NCLEX Chronic Renal Failure

NCLEX Chronic Renal Failure

Chronic Renal Failure Overview

Chronic renal failure, also known as, chronic renal disease, is a progressive loss in kidney function over a period of months or years.  The symptoms of worsening kidney function are not specific, and might include feeling generally unwell and experiencing a reduced appetite.  Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic renal disease.  This disease may also be identified when it leads to one of its recognized complications, such as cardiovascular disease, anemia, pericarditis or renal osteodystrophy.

Chronic kidney disease is identified by a blood test for creatinine, which is a breakdown product of muscle metabolism.  Higher levels of creatinine indicate a lower GFR and as a result a decreased capability of the kidneys to excrete waste products.  Creatinine levels may be normal in the early stages of chronic renal disease, and the condition is discovered if urinalysis shows the kidney is allowing the loss of protein or red blood cells into the urine.  To fully investigate the underlying cause of kidney damage, various forms of medical imaging, blood tests, and sometimes a kidney biopsy are employed to find out if a reversible cause for the kidney malfunction is present.

Signs and Symptoms

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses.  Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

• Nausea and vomiting
• Loss of appetite
• Fatigue and weakness
• Sleep problems
• Changes in urine output
• Muscle twitches and cramps
• Swelling of feet and ankles
• Chest pain, shortness of breath
• HTN that’s difficult to control

Causes

• Type 1 or Type 2 Diabetes
• High blood pressure
• Glomerulonephritis
• Interstitial nephritis
• Polycystic kidney disease
• Prolonged obstruction of the urinary tract
• Vesicoureteral reflux
• Pyelonephritis

Risk Factors

• Diabetes, HTN
• Smoking
• Heart disease
• Obesity
• High cholesterol
• African Americans
• Family history of kidney disease
• Age 65 or older

Complications

• Fluid retention – pulmonary edema
• Hyperkalemia
• Cardiac disease
• Osteoporosis
• Decreased sex drive or impotence
• Anemia
• Decreased immune response
• Pericarditis

Treatments

Depending on the underlying cause, some types of kidney disease can be treated.  Often, though, chronic kidney disease has no cure.  In general, treatment consists of measures to help control signs and symptoms, reduce complications, and slow the progression of the disease.

• Antihypertensives
• Medications to lower cholesterol levels
• Treat anemia
• Diuretics to relieve the swelling
• Vitamin D supplements
• Low protein diet to minimize waste products in your blood
• Hemodialysis or Peritoneal dialysis