Kidney failure is also called end-stage renal disease (ESRD), which is the last stage of chronic kidney disease. When your kidneys fail, it means that it has stopped working well enough for you to conduct normal kidney functions and survive without dialysis or a kidney transplant.

kidney failure is most commonly caused by other health issues that cause permanent damage (harm) to kidneys little by little, over time.

When kidneys are damaged, it may not work as well as it should. If the damage continues and worsens, then kidneys are less and less able to do their job, and you have kidney failure. Kidney failure is the last and most severe stage of chronic kidney disease. This is why kidney failure is also called ESRD, end-stage renal disease.

Diabetes, being the most common cause of ESRD. High blood pressure is the second most common cause and Other problems that might cause kidney failure include:

Urinary tract problems

• Genetic diseases (diseases you are born with), such as polycystic kidney disease
• Autoimmune diseases, such as lupus and IgA nephropathy
• Nephrotic syndrome

   

Sometimes the kidneys can stop working suddenly, that is, within two days or so. Then, This type of kidney failure is called acute renal failure or acute kidney injury. Common causes of acute renal failure include:

• Heart attack
• Illegal drug use and drug abuse
• Improper blood flow to kidneys
• Urinary tract problems

   

This type of kidney failure is not permanent. Kidneys may go back to normal or almost normal with treatment if you do not have other serious health problems.

Having one of the health problems does not mean that you will definitely have kidney failure. Working with your doctor and living a healthy lifestyle to control these health problems can help your kidneys function well for as long as possible.

Kidney failure usually gets worse slowly, and symptoms may not appear until your kidneys are badly damaged. In the late stages, as you are nearing kidney failure (ESRD) you may notice symptoms, that are caused by extra fluid and water building up in your body.

Notice for following symptoms, if your kidneys are beginning to fail:

• Too much urine (pee) or not enough urine
• Itching
• Swelling in your feet and ankles
• Trouble catching your breath or breathlessness
• Muscle cramps
• Vomiting and nausea
• Not feeling hungry
• Trouble sleeping

   

If your kidneys stop working suddenly (acute kidney failure), you may notice the following symptoms:

• Back pain
• Fever
• Nosebleeds
• Abdominal (belly) pain
• Diarrhea
• Rash
• Vomiting

   

If you notice any of these symptoms, you should contact your doctor right away because having one or more of the above-mentioned symptoms may be a sign of serious kidney problems.

Kidney failure is broadly classified into two types, acute kidney failure, and chronic kidney failure.

Acute kidney failure

Acute kidney failure is sudden damage to the kidneys. In many cases, it is short term but in some people, it may proceed to long-term chronic kidney injury.

The causes are:

• People who have chronic kidney disease are at increased risk of acute kidney injury.
• damage to the actual kidney tissue caused by the drug, radioactive dye or severe infection
• obstruction to urine passage, because of kidney stones or an enlarged prostate.

   

Chronic kidney failure

Usually if not treated initially, kidney function worsens over a number of years. This is known as chronic kidney failure. Sometimes it can progress to kidney failure also called end-stage kidney disease,  which requires kidney transplant or dialysis.

There are different causes :

• Growth of cysts in kidneys, polycystic kidney disease
• damage to blood vessels due to high blood pressure and diabetes
• attack on the kidney tissue by the immune system (glomerulonephritis) or disease
• damage due to the backward flow of urine into the kidneys such as in reflux nephropathy congenital abnormalities of kidney or urinary tract.

If the person is having a kidney failure (end-stage renal disease or ESRD), you will need a kidney transplant or dialysis to live. Many people live long lives while on dialysis or after having a kidney transplant, but there is no cure for kidney failure.

There are only a few options for treating kidney failure, including several types of dialysis and kidney transplant. Your doctor can help you figure out which treatment suits you the best.

The nursing care plan of treating patients with renal failure is to eliminate or correct any reversible causes of kidney failure. Providing support by taking accurate measurements of intake and output, maintain proper electrolyte balance and monitor vital signs.

Here are six nursing diagnosis and nursing care plans (NCP) for patients with renal failure:

• Risk for Infection
• Excess Fluid Volume
• The risk for Decreased Cardiac Output
• The risk for Imbalanced Nutrition: Less Than Body Requirements
• The risk for Deficient Fluid Volume
• Deficient Knowledge
• Other Possible Nursing Care Plans

Subjective Data:

• Muscle twitches and cramps
• Peripheral edema
• Loss of appetite
• Nausea
• Fatigue and weakness
• Persistent itching
• Urinary frequency, nocturia
• Chest pain
• Shortness of breath

Objective Data:

• Poorly controlled hypertension
• Decreased mental agility
• Swelling of feet and ankles
• Weight gain
• Elevated serum creatinine

• The nurse will call any abnormal creatinine and BUN results to the md.
• The nurse will monitor the patient intake and output in every shift.
• The nurse if needed per md order will place a catheter to monitor urinary output more closely.
• The nurse will also weigh the patient daily.
• The nurse will educate the patient about limiting salt intake by discharge and the importance of daily weights
• The nurse will educate the patient about foods which contain high salt intake, so to avoid by discharge.
• The nurse will educate the patient about how hemodialysis works before the patient is on dialysis.
• The nurse will assess the patient’s peripheral edema every shift.
• The nurse will monitor the patient’s urinary output every shift.

EXERCISES

Choose continuous exercise such as, swimming, walking, bicycling indoors or outdoors, skiing, aerobic dancing or any other activities in which you have to move large muscle groups continuously.

Low-level strengthening exercises will also be beneficial. Design your program to use low weights and high repetitions.

CARE-24 brings world-class standards of medical expertise to you and your employees, should they need it. Our Clinics can be accessed directly.