A Comparative Study of Chronic Kidney Disease Patients in India and UK

This report presents a comprehensive comparative study of chronic kidney disease (CKD) patients in India and the United Kingdom. It begins with an introduction to CKD, its stages, symptoms, and causes, emphasizing the importance of early diagnosis and treatment. The report then outlines the aims and objectives, focusing on evaluating lipid abnormalities in CKD patients across the two countries. A thorough literature review explores the basic understanding of CKD, including diagnosis and treatment methods, and examines the changes in clinical processes and technology. The methodology section details the research design, approach, philosophy, data collection methods, and ethical considerations. The study aims to identify differences in lipid profiles and treatment outcomes between Indian and UK CKD patients. The report also includes a reflective commentary and concludes with a summary of findings, highlighting the need for tailored approaches to CKD management based on regional variations and advancements in healthcare practices.

Comparative study of chronic
kidney disease patients in
Indian and UK

Contents
INTRODUCTION...........................................................................................................................3
AIM AND OBJECTIVES................................................................................................................3
Aim of the project...................................................................................................................3
Objectives of the project.........................................................................................................3
Questions of the project..........................................................................................................4
BACKGROUND.............................................................................................................................4
Literature review..............................................................................................................................5
The basic understanding about chronic kidney disease..........................................................5
The diagnosis and treatment methods used for patient suffering from chronic kidney disease
................................................................................................................................................6
The comparison between lipid abnormalities of chronic kidney disease patients in India and
UK..........................................................................................................................................7
The changes in clinical process and technology occurs in terms of kidney chronic disease. 9
METHODOLOGY........................................................................................................................10
Types of investigation..........................................................................................................10
Proposed plan.......................................................................................................................10
Theoretical frameworks of change.......................................................................................11
Research design....................................................................................................................13
Research approach................................................................................................................14
Research philosophy.............................................................................................................14
Data collection methods.......................................................................................................15
Method of sampling..............................................................................................................15
Data Analysis........................................................................................................................16
Ethical considerations...........................................................................................................16
IMPACT OF CHANGE.................................................................................................................17
REFLECTIVE COMMENTARY..................................................................................................18
CONCLUSION..............................................................................................................................19
REFERENCES..............................................................................................................................21
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INTRODUCTION
Chronic kidney disease refers to the medical condition of longstanding disease of kidneys
that leads to renal failure. It includes the situation when the kidneys functioning become
interrupted and they failed to filter the waste as well as excess fluid from the blood (Prakash and
Sharma, 2014). However, the abnormality of kidney functioning is responsible for spreading
toxins in human body which develop several health problem of in a human being. It includes the
fact that chronic kidney has number of stages like high or normal GRF, mild CKD, moderate
CKD, severe CKD and end stage of CKD. It is necessary for people to immediately gain
treatment by registered physician to get quick treatment otherwise complicated conditions
occurs. It becomes difficult for care professionals to deal with severe chronic kidney disease
condition because patient becomes weak and strong doses as well as clinical procedures will not
easily control the entire situation (Akbarsha, 2019).
Chronic kidney disease has number of symptoms such as vomiting, loss of appetite, fatigue
& weakness, sleep problems, changes in urination, reduced mental sharpness, muscle twitches &
cramps, swelling of feet & ankles, chest pain, persistent itching, shortness of breath, high blood
pressure and nausea. It is observed that kidney plays an important role to filter the waste and
helps in extracting the waste and toxins from the body. Basically, kidney problems are
responsible for developing diseases or infections in other parts of the body (Romagnani and et.
al., 2017). If unfiltered fluids will move throughout the body then it will develop problem in
different areas of human body. However, if these issues were not treated at initial level then it
may acquire severe health condition. It includes that chronic kidney diseases include kidney
damage condition they may acquire worst situation. Moreover, it has been analysed that there
number of other health problems such as high blood pressure, heart disease, heredity of kidney
problem, old age and diabetes which are responsible for causing chronic kidney disease.
AIM AND OBJECTIVES
Aim of the project
“To evaluate the comparative study of lipid abnormalities of chronic kidney disease
patient in India and United Kingdom.”
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Objectives of the project
 To identify the basic understanding about chronic kidney disease.
 To analyse the diagnosis and treatment methods used for patient suffering from chronic
kidney disease.
 To evaluate the comparison between lipid abnormalities of chronic kidney disease
patients in India and UK.
 To examine the changes in clinical process and technology occurs in terms of kidney
chronic disease.
Questions of the project
 How to identify the basic understanding about chronic kidney disease?
 What are the diagnosis and treatment methods used for patient suffering from chronic
kidney disease?
 How to evaluate the comparison between lipid abnormalities of chronic kidney disease
patients in India and UK?
 What are the ways to examine the changes in clinical process and technology occurs in
terms of kidney chronic disease?
BACKGROUND
The chronic kidney disease is known to be a severe health problem which should be treated
immediately to maintain appropriate health condition. In context of this project, it is based on the
research aim to evaluate the comparative study of lipid abnormalities of chronic kidney disease
patient in India and United Kingdom. It includes to carry out investigation in regards to lipid
abnormalities related to chronic kidney disease patient in two countries (Khandelwal and et. al.,
2016). This project will focus on the basic understanding about chronic kidney disease including
its symptoms and causes in proper manner. It will also includes the method of diagnosis and
treatment to deliver appropriate care services for making patient healthy. It includes to conduct
diagnosis in order to evaluate actual problem and its causes according to which effective care
plan can be prepared for betterment of a diseased person (Koye and et. al., 2018). The evaluation
of comparison between lipid abnormalities of chronic kidney disease patient in India and United
Kingdom is explained below. It consist the other research objective to examine the changes in
clinical process and technology occurs to deal with kidney chronic disease are mentioned here.
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Literature review
Literature review can be described as a process in which different research articles of
similar research topic has been studied. It includes carrying out effective review of articles by
analysing viewpoints of different authors. However, this process can be considered as to gather
appropriate data in order to conduct investigation in order to gain desired findings (Koye and et.
al., 2018). The literature review is an efficient procedure related to investigation which involves
the criterion of enumerating, describing, summarising, objectively evaluating as well as
clarifying the previous research articles. Moreover, it includes the utilisation of survey books,
scholarly articles and other relevant sources in respect of collecting appropriate information. This
literature review will focus on the aim of evaluating lipid abnormalities of chronic kidney disease
patients by considering respective objectives (Habeeba and et. al., 2020).
The basic understanding about chronic kidney disease
Chronic kidney disease can be defined as a medical condition when kidney damage occurs
and it acquire wrist situation. As per view given by Edelstein (2016), t includes the condition of
occurring abnormalities in functioning of kidneys due to which diseases have started to occur in
human body. Basically, it has been analysed that kidney cannot able to carry out its functions of
filtering all the waste and toxins and facilitate to relive the same form the body. The chronic
kidney disease are responsible for developing different types of symptoms such as fatigue, loss
of appetite, nausea, vomiting, sleep problems, muscle twitches, swelling of feet & ankles,
persistent itching and chest pain. However, has been identified that several health problem are
responsible for causing chronic kidney disease including, type 1 or type 2 diabetes, high blood
pressure and glomerulonephritis which is known as an inflammation of kidney’s filtering units
i.e. glomeruli. However, includes other cause such as intestinal nephritis that is an inflammation
of kidney’s tubules as well as surrounding structured and polycystic kidney disease. However, it
includes the condition of prolonged obstruction of urinary tract from conditions like enlarged
prostate, kidney stones and some type of cancer facilitate occurrence of kidney problem. In
addition to this, it has been analysed that vesicoureteral reflux which is condition causing urine
to back up into the kidneys and recurrent kidney infection also called as pyelonephritis are
responsible for causing chronic kidney diseases. It is necessary for an individual to improve their
lifestyle and consult immediately to doctor while having symptoms of any health problem in
order to remain well-being by avoiding severe diseases (Hopewell, Haynes and Baigent, 2018).
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On the other hand, it is observed that chronic kidney diseases may acquire by people
having problems of health like diabetes, hypertension, polycystic diseases etc. In the same way,
the chronic kidneys are accountable to have number of risk factors in relation of health condition
of people. Basically, it includes the risk of facilitating occurrence of various kinds of severe
diseases such as high blood pressure, heart & blood vessel disease, smoking, obesity, family
history of kidney disease, abnormal kidney structure. According to the opinion of Impellizzeri
and et. al. (2014), it has been analysed that people may overcome from the kidney problem but
the shape & size id kidney get changed due to which their functioning get modified for the life
long duration. Meanwhile, the older age is also known as potential risk factors that increase
chance of occurring chronic kidney problems (Tallman and et. al., 2018). Apart from this, it has
been analysed that chronic kidney disease is accountable to have their impact on almost every
part of human body and relevant complications consist certain conditions it includes fluid
retention, sudden increase in levels of potassium in body, cardiovascular problems, weak bones
& increased risk of bone fractures and anaemia. However, it consist the other problems including
reduced sex drive, erectile dysfunction or decreased fertility, damage in central nervous system,
reduced immune responses, pericarditis, increased risk of pregnancy complications and
irreversible mange to kidneys. Moreover, it is necessary for patient with kidney disease are
required to immediate consult with doctor in order to gain more effective as well as efficient
treatment to become wellbeing by ignoring relevant complications.
The diagnosis and treatment methods used for patient suffering from chronic kidney disease
The diagnosis plays an important role in terms of evaluating symptoms and actual causes
behind specific health problems. As mentioned by Baumgaertel, Kraemer and Berlit (2014), it
includes the criterion of identifying the cause of particular diseases and its stage according to
effective care services can be delivered for wellbeing of an individual. Basically, it includes that
chronic kidney disease and its impact on human body is required to be examined by clinical
practitioners to terms of providing medications to overall wellness of an individual. This problem
is responsible to be occurring in number of stages which are required to be diagnosed in
appropriate manner. Initially, the stage 1 includes that GFR rate is normal and evidence of
kidney disease has been detected. Secondly, the stage 2 consist the situation in which GFR rate is
lower than 90 millilitres and evidence of kidney disease has been detected (Anderson and et. al.,
2019). Thirdly, the stage 3 includes the GFR rate is lower than 60 millilitres regardless of
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whether evidence of kidney disease has detected. However, it involves the stage 4 when GRF
rate is lower than 30 millilitres regardless of whether evidence of kidney disease has been
detected. In addition to this, final stage consist GFR rate is lower than 15 millilitres then renal
failure had occurred.
In context of chronic kidney disease, it includes the specific diagnosing methods and
procedures in order to detect the actual problem and its causes. Musso, Jauregui and Núñez
(2015) states that it consists to carry out physical exam to analyse temperature, respiratory rate,
heart rate etc. for detecting the health problem of patient. However, it involves the method of
blood test in terms of evaluating the blood sample to study about its components like red blood
cells, white blood cells, platelets, plasma to identify the abnormalities. It includes the
measurement of electrolytes and waste present in blood which is helpful to detect the problem of
kidney and its severity that helps to establish accurate care plan for betterment of an individual.
It has been evaluated that the physician measure amount of waste products such as creatinine as
well as blood urea. The creatinine is known to be by-product of muscle metabolism whereas
blood urea is leftover by breakdown of protein in human body, when kidney functioning is
appropriate then both these components are excrete out. Moreover, it consist the other method of
urine tests, imaging test including CT scan, MRI & ultrasound and biopsy (Streja and et. al.,
2018).
The treatment of chronic kidney disease is based on establish care plan by evaluating
actual condition of patient to provide desired medications. It includes the criterion of providing
statins to control the blood pressure and cholesterol level because kidney diseases are associated
with these problems (Halcox and Misra, 2015). Basically, it involves the utilisation of
supplement for production of sufficient amount of red blood cells in patient who have experience
the anaemia due to kidney disease. It is so because human body requires enough iron is
manufactured by blood cells due to which clinical practice of blood transfusion occurs to
improve red blood cell health in body. However, the vitamin D and calcium supplements are
provide to patients for improving strength of bones that weakened due to chronic kidney
problem. Moreover, the medications include antihistamines to relive symptom of itchy skin and
antiemetic that is helpful to overcome with nausea (Sethna, Merchant and Reyes, 2018).
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The comparison between lipid abnormalities of chronic kidney disease patients in India and UK
The chronic renal problem is caused due to occurrence of lipid abnormalities in terms of
metabolism. As per view of Locatelli and et. al. (2014), it will facilitate the appearance of
nephrotic syndromes as its consequences or the problem of renal insufficiency takes place.
Basically, these consequences can be reflected in an altered Apo lipoprotein profile along with
elevated plasma lipid levels. It has been analysed that the abnormalities due to lipids is
responsible for developing problem which facilitate the occurrence of chronic kidney disease. It
consist the correlation between the renal disease and dyslipidaemia because abnormal
concentration of lipids develop problem of kidney as well as its parts. It has been analysed that
the high level of cholesterol and triglyceride plasma has independent risk of encouraging renal
disease among people (Ribeiro and et. al., 2016). However, the progression of renal disease take
place due to lipid abnormal levels in body and it is caused by oxidative stress as well as insulin
resistance accordingly. It includes the fact that lipids inappropriate levels is responsible for
facilitating damage in specific parts of kidney which further acquire the chronic kidney disease
condition. Moreover, it has been examined that renal function decline due to reduction in lipids
that is responsible for causing primary renal outcome lipid lowering therapy study (Lanza and et.
al., 2020).
In context of India, it has been analysed that there are several cases observed in which
chronic kidney disease occurs due to condition of lipid abnormalities. According to the view of
Herrick Litvin and Goldberg (2014), it includes their reduction in body due to which renal
functioning declined which leads to condition of chronic kidney disease among patient in the
country. Basically, it involves the condition that there is a moderate hypertriglyceridemia and
reduced in HDL level in CKD patients. It has been evaluated that the problem lf chronic renal
failure in India varied from no lipid abnormalities at all to significant abnormality
hypertriglyceridemia along with reduced HDL. It is observed that patient having problem of
kidney disease were profound with lipid disorders then relevant treatment is required to be
delivered for wellbeing of an individual. However, it has been identified that there is a potential
reduction in HDL and increase in LDL level on patients suffering from chronic kidney diseases
in effective manner.
On the other hand, the patients of chronic kidney diseases in United Kingdom have
condition of abnormal lipid level in their body. It consist the condition among citizens of UK to
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acquire problem of related to lipid metabolism that results into chronic kidneys disease among
them. However, it involves the fact that elderly people are more likely to become diseased by
kidney problem due to occurrence of lipids abnormalities in United Kingdom. It is observed the
lipid abnormalities were mostly evaluated among older people in respect to lipid metabolism due
to which they acquire chronic kidney disease (Grzegorzewska, 2014). Some of these individual
face renal problem because they have condition in which reduction in levels of lipids become
inappropriate.
The changes in clinical process and technology occurs in terms of kidney chronic disease
The clinical procedures and use of technology plays an important role in terms of
providing effective treatment to needy people. As mentioned by Ishani and et. al. (2016), it is
necessary for healthcare organisations to put efforts for adopting new and innovative technical
instruments which helps to delivery better quality of treatment along with saving the time.
However, it has been analysed that time is very crucial in terms of medical field because delay in
treatment for few minutes may take life of an individual or it may make patient stable by giving
quick treatment. It includes the fact that innovative clinical practices are more effective as well
as efficient in respect of providing appropriate care services (Vallianou and et. al., 2019). It will
provide support to reduce chance of complications which facilitate to boost up patient experience
respectively. Meanwhile, the use of technology plays an important role to maintain accuracy of
patient information about chronic kidney disease which facilitates to make decision accurately in
terms of improving condition of an individual. It includes the criterion of making an effective
care plan and ensures that patient is wellbeing or not. Innovative technology is favourable in
order to monitor the treatment effects on patient with chronic kidney disease and regularly deal
with patient in appropriate manner.
In case of India, the healthcare system includes use of Robot assisted surgery which is
helpful to maintain accuracy of conducting entire procedure of operation. Ong and et. al. (2015)
states that it includes the use of robots to carry out desired clinical practices on regular basis
which helps staff to give proper time to specific patient and satisfy their medical needs.
However, it has been analysed that patient with chronic kidney disease were commonly observed
then extra pressure of sick people can be easily deal with the help of robot employees. It involves
the utilisation of machines and robots to carry out other administration work then Investigator
can perform their treatment practices with more focus that facilitate to improve the condition of
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an individual. Meanwhile, the use advanced technology is adopted in hospitals of India that helps
to overcome with the problem of inaccurate diagnosis of disease which is risky for patient. It
includes the utilisation of advanced machines and equipment that helps to detect accurate
problem which encourage to deliver appropriate medical services with improve quality to make
an individual wellbeing (de Almeida Alvarenga and et. al., 2018).
In context of United Kingdom, it has been analysed that the innovative technology is
telemedicine is used by physicians and doctor of the country in order to deal with patients’ lives
far away from hospital, the telemedicine is helpful for patient who were not able to visit the
hospitals or clinics on regular basis then they can conduct electronic telecommunications with
their doctor (Hamed, 2014). However, it is helpful for patients to consult with their physician
easily and get proper prescription online and overcome with chronic kidney problems. They can
communicate about problem with doctors and physician can monitor their patients’ condition
online by telecommunication through the facility of telemedicine respectively.
METHODOLOGY
Types of investigation
The types of investigation can be considering two methods such as qualitative and
quantitative method of research. It is very important for an investigator to establish an effective
decision to select suitable method to carry out entire study. However, it is necessary for a
researcher to select favourable method according to the specific research problem and topic to
conduct the investigation in proper manner (Raghav and et. al., 2018). In context of this
qualitative research method is used to conduct investigation on selected topic in order to gain
appropriate outcomes. It is appropriate for the given investigation because it is responsible to
focus on in depth knowledge of particular topic in order to gather desired information which
facilitates to gain accurate findings respectively. Meanwhile, it includes studying the opinions,
thoughts and feelings of participants to collect relevant data which will provide support to
improve accuracy of the research outcomes. It is beneficial in terms of informing new concepts
and theories in proper manner (Kalaitzidis and Elisaf, 2018).
Proposed plan
The proposed plan includes the time of every specific task of the investigation which is
helpful to direct efforts of an investigator in correct direction. It includes the benefit that
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researcher will perform every specific activity of study within the set specific deadline which
will provide support to complete the entire investigation with desired duration of time (Stefan
and et. al., 2014). In context of this investigation, it will focus on the Gannt chart which mention
each specific task of investigation like introduction literature review, methodology and findings
along with its duration of time mentioned with specific dates. It includes the plan with flow chart
that helps to understand the appropriate sequences of different tasks that can be carried one by
one. It is also favourable to understand that which tasks can be done initially and alternative with
other research activities (Mohammed and et. al., 2019).
Theoretical frameworks of change
Leadership models will be considered in terms of adopting new and innovative clinical
techniques in order to implement desired change for attaining better patient outcomes. It includes
the utilisation of change management models to apply desired changes in healthcare system of
the country to improve delivery of appropriate care services. However, it is required or
healthcare sector in India and UK to adopt several changes in order to facilitate desired
modifications in care services by considering better quality. It is necessary to use leadership
models and management theories to manage all the work after considering innovative changes in
healthcare services to enhance efficiency of health system. It will provide support to reduce the
waiting time of patients and deliver effective facilities for making them disease free (Lopes and
et. al., 2018).
Situational leadership theory:
Situational leadership theory can be defined as a framework that is suitable to deal with
different types of circumstances. In other words, Situational leadership Theory describe that
leaders opt the prominent leadership style according to the existing skills of their employees and
also consider their developmental level. It also provide that the leaders with the prominent
flexibility can assess the situation in order to adopt significant leadership style which is best
suited according to the requirement of the followers. While using situational leadership the
leaders need to be aware regarding the viewpoint and perception of their followers.
By considering the prominent Kidney Disease that leads to arise vomiting, insomnia,
reduction of memory and so on at the time of various steps of the process then the health leaders
need to be aware of it and prominently adopt the leadership style that matches with the
developmental status of their team members. Along with this, it is based on two behavioural
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categories including task behaviour and relational behaviour as task describe that leader involve
in performing its duties and responsibilities whereas relational describe that leader involved in
the two way communication process. Therefore, by considering this theory it is prominently
adopted by the Indian health leaders by maintaining balance among their work including
guidance and direction that comes under task behaviour and socio-emotional support that relies
under relational behaviour (Oguntola, 2018).
Contingency leadership theory:
Significance of leadership style depends on the leader who handles the prominent
situation and Organisation. The contingency theory states that there is no prominent solution for
the specific situation and in this context health leaders need to take immediate decision according
to the certain situation. Therefore, it describes that the certain aspects of the situation can impact
the effectiveness of leadership. For example, the leader who is good in task orientation will
perform its best in any situation and can easily control it whereas a leader who is good in
relations will perform best in only moderate control situation. In terms of this the situations are
varied according to the level of control position power and the task structure (Calza and et. al.,
2018).
It is apparent for the contingent leaders that are suitable for various setups regarding the
understanding and providing strategic direction. Therefore considering the Healthcare leaders of
UK it is best suited on them as the varying level of culture and development is contingent over
there and for this contingency approach is suitable. By evaluating the Healthcare conditions of
UK contingency theory is a good starting point in order to identify the type of leadership which
the Healthcare leaders need to manage their organisation.
Lewin’s change management model:
Considering the change model of Lewin’s describes the dynamic balance of forces that
work in different directions. This change theory has three prominent concepts that is driving
force restraining force and equilibrium. Moreover, driving forces are the one that push towards
the direction by which change occurs. It is also facilitate the change by considering the patient in
the prominent direction. It leads to shift in the equilibrium towards the change and restrain the
forces that counter the driving forces. Along with it, this change criteria is used by the Indian
change agent as the head the change because the push the patient towards the opposite direction.
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