EPIDEMIOLOGY OF CHRONIC RENAL FAILURE (CRF)

EPIDEMIOLOGY OF CHRONIC RENAL FAILURE (CRF)

Frequency Distribution of Chronic Renal Failure (CRF)

Frequency Distribution of Chronic Renal Failure (CRF) is divided by:

a. Frequency Distribution of Chronic Renal Failure (CRF) By People

Age will change the shape of the anatomy of the human body and is also accompanied by decreased function of the body. Kidney anatomical and physiological changes caused by the aging process, causing it to occur in the elderly with chronic glomerulonephritis terminal renal failure (GGT). According Romauli Research (2009) in Hospital Dr. H. Set Pane High Cliff, most patients with chronic renal failure in the age group 53-61 years (30.4%). According to research Hafidz (2010) in the department of H. Adam Malik Medan, most patients with chronic renal failure in the age group 46-55 years (39%). Overall prevalence of End-Stage Renal Disease (ESRD) was greater in men (56.3%) than women (43.7%) although certain systemic diseases that cause ESRD (such as diabetes mellitus type 2) is more common in women . According to the research Doloksaribu (2008) showed that patients with chronic renal failure undergoing regular hemodialysis in Hemodialysis Clinic Field Rasyida most males (65.9%). According Hanifa (2010) Dr Adam Malik Medan in CRF patients most in men (61.4%).

In the United States, chronic renal failure due to hypertensive nephropathy was 6.2 times more common in African Americans than in Caucasians. Individuals with type 2 diabetes a little more progress to chronic renal failure (approximately 10% to 20%) with the exception of Pima Indians with incidence approaching 50%. Native Americans and African-Americans are at risk of developing diabetic kidney failure.

b. Frequency Distribution of Chronic Renal Failure (CRF)

Based Time and Place Japan and Taiwan is a country with a prevalence of End-Stage Renal Disease (ESRD) Highest. In 2003, the prevalence of ESRD in Japan and Taiwan residents 1800/1.000.000 1600/1.000.000. According to the USRDS laroran, in the United States in 2005, more than 350,000 patients ESDR living in urban areas and more than 112,000 ESRD patients living in rural strip. The prevalence of ESRD in Brazil in January 2007 about 540/1.000.000 population, lower than other Latin American countries, such as the prevalence of ESRD 750/1.000.000 Chile and Uruguay 800/1.000.000 resident population. Survey of Internal Medicine unity Indonesia (Papdi) in 1990-1992 showed that 13% of the approximately 50,000 inpatients in hospitals across Indonesia suffered kidney failure and hypertension, which ranks fourth after typhoid, pulmonary tuberculosis and enteritis.

Lifestyle

Definitions

The third corner of the triangle condition that affects an individual's health is lifestyle. The pattern of life is a set of behaviors associated with everyday life which included nutrition, rest, exercise, recreation and work. Such behavior may be a significant factor causing someone becomes ill or injured (Ayers Bruno and Langford, 1999).

The pattern of life is one of the internal factors that affect a person's health. To improve health behavior can be controlled and selected. One of the least healthy choice of activities undertaken is influenced by sociocultural factors individual characteristics. Behaviors that are negative for known health risk factors (Kozier, 2004)

Influencing Healthy Lifestyle

(Potter, Perry, 2005) suggests that there are activities and behaviors that can affect the health. How the implementation of activities that could potentially have negative effects such as overeating or poor nutrition, lack of sleep and rest, and poor personal hygiene. Another habit that causes a person at risk of suffering from the habit of smoking or drinking alcohol, drug abuse, and dangerous activities such as skydiving and mountain climbing. Individuals with a habit which can also cause pain that is a habit of basking in the sun increases the risk of skin cancer, and being overweight can increase the risk of cardiovascular disease.

More (Potter, Perry2005) suggested various crises of life stress and lifestyle changes. Emotional stress may be a risk factor when it is severe, occurs in a long time or if someone has not experienced an adequate coping may increase the chances of illness. Stress can occur due to life events such as divorce, pregnancy and strife. Areas of life that cause long-term emotional stress as a risk factor for work-related stress can have an impact on cognitive abilities and weaknesses of the ability to make decisions that lead to mental overload or death. (Ayers, Bruno, Langford, 1999) suggests that lifestyle is an area that can best be controlled by someone and have a few rules in order to maintain and improve health. Conduct included in lifestyle is likely to change.

Nutrition / Diet Pattern

Put adequate nutrition will provide the power to move the body and maintain weight. Someone who does not have good nutritional composition that are overweight are at risk for diseases such as diabetes, bladder disorders, high blood pressure and coronary artery disease.
Someone who does not pay attention to the composition of the nutrients in the daily diet, be more susceptible to disease than careful in consuming food. Intake of foods containing high levels of carbohydrates but low fiber such as fast food, speed up the accumulation of fat in the body that lead to obesity. Individuals who are obese are prone to type 2 diabetes mellitus and cardiovascular disease. Accumulation of fat in the abdominal area is one of the risk factors that lead to diabetes mellitus.

The increase in people with diabetes will increase the number of people with kidney failure due to complications of diabetes is diabetic nephropathy (Francis, 2008). The same thing expressed by (Iseki, 2005) that investigates the factors that contribute to terminal renal failure with a status of kidney (renal outcomes). The examination found that excessive nutrients into one risk factor that supports the emergence of chronic renal failure and kidney failure terminal. Excessive dietary intake causes weight gain uncontrolled which is a risk factor of various diseases.

Study in Japan showed that weight gain as measured by Body Mass Index (BMI) is a significant parameter associated with the incidence of chronic renal failure. This is due to any increase of BMI will be followed by a rise in blood pressure, serum lipids and blood glucose levels. Any increase in BMI will be followed by an increased risk of chronic renal failure. Although the mechanisms underlying the association of BMI increase with chronic renal failure are not well understood but it is estimated that the incident was related to activation of the renin-angiotensin system, increased sympathetic nerve activity, insulin resistance occurs or hyperinsulinemia and dyslipidemia. Damage is suspected of impaired glucose tolerance associated with chronic renal failure events (Nomura et al, 2009).

Weight gain or obesity especially abdominal obesity may be a risk factor for chronic renal failure can lead to increased blood pressure. Moreover obese people are more resistant to treatment to lower blood pressure. Excessive weight gain has supported increased levels of leptin, volume expansion, difficulty sleeping and when the increase in blood pressure is not controlled will accelerate loss of kidney function. Increased risk of chronic renal failure in obese individuals occurs through several mechanisms. One mechanism is related to increased levels of leptin cause kidney damage of the cardiovascular system which is a significant contribution of the pathogenesis of hypertension and diabetes due to obesity (Ronco et al, 2008). Individuals who have excessive weight or overweight due to improper diet are found more likely to undergo hemodialysis treatment for terminal renal failure than patients who had normal weight or less. A study of 1010 patients showed that, in view of the weight then 47.9% of patients had overweight, 40.2% normal weight and 11.9% had a below standard weight for age and sex (Salahudeen et al, 2004).

Factors - Factors Affecting Chronic Renal Failure (CRF)

Healthy Eating

Healthy foods must contain all the elements the body needs balanced nutrition, good protein, carbohydrate,-fat, vitamins, minerals and water. As much as possible avoid foods that contain high fat, Avoiding foods that berpengawet, Increase consumption of fruits and vegetables - vegetables, Reduce bersantan food, attention to food processing techniques, Increase consumption of water and avoid alcohol (Wafiq Hisham, 2007).

Physical activity / exercise

The benefits to be gained from physical activity done regularly been widely reported. Physical activity done regularly for 30 minutes a day at least 3 times a week will help extend the life expectancy and reduce morbidity and mortality due to disease (Ramadan, 2008).
Regular exercise will help keep your body healthy and fit because of the calories burned every day and relax all the muscles are stiff. Exercise can help improve bone strength, immunity, strengthens the lungs, reducing negative emotions, the body and skin, increase energy, reduce the impact of the aging process, and help you sleep soundly. The impact will be felt in the sport when performed aerobic exercise at least 3-5 times a week for 30 minutes to warm up first (Ramadan, 2008). In accordance with the statement of Ayers, Bruno and Langford (1999) that the pattern of life which tends to increase the risk of disease seen of physical activity is more sedentary individuals, do not exercise or do not exercise regularly or frequency of physical exercise to 30 minutes with no activity at least 3 times in one week.

Individuals who have lower levels of physical activity are at risk of various diseases such as diabetes, hyperlipidemia, hypertension, and obesity are risk factors for cardiovascular disease, chronic renal failure and kidney failure terminal. It is estimated based on epidemiological studies of the risk factors for non-communicable diseases and a series of medical examinations of individuals who develop kidney disease associated with the increasing prevalence of chronic kidney disease in Japan. An association between chronic renal failure and risky lifestyle will help in improving the prevention of chronic kidney disease and kidney failure terminal (Iseki, 2005).

Smoking Habit

Statement Ayers, Bruno and Langford (1999) that the pattern of life which is not good views of substance use is risky behaviors such as smoking, use of drugs not in accordance with the rules that have been given, the use of chemicals that are harmful to the body, and so on. This behavior when done by an individual in the long run can lead to impaired kidney function ended with chronic renal failure.

Another opinion suggests, individuals who smoke are at risk of suffering from chronic renal failure 2.2 times higher than individuals who do not smoke. The risk of suffering from chronic kidney failure is still higher in smokers, although it was later decided to quit smoking. But still lower when compared with individuals who decide to continue smoking. Smokers who had stopped 1.08 times the risk of suffering from chronic kidney failure while choosing to remain smoke were 2.4 times more likely to have chronic renal failure (Shankar et al, 2006).
Mechanism person experiences chronic renal failure who progress to terminal renal failure induced by smoking, occurs in three ways. The first mechanism is through nonhemodinamik (Nonhemodynamic mechanisms as potential mediators of smoking-induced renal damage). Simply put it is described that the toxic substances contained in cigarettes has resulted in endothelial dysfunction. Nicotine causes human cells undergo proliferation while increasing fibronectin by 50%. It induces renal fibrosis experience that ultimately reduces the kidneys excrete in urine. Other substances that also damage the kidneys are cadmium (Cd) contained in cigarettes which the accumulation of these substances in the renal cortex resulting in tissue damage due to the toxicity of the substance that will cause scarring in the kidneys. Mechanisms that occur subsequent hemodynamic (hemodynamic mechanisms as potential mediators of smoking-induced renal damage). Harmful substances in cigarettes other than directly triggering changes in the kidneys, increase the risk of heart and blood pressure. Increased blood pressure is an important factor for the progression of chronic kidney disease. The mechanism of kidney damage can be seen in histopathological last (Histopathologic features of smoking-induced renal damage). Preview histopalotogik were found showing progressi glomerular damage

The habit of consuming alcohol

a.       Alcohol can affect the body's system as follows:

b.      The immune system tubuh.alkohol reduce the ability of white blood cells to fight the disease, then it increases the risk of pneumonia, tuberculosis, hepatitis, some cancers.

c.       Endocrine system in which a minimum of 2 or 3 glasses of alcohol can lead to miscarriage, stillbirth and premature birth.

d.      The digestive system of alcohol harm berdarah.kebiasaan stomach causing gastric alcohol use increases the risk of fatty liver, hepatitis and liver siratis.