1. RENAL DISEASE CAITLIN MCFARLAND JENNIFER SEEGERS RICKY TURNER

2. STRUCTURE AND FUNCTION OF THE KIDNEY Paired, bean shaped organ Filter sodium and potassium ions from the blood and help to reabsorb these substances to maintain normal composition of body fluids. Substances that are not needed are are passed through urine.

3. WHAT IS RENAL DISEASE? General term for any damage that reduces the functioning of the kidney Leading causes are diabetes, high blood pressure, inherited disease, and infection. Symptoms of disease include; nausea, vomiting, decreased or increased urination, swelling of ankles, puffiness around the eyes, fetid breathe, fatigue, shortness of breathe, loss of appetite, high blood pressure, leg cramps, pale skin, dry/itchy skin. Acute and Chronic forms of disease

4. ACUTE RENAL FAILURE Rapid decline in renal function Caused by: drop in blood flow to kidneys, damage from meds, or blockage that stops urine Reversible if recognized early and if the contributing factors can be corrected More often in older people Most common indicator if it is azotemia (accumulation of nitrogenous waste in the blood)

5. CHRONIC RENAL FAILURE Irreversible destruction 1 in 9 adults have chronic renal failure Greater risk in African Americans Complication: cardiovascular disease, anemia, or pericarditis Differentiated from AKD in that reduction of kidney function must be present for over 3 months

6. END STAGE RENAL DISEASE The last stage of chronic renal disease Complete kidney failure Dialysis or kidney transplantation is the only treatment for this condition Leads to death if you do not have dialysis or a kidney transplant

7. DIALYSIS Used when kidneys do not function properly Removes harmful substances from blood when the kidney cannot 2 types: hemodialysis & peritoneal

8. TREATMENT Dialysis for kidney failure ACE inhibitors ARB (angiotensin II receptor blocker) Diet- lower amounts of sodium, phosphorus, potassium, and protein May need extra vitamin D to increase calcium absorption Exercise Use caution with alcohol, tobacco, illegal drugs and make sure your doctor knows what medications, over the counter, prescription and herbal that you are taking.

9. DENTAL CONCERNS Bad tastes in mouth Halitosis At risk for losing bone from their jaw Abnormalities in PMN Enamel hypoplasia

10. INDICATIONS FOR DENTAL TREATMENT Aggressive treatment prior to transplant Restorations, removal of non vital teeth, and prophylaxis

11. CONTRAINDICATIONS FOR DENTAL TREATMENT Wait 6 months after transplant for elective treatment Wait to do treatment day after dialysis for no heparin in the blood stream

12. PERIODONTAL MANAGEMENT Cyclosporine, expect gingival hyperplasia Weakened immune system

13. TREATMENT MODIFICATIONS Pre-Med antibiotic prophylaxis 6 months after kidney transplant 3 months recall Best time for dental treatment is the day after dialysis treatment Don’t take blood pressure on same arm with the shunt

14. Cont. Consult with nephrologist - may need pre- meds Obtain a complete blood count before treatment Monitor blood pressure Avoid NSAIDS – if on cyclosporine might cause renal toxicity

15. ANY QUESTIONS

16. QUESTION Dialysis is given to a patient that has no renal failure. – True – False

17. QUESTION There is no treatment modifications necessary for renal disease patient. – True – False

18. QUESTION Cyclosporine can result in gingival hyperplasia, and is has no side effects when taken with NSAIDS. – Both statements are true – Both statements are false – The first statement is true, the second statement is false. – The first statement is false, the second statement is true.

19. REFERENCES http://medical-dictionary.thefreedictionary.com/Kidney+Disease http://nkdep.nih.gov/learn/are-you-at-risk/race-ethnicity.shtml http://www.scribd.com/doc/96752875/Renal-Diseases-Disorders http://www.cdeworld.com/courses/4478- Laboratory_Evaluation_of_Chronic_Medical_Conditions_for_Dental_Treat ment--Part_II-Diabetes_and_renal_function http://www.cdeworld.com/courses/4478- Laboratory_Evaluation_of_Chronic_Medical_Conditions_for_Dental_Treat ment--Part_II-Diabetes_and_renal_function http://www.medicinaoral.com/pubmed/medoralv13_i7_p419.pdf http://www.dentistrytoday.com/periodontics/1591 Porth, Carol. Essentials of Pathophysiology: Concepts of Altered Health States. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007. Print.