NURSING 3 Essay: Importance of Early Renal Disease Management

This essay focuses on the critical importance of early detection and optimal management of renal disease to prevent End-Stage Kidney Disease (ESKD). The author disagrees with the notion that late-stage treatment is sufficient, advocating for early screening and intervention. The essay supports this opinion with evidence-based research, highlighting the barriers to optimal care in late-stage chronic kidney disease, such as delayed referrals to nephrologists, fragmented care, and inadequate patient education. The author emphasizes the need for improved care coordination, early screening, and advanced care planning to reduce complications and prevent ESKD. The essay references studies on the current state of renal care in Australia, emphasizing the need for training and awareness among healthcare professionals and the general public to modify management approaches from treatment to primary prevention. The essay concludes by underscoring the importance of proactive strategies to improve patient outcomes and prevent the progression of renal disease.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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End-stage kidney disease (ESKD) is the most severe type of kidney disease that requires
dialysis or kidney transplantation for survival of patient. The prevalence of the disease in
Australia is understood from the estimation that prevalence will increase by 60% in the year
2020 compared to 2011 (aihw.gov.au., 2017). Diabetes is one of the biggest risk factor for
developing ESKD and management of modifiable risk factors such as type 2 diabetes can reduce
the progression from chronic renal disease to ESKD. However, I disagree with fact and my
personal opinion is that early detection and optimal management of renal disease in the early
stage is crucial to prevent the profession from renal disease to ESKD. I will justify my opinion
with the use of evidence based research to support the impact of early screening on improving
health of people.
I favor management of renal disease in the early stage to prevent ESKD because of
several barriers identified in providing optimal care in late-stage of chronic kidney disease found
in recent research evidence. Luckett et al. (2017) discussed that the complexity in ESKD is
reflected by high rates of hospitalization, initiation of hemodialysis, transplantation and high
health care cost. In addition, other barriers to optimal care in late-stage CKD includes delayed
referral to nephrologist, fragmentation of care, inadequate patient education and poor
communication between staffs. Early referral to nephrologist is essential to optimize medical
management of patient, however due to delayed referral, several other complications are seen in
patient such as bone disease anemia. Limitation is found in preparing unified care plan for
patients with renal disease because of poor coordination between primary care physician and
specialist physician thus increasing the risk for hospitalization. Lack of disease stage education
also prevents patient to take necessary precaution to prevent progression to ESKD (Fishbane et
al., 2014). Hence, continuity of care and increasing early screening and management of renal

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disease patient is essential to reduce rate of complication and prevent ESKD. This can help to
closely match health care services as per the needs of renal disease patient.
Early screening and management of ESKD is also reflective of advanced care planning
for chronic kidney disease. This can pave way for changing current advanced care planning
practice, developing skills of health care professionals in coordinated care and identifying
chronic kidney disease- specific approaches to manage renal disease and prevent KSD. A recent
study done in Australia also gave the evidence that current nephrologist and respiratory specialist
have poor advanced care planning knowledge and the current renal care services in Australia are
sub-optimal (Luckett et al., 2017). Hence, training and appointment of dedicated advanced care
planning facilitators are essential to promote health of renal disease patient and prevent ESKD.
Another aspect that is important to prevent ESKD and fulfill the goal of improving
advanced care planning for ESKD patient includes raising awareness of chronic kidney disease
in general public and among primary health care professionals. This is important because current
primary care professionals in Australia are not aware about guidelines for screening and
management of chronic renal disease (Fishbane et al., 2014). Hence, modifying management of
renal disease from treatment to primary prevention can reduce incidence of ESKD.

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References:
aihw.gov.au. (2017). Projection of prevalence of treated end-stage kidney disease in Australia
2012-2020. Retrieved from:
https://www.aihw.gov.au/reports/chronic-kidney-disease/prevalence-treated-end-stage-
kidney-disease-2012/contents/summary
Chen, T., & Harris, D.C. (2015). Challenges of chronic kidney disease prevention. Med J Aust,
203(5)
Fishbane, S., Hazzan, A. D., Halinski, C., & Mathew, A. T. (2014). Challenges and opportunities
in late-stage chronic kidney disease. Clinical kidney journal, 8(1), 54-60, doi:
10.5694/mja15.00241
Luckett, T., Spencer, L., Morton, R. L., Pollock, C. A., Lam, L., Silvester, W., ... & Clayton, J.
M. (2017). Advance care planning in chronic kidney disease: a survey of current practice
in Australia. Nephrology, 22(2), 139-149.