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Chronic kidney disease (CKD) is a progressive loss of renal function over the course of several months or years. Chronic kidney disease has no specific symptoms at first and can only be identified as a spike in serum creatinine or protein in the urine. Increased blood pressure due to fluid overload and production of vasoactive hormones the kidney creates via the renin-angiotensin system.
Urea accumulation, resulting in azotemia and eventually uremia, with symptoms ranging from lethargy to pericarditis and encelopathy. Potassium accumulation in the blood, which could lead to potentially fatal cardiac arrhythmias. Fluid volume overload, with symptoms ranging from mild edema  to pulmonary edema, which is life-threatening.
Decreased erythropoietin synthesis which could lead to anemia, which in turn displays fatigue as a symptom. Hypocalcemia eventually progressing to secondary hyperparathyroidism, renal osteodystrophy, and vascular calcification, affecting cardiac function. Individuals suffering from chronic kidney disease also experience accelerated atherosclerosis, which makes them more prone to developing cardiovascular disease compared to the general population. The most common causes of chronic kidney disease are hypertension (high blood pressure), diabetes mellitus, and glomerulonephritis.
Vascular causes include large vessel disease such as bilateral renal artery stenosis, or small vessel disease such as ischemic nephropathy, vasculitis and hemolytic-uremic syndrome. Meanwhile, all patients with kidney damage are classified as having CKD regardless of the level of GFR. The loss of protein in urine is also considered an independent marker for worsening renal function and cardiovascular disease.
During the first stage of chronic kidney disease, patients may experience slightly diminished function, i.e.
By identifying patients with kidney disease early on, proper measures may help slow progression and reduce cardiovascular risk. CKD considerably increases the risk of cardiovascular disease, and CKD patients often face higher risk factors for heart disease such as hyperlipidemia.
Other risk factors aside, the treatment for chronic kidney disease aims to slow down or stop the progression of CKD to stage 5.
ACE inhibitors and ARBs are the current standard of care for CKD patients, but various studies show that subjects still progressively lose kidney functions while on these medications. Patients with advanced CKD often require replacement of erythropoietin and calcitriol, two hormones the kidney processes. While renal replacement therapies can benefit patients indefinitely and prolong life, CKD severely affects the quality of life. UNICEF is committed to doing all it can to achieve the Sustainable Development Goals (SDGs), in partnership with governments, civil society, business, academia and the United Nations family – and especially children and young people. UNICEF uses innovative approaches to solve problems and improve the lives of children around the world.
The spread of Ebola in West Africa has slowed dramatically, but the challenges remain huge in defeating this scourge while re-establishing basic social services and building resilience in Guinea, Liberia and Sierra Leone.
International solidarity remains essential in the immediate response and in helping address the conditions – particularly weak health systems and deficient sanitation – that enabled a localized epidemic to escalate into a major crisis.
Communication for development (C4D) is especially necessary in this crisis because containing the outbreak requires a shift in the rituals and activities of entire populations.


Engaging in and with communities is the primary way to help individuals and families protect themselves, care for and transport the sick, and enable those appointed to safely bury the dead. UNICEF backs a nationwide effort to reach every household with lifesaving information in Sierra Leone’s three-day, door-to-door Ebola prevention campaign (read full story story below). The stories below are examples of UNICEF C4D on the ground, getting info and ideas to as many people as possible to help keep them healthy and safe. One of the hidden impacts of the Ebola outbreak in Guinea is that children have missed out on six months of learning – schools did not reopen after the summer recess, instead staying shut to help prevent the spread of the disease. When child survivors like 10-year-old Hawa emerge from the plastic-walled Ebola treatment centres, there are relief, smiles and often a joyous mix of dancing and singing. A dozen people sit in the shade of a jackfruit tree, commenting on an illustration that shows a Muslim cleric and a few mourners watch men in protective suits conducting a burial. International organizations like UNICEF are no stranger to dealing with devastating medical outbreaks like the ongoing Ebola crisis happening in West Africa, which has already claimed almost 5,000 lives.
The Ose to Ose Ebola Tok initiative, which means ‘house-to-house talk’ in the Sierra Leonean local language, will see over 28,500 trained social mobilizers, youths and volunteers go to door-to-door to reach 1.5 million households and provide them with information on ways families can protect themselves against the Ebola virus disease and prevent its spread. In Liberia, 150 adolescent girls trained by UNICEF and partners marched across the West Point community in Monrovia to launch Adolescents Leading the Intensive Fight against Ebola, or ‘A-LIFE’. UNICEF, the Guinean Ministry of Youth and Youth Employment and other UN and Civil Society partners, empowered 2100 youth volunteers to go door to door in Conakry, Guinea to inform the public about Ebola and distribute chlorine and soap. UNICEF supported a Government-led social mobilization campaign aimed at reaching every household in Sierra Leone with life-saving information on preventing further spread of the disease.
A volunteer explains how Ebola is transmitted, what the symptoms are and how to prevent it. Meningococcal Meningitis is caused by bacteria from the family Neisseria meningitides.There are 13 serologically distinct groups, but the serogroups that most commonly cause disease are A, B, C, Y and W-135. This article aims to high light the symptoms and signs of meningitis so you can get help early and treat this deadly disease. Meningococcal Meningitis is spread from person to person through droplets (coughing or sneezing) or direct contact with respiratory secretions.
Fever, Possible with Cold Hands and Feet, Refusing Feeds or Vomiting, High Pitched Moaning Cry or Whimpering, Dislike of Being Handled or Fretful, Neck Retraction with Arching of the Back, Blank and Staring Expression, Child is Difficult to Wake, Lethargic, Pale, Blothcy Complexion.
There are two kinds of vaccination available for prevention for certain strains of meningitis bacteria.
Urea is pushed out by sweating and crystallizes on the skin, creating the “uremic frost” effect.
Patients with both CKD and cardiovascular disease typically have significantly worse prognoses than those suffering only from cardiovascular disease. Glomerular causes cover a diverse group and are broken down into primary glomerular disease such as focal segmental glomerulosclerisis and lgA nephritis, and secondary glomerular disease such as lupus nephritis and diabetic nephropathy. The reason behind this classification is that a reduction in kidney function to this level or lower means a loss of half or even more of normal kidney function in adults.
Consequently, British guidelines mark the stage of CDK with the letter “P” if there is significant protein loss. Individuals who should be screened foe CKD include those with hypertension or history of cardiovascular disease, subjects with diabetes or marked obesity, people aged 60 or older, those with indigenous origin (Native American Indian, First Nations), those with a history of previous renal disease, and those with relatives who required dialysis due to kidney disease. Cardiovascular disease is the most common cause of death in CKD patients, not renal failure. The broad principles of managing this disease are proper control of blood pressure and treating the original disease, whenever possible.


Compared to other therapeutic options, renal transplantation is the most effective in increasing survival for stage 5 CKD patients. The outbreak has been unprecedented in scope and intensity, and hit some of the most vulnerable communities in some of the world’s poorest countries. Helping the affected countries build back better will mean they’ll be better equipped to prevent another such an outbreak and to tackle other killer diseases – such as malaria, measles, pneumonia and diarrhoea – that take a heavy toll on children. Spreading knowledge and information requires a range of communication tools to be effective and UNICEF’s C4D team is well placed to help with this work on the ground in the countries hardest hit. To engage local supporters, UNICEF recently hosted a speaker luncheon in San Francisco to explain the powerful work they have been doing on the ground throughout Liberia, Sierra Leone, and Guinea. A virus of opportunity, Ebola is preying on already weak health systems with outstripped resources and overworked personnel, as well as misinformation and fear. In many cases, this condition is diagnosed as a result of screening when individuals are considered to be at risk of kidney problems, such as those with diabetes or high blood pressure or those related to someone with chronic kidney disease.
CKD may also have tubulointestinal causes, including polycystic kidney disease, drug and toxin-induced chronic tubulointerstitial nephritis and reflux nephropathy.
In addition, patients with kidney damage face increased risk of two major outcomes of CDK: loss of kidney function and development of cardiovascular disease. Kidney damage is comprised of pathological abnormalities or markers of damage, including abnormalities in blood tests, urine tests or imaging studies.
Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are typically used as treatment, as they proved effective in slowing the progression of CKD to stage 5. Such compounds include bardoxolone methyl, olmesartan medoxomil, sulodexide, avosentan and others. Serum phosphate levels must also kept under control with phosphate binders, as patients with advanced chronic kidney disease usually have elevated levels of serum phosphate. It is, however, associated with a higher risk of short-term mortality, as surgery involves risks of complications. Millions of children have been affected in some way or other -- falling victim to the deadly virus, becoming orphans, facing stigmatization, losing months of school education, and being traumatized.
We cannot touch the body,” one of the villagers says, drawing nods and mm-hmms of approval from the rest of the audience. Call into Eastmed Doctors if it is working hours - 8am to 6pm weekday or 9am to 12 noon Saturdays.
The condition can also be discovered when it leads to one of its notorious complications such as cardiovascular disease, pericarditis or anemia.
Meanwhile high-intensity home hemodialisys seems to lead to an improved survival rate and a greater quality of life, especially compared to the conventional hemodialysis and peritoneal dialysis three times a week. Afterwards she starts screaming, dramatizing a scene: “Do not touch me, do not touch me” whilst her mother chases her, stretching her arms, and touching her belly.
Recently there has been a few deaths related to meningitis caused by a C serogroup of Meningococcol bacteria. After hours ring the ambulance on 111 or if you are close to the emergency department go to Auckland Hospital or Starship Children's Hospital. Karen Leham is double board-certified in Obstetrics and Gynecology and in Reproductive Endocronology and Infertility.



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