years. It is still referred to by patients as ‘rat poison’ and,indeed, warfarin derivatives are still used as rodenticides.In this article, we take a look at some of the new oral anticoagulants coming along.
The Renal Social Worker: an Essential Team Member for Good Renal Care?
Renal services do not need renal social workers to keep patients alive.Nephrologists, transplant surgeons and renal nurses can manage that challenge without our involvement. So why are social workers attached to a renal service? Are they just an added extra – an upgrade in the service rather than an essential component of it?
Taking an ECG: Getting the Best Possible Recording
An electrocardiogram (ECG) is a quick and non-invasive way of recording the heart’s electrical activity. One of its many uses is in the diagnosis of myocardial infarction, angina, and rhythm disturbances. Although the ECG is a simple and easy test to perform, it is vital to obtain the best possible recording because of its importance.
Keeping it in the Family: Reducing Risk in Relatives of Patients with Premature Heart Disease
In this article, we look at how a primary prevention team introduced a systematic approach to target people who had premature coronary heart disease in their family and offer them a comprehensive cardiovascular disease risk assessment.Based on the findings from the EUROACTION study, the next step was to involve their partners based on the recognition that they often share risk factors due to lifestyle.
Choosing the Right Pharmacotherapy to Help Patients Stop Smoking
Most smokers want to stop smoking and intend to stop at some point, according to research. Nearly half of all smokers expect not to be smoking in a year’s time, but only two to three in every hundred actually stop smoking permanently each year. It is widely recognised that healthcare professionals have an important role to play in helping patients to stop smoking, but what is the best way to achieve this?
C-reactive Protein (CRP): an Emerging Marker of Cardiovascular Risk
The major risk factors for cardiovascular disease (CVD) include high blood pressure, dyslipidaemia,diabetes, and smoking, all of which can be managed with lifestyle and therapeutic interventions. C-reactive protein is emerging as a useful new risk marker.
