Chronic Renal Failure (Kidney Disease) Nursing | End Stage Renal Disease Pathophysiology NCLEX
From Kelly Cuyler
Chronic kidney disease is a significant decline in kidney function that happens over a long period of time that leads to the buildup of waste, water, and electrolyte imbalances in the body. CKD is irreversible.
There are various stages of chronic kidney disease and each stage is based on the patient's glomerular filtration rate (GFR). Stage 1 is kidney disease with normal renal function (GFR greater than 90 mL/min) and proteinuria for 3 months or more. Each stage progresses with a declining glomerular filtration rate until the GFR is 15 mL/min or less and this is known as end-stage renal disease, which is Stage 5.
In the severe stages of chronic renal failure, the GFR is dramatically decreased and this leads to the following signs and symptoms of chronic kidney disease: increased BUN and creatinine levels, hypervolemia, electrolyte imbalances (hyperkalemia, hyperphosphatemia, hypocalcemia, hypermagnesemia, oliguira or anuria, metabolic acidosis, and proteinuria/hematuria).
In addition, the kidneys are no longer producing hormones, such as EPO (erythopoietin) or renin. This leads to anemia and more hypertension. Furthermore, the kidneys are failing to activate vitamin, which leads to more hypocalcemia.
Treatment for chronic renal failure includes dialysis, medications, and kidney transplant.
Nursing interventions for chronic renal failure include diet implementation, monitoring fluid status, vital signs, administering medications per physician order, monitoring electrolyte levels etc.
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