Kidney health Kidney care

Transcription

1 Kidney health Kidney care Per Åke Zillén

2 Different perspectives

3 Kidney Health Kidney Care

4 Responsi- -bility Self-care Economy Kidney Health Kidney Care

5 Responsi- -bility Self-care Economy Specialist Primary Prevention Kidney Health Kidney Care

6 Responsi- -bility Self-care Economy Specialist Primary Prevention Kidney Health Kidney Care Relations Psychology Pedagogics

7 Responsi- -bility Self-care Economy Specialist Primary Prevention Kidney Health Kidney Care Politics Economy Priorities Relations Psychology Pedagogics

8 My kidney function 0 50 years

9 My kidney function 100%? 10%

10 My kidney function 100% Stupid me? 10%

11 Two diseases A kidney cancer 10% kidney function

12 Two diseases A kidney cancer - Nephrectomy 10% kidney function - Dialysis

13 My trauma Healthy individual Emergency case

14 My trauma Healthy individual Emergency case Chronically ill patient

15 My trauma Healthy individual Emergency case Chronically ill patient Pre-dialysis patient

16 Stages of CKD % (GFR) 1. Normal function > Mild reduction Moderate reduction Severe reduction Kidney failure < 15

17 Life is wonderful... considering the alternative

18 Expectations

19 Dentistry in the 60 s End Stage Dental Disease

20 The drill Absolutely necessary for the replacement of lost tooth structures Symtomatic treatment, not aimed at the causes of the disease

21 Prevention Use fluoride Strengthen the defence Keep clean Reduce the attack

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26 Prevention Use fluoride Keep clean Regular check-ups

27 Oral Health Education for Oral Health Self-management

28 8 760 hours/year

29 8 760 hours/year - 2 dental office

30 8 760 hours/year - 2 dental office hours/year = my responsibility = self-management, self-care

31 Long term change My parents generation My generation My children My grandchildren

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33 The ISN s Mission Statement The elimination of kidney disease world-wide wide

34 World Kidney Day Statement The only realistic way prevention, early detection and early treatment

35 Renal health care Prevention Early detection Early life-style changes Early treatment Slow or stop progression Replacement

36 Dialysis patients: I I really wish I can get a new kidney

37 ... we must recognize all forms of dialysis to be highly expensive palliation which still carries a totally unacceptable mortality. Professor Stewart Cameron

38 Thus dialysis and transplantation exist and flourish as a result of failure, not of success. Professor Stuart Cameron

39 Stop the progression?

40 What can I do MYSELF?

41 Prerequisites Good relations Real partnership Proper education

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43 Relations Compliance Adherence Empowerment Self-management

44 Em-power power-ment The Doctor - Expertise - Integrity - Decisions

45 Em-power power-ment The Doctor - Expertise - Integrity - Decisions The Patient - Expertise - Integrity - Decisions

46 Em-power power-ment The Doctor The Patient - Expertise - Integrity - Decisions - Expertise - Integrity - Decisions - Mutual respect - Mutual empowerment - Agreements - Partnership

47 Patient information

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49 Education Knowledge Learning is more important than teaching

50 Education Knowledge Learning more important than teaching Motivation Enhanced through group discussions

51 Education Knowledge Learning more important than teaching Motivation Enhanced through group discussions Healthy behaviour A process of change

52 Proper behaviour When we are: Ready Convinced Empowered Entrusted Supported

53 Reno-protection The evidence

54 I m m taking all your pills. But where is my treatment?

55 My kidney function 100%? 10%

56 Treatment plan 1. Medication 2. Special diet 3. Healthy life-style

57 Blood pressure Medication

58 Blood pressure Medication Regular physical activity Weight control Stop smoking Less salt, no extra Drink less Stress management Relax and sleep well Get a pet

59 The special diet Less protein 0.6 g/kg bodyweight/day More energy 35 kcal/kg bodyweight/day Balances

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65 1 25

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67 The special diet helps minimize the symptoms and slow the progression + makes me feel in charge keeps my family involved

68 Health behaviour Regular physical activity Blood pressure control Glucose control Weight control No smoking Healthy diet

69 My daily to-do do-list Medication Blood pressure Blood sugar Weight control No smoking Physical activity Special diet Mental health Patient Yes Yes Yes Yes Yes Yes Yes Yes

70 My daily to-do do-list Medication Blood pressure Blood sugar Weight control No smoking Physical activity Special diet Patient Yes Yes Yes Yes Yes Yes Yes Mental health Yes Doctor Yes

71 Outside the clinic No doctor No nurse No dietician No physiotherapist

72 It s s so obvious: My health is my responsibility My illness is my problem

73 My medication

74 My CKD diet Protein down Energy up Balanced+balancing

75 My healthy life-style

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77 The outcome 100% No dialysis Tolerable symptoms 10%

78 It worked for me It may work for others Not for all

79 Advantages Me: 6 years of health, freedom The clinic: 15 min/2 months Local gov: Saved My doctor: HERO My

80 We have to achieve an arrest of progression of renal failure, or better still, prevention. Professor Stewart Cameron

81 Thank you