Course Overview
This course is designed to equip Nurse Practitioners with the knowledge and skills necessary to manage Chronic Kidney Disease (CKD) through a comprehensive case study approach. Learners will explore the stages of CKD, the assessment and monitoring of kidney function, and strategies for slowing disease progression. Emphasis will be placed on developing individualized management plans, including lifestyle modifications, pharmacological interventions, and when to refer to nephrology. Through real-world patient scenarios, learners will enhance their clinical decision-making and improve their ability to provide effective CKD management in practice.
Learning Objectives
- Understand the stages and pathophysiology of Chronic Kidney Disease (CKD).
- Perform a thorough assessment of CKD, including laboratory tests and patient history.
- Recognize the role of lifestyle modifications, such as diet and exercise, in managing CKD.
- Apply evidence-based pharmacological treatments to slow CKD progression.
- Identify when referral to nephrology is necessary for advanced CKD management.
- Educate patients on managing CKD and preventing complications.
Course Duration
Total Time: 4 hours
Time Allocation:
- Module 1: Introduction and Pathophysiology of CKD (30 minutes)
- Module 2: Assessment and Diagnosis of CKD (60 minutes)
- Module 3: Management of CKD with Pharmacological and Non-Pharmacological Interventions (90 minutes)
- Module 4: Referral to Nephrology and Advanced CKD Management (30 minutes)
- Quiz and Case Review: 30 minutes
Course Outline
Module 1: Introduction and Pathophysiology of CKD
Duration: 30 minutes
Content:
- Overview of CKD: Understanding CKD as a progressive, multi-system disorder and its global impact on health.
- Stages of CKD: Detailed explanation of the five stages of CKD, based on glomerular filtration rate (GFR) and the clinical significance of each stage.
- Pathophysiology: Mechanisms of kidney damage, including nephron loss, glomerulosclerosis, and the role of inflammation and fibrosis in disease progression.
Learning Activity:
Review the content on the pathophysiology of CKD. Answer the following questions to reflect on the information:
- What is the role of GFR in determining the stage of CKD?
- How do inflammatory and fibrotic processes contribute to the progression of CKD?
Module 2: Assessment and Diagnosis of CKD
Duration: 60 minutes
Content:
- Clinical Presentation: Common symptoms and signs of CKD, including fatigue, edema, and changes in urine output.
- Laboratory Assessments: Key diagnostic tests, such as serum creatinine, eGFR, urine albumin-to-creatinine ratio, and urinalysis, to assess kidney function and detect early signs of CKD.
- Differential Diagnosis: Differentiating CKD from other conditions with similar symptoms, such as acute kidney injury (AKI), heart failure, and diabetes-related complications.
Learning Activity:
Review the provided case scenario of a patient with suspected CKD. Based on the clinical and diagnostic data, determine the stage of CKD and document your findings. Identify the next steps in the diagnosis and treatment process.
Module 3: Management of CKD with Pharmacological and Non-Pharmacological Interventions
Duration: 90 minutes
Content:
- Non-Pharmacological Interventions: Lifestyle modifications, including dietary changes, weight management, and exercise, to slow CKD progression.
- Pharmacological Management: Common medications used to manage CKD, including angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs), and sodium-glucose co-transporter-2 (SGLT2) inhibitors.
- Managing Comorbidities: Managing hypertension, diabetes, and dyslipidemia to prevent further kidney damage and complications.
Learning Activity:
Based on the patient’s clinical condition, develop a personalized management plan, including medication choices and lifestyle changes. Justify your treatment decisions and reflect on the rationale behind them.
Module 4: Referral to Nephrology and Advanced CKD Management
Duration: 30 minutes
Content:
- Referral to Nephrology: Criteria for referring patients to nephrologists, including progressive loss of kidney function, complications such as electrolyte imbalances, and the need for dialysis planning.
- Advanced CKD Management: The role of dialysis and kidney transplantation in the management of end-stage renal disease (ESRD).
- End-of-Life Care: Discussing palliative care options and decisions regarding end-of-life care in patients with ESRD.
Learning Activity:
Review the patient’s CKD progression and determine whether referral to nephrology is warranted. Develop an action plan for initiating the referral process and planning for advanced CKD management.
Quiz and Case Review
Duration: 30 minutes
Content:
- Complete the quiz assessing your understanding of CKD management, including diagnosis, pharmacological and non-pharmacological interventions, and referral criteria.
- Review the entire case study and reflect on the management steps taken. Ensure you understand the rationale behind each clinical decision.