End stage of renal disease

End-stage renal disease is a condition in which the kidneys no longer function normally and required excellent medical and nursing care for the managing this condition.

2. Kidneys eliminate poisons from the body, and Kidneys eliminate poisons from the body, and
keep a normal balance of fluid and certain keep a normal balance of fluid and certain
minerals in the body. When the kidneys can no minerals in the body. When the kidneys can no
longer perform this function, a person becomes longer perform this function, a person becomes
very ill and ultimately dies.very ill and ultimately dies.
In end-stage renal disease, the kidneys In end-stage renal disease, the kidneys
function at a fraction of their normal capacity. function at a fraction of their normal capacity.
When this occurs, there are only two options: When this occurs, there are only two options:
replace the job the kidneys are supposed to do replace the job the kidneys are supposed to do
by using a machine, instead (kidney dialysis) by using a machine, instead (kidney dialysis)
or transplant a new, healthy kidney. A single or transplant a new, healthy kidney. A single
new kidney can do the work of the two kidneys.new kidney can do the work of the two kidneys.

3. End-stage kidney disease means that End-stage kidney disease means that
the final stage of kidney disease, and the final stage of kidney disease, and
kidneys are not functioning well enough kidneys are not functioning well enough
to meet the needs of daily life. to meet the needs of daily life.
End-stage renal disease is a condition in End-stage renal disease is a condition in
which the kidneys no longer function which the kidneys no longer function
normally. normally.

4. DiabeticsDiabetics cannot break down glucose cannot break down glucose
(sugar) correctly, and levels remain high (sugar) correctly, and levels remain high
in the blood. High levels of glucose in the in the blood. High levels of glucose in the
blood damage the glomeruli in the blood damage the glomeruli in the
nephrons. nephrons.
HypertensionHypertension, the increased pressure , the increased pressure
that is forced upon the small vessels in that is forced upon the small vessels in
the kidneys leads to damage that makes the kidneys leads to damage that makes
the vessels unable to perform their the vessels unable to perform their
blood-filtering duties.blood-filtering duties.

5. Autoimmune diseases like systemic lupus Autoimmune diseases like systemic lupus
erythematosus (lupus)erythematosus (lupus)
Genetic disorders, such as polycystic kidney Genetic disorders, such as polycystic kidney
diseasedisease
Exposure to toxic drugs, including:Exposure to toxic drugs, including:
certain antibioticscertain antibiotics
chemotherapychemotherapy
contrast dyescontrast dyes
pain relieverspain relievers

7. a decrease in urine outputa decrease in urine output
inability to urinateinability to urinate
fatiguefatigue
general ill feelinggeneral ill feeling
headachesheadaches
unexplained weight lossunexplained weight loss
loss of appetiteloss of appetite
nausea and vomitingnausea and vomiting
dry skin and itchingdry skin and itching
changes in skin colorchanges in skin color
bone painbone pain
confusion and difficulty concentratingconfusion and difficulty concentrating

8. Other symptoms may include:Other symptoms may include:
bruising easily, along with frequent nosebleedsbruising easily, along with frequent nosebleeds
numbness in hands and feetnumbness in hands and feet
bad breathbad breath
excessive thirstexcessive thirst
frequent hiccupsfrequent hiccups
absence of menstrual cyclesabsence of menstrual cycles
sleeping problemssleeping problems
swelling (edema), especially in the legs and handsswelling (edema), especially in the legs and hands

9. History takingHistory taking
Physical ExaminationPhysical Examination
Blood tests: Blood tests: Kidney function tests look for the level of Kidney function tests look for the level of
waste products, such as creatinine and urea, in the waste products, such as creatinine and urea, in the
blood.blood.
Urine tests: Urine tests: Analyzing a sample of urine may reveal Analyzing a sample of urine may reveal
abnormalities that point to chronic kidney failure and help abnormalities that point to chronic kidney failure and help
identify the cause of chronic kidney disease.identify the cause of chronic kidney disease.
Imaging tests: UImaging tests: Ultrasound to assess kidneys' structure ltrasound to assess kidneys' structure
and size. and size.
Removing a sample of kidney tissue for testing: Removing a sample of kidney tissue for testing: A A
kidney biopsy to remove a sample of kidney tissue. kidney biopsy to remove a sample of kidney tissue.
Kidney biopsy is often done with local anesthesia using a Kidney biopsy is often done with local anesthesia using a
long, thin needle that's inserted through skin and into long, thin needle that's inserted through skin and into
kidney. The biopsy sample is sent to a lab for testing to kidney. The biopsy sample is sent to a lab for testing to
help determine what's causing kidney problem.help determine what's causing kidney problem.

10. End-stage kidney disease has two treatments: End-stage kidney disease has two treatments:
dialysis or kidney transplant.dialysis or kidney transplant.
DialysisDialysis
There are two types of dialysis:There are two types of dialysis:
Hemodialysis: Hemodialysis: During hemodialysis, blood is During hemodialysis, blood is
removed from a vein. It is run through filters to removed from a vein. It is run through filters to
remove waste products. The blood is then remove waste products. The blood is then
returned to the body. Hemodialysis usually is returned to the body. Hemodialysis usually is
done at a dialysis center. The treatments are done at a dialysis center. The treatments are
done three times a week, in three- to four-hour done three times a week, in three- to four-hour
sessions.sessions.

12. Peritoneal dialysis: Peritoneal dialysis: During peritoneal During peritoneal
dialysis, sterile fluid is infused into the dialysis, sterile fluid is infused into the
abdomen. Waste products gradually abdomen. Waste products gradually
accumulate in the fluid, which is drained accumulate in the fluid, which is drained
several hours later. Peritoneal dialysis is several hours later. Peritoneal dialysis is
done at home. It takes longer than done at home. It takes longer than
hemodialysis and must be done four to hemodialysis and must be done four to
five times a day. It can be automated to five times a day. It can be automated to
occur during sleep.occur during sleep.

14. Kidney transplantsKidney transplants
Kidney transplants allow people with severe kidney Kidney transplants allow people with severe kidney
disease to avoid or discontinue dialysis. However, even disease to avoid or discontinue dialysis. However, even
a successful kidney transplant is not a cure.a successful kidney transplant is not a cure.
Anyone who receives a kidney transplant must take Anyone who receives a kidney transplant must take
immunosuppressive drugs for life, unless they received immunosuppressive drugs for life, unless they received
a kidney donated by their identical twin. These are a kidney donated by their identical twin. These are
drugs that prevent the body from rejecting the donated drugs that prevent the body from rejecting the donated
organ. In addition, a good genetic match is needed for organ. In addition, a good genetic match is needed for
a successful transplant. Most transplant candidates a successful transplant. Most transplant candidates
wait one to three years before they are matched to a wait one to three years before they are matched to a
kidney from an unrelated donor.kidney from an unrelated donor.

16. Other treatment TechniquesOther treatment Techniques
Diabetics and those with hypertension must Diabetics and those with hypertension must
control their conditions. Both conditions benefit control their conditions. Both conditions benefit
from drug therapy using angiotensin-converting from drug therapy using angiotensin-converting
enzyme (ACE) inhibitors or angiotensin enzyme (ACE) inhibitors or angiotensin
receptor blockers (ARBs).receptor blockers (ARBs).
A diet low in sodium, potassium, and other A diet low in sodium, potassium, and other
electrolytes may be needed, along with fluid electrolytes may be needed, along with fluid
restrictions. Caloric intake may need to be restrictions. Caloric intake may need to be
increased, and protein consumption may need increased, and protein consumption may need
to decrease.to decrease.

17. skin infections from itching and dry skinskin infections from itching and dry skin
hepatitis B, hepatitis C, and/or liver hepatitis B, hepatitis C, and/or liver
failurefailure
heart and blood vessel problemsheart and blood vessel problems
fluid buildup around the lungsfluid buildup around the lungs
hyperparathyroidismhyperparathyroidism
increased risk of infectionsincreased risk of infections
malnutritionmalnutrition

18. nerve damagenerve damage
joint, bone, and muscle painjoint, bone, and muscle pain
anemiaanemia
stomach and intestinal bleedingstomach and intestinal bleeding
brain dysfunction and dementiabrain dysfunction and dementia
abnormal electrolyte levelsabnormal electrolyte levels
blood glucose level changesblood glucose level changes
seizuresseizures
weakening of the bones, joint disorders, and weakening of the bones, joint disorders, and
fracturesfractures

19. AssessmentAssessment
Subjective DataSubjective Data
Objective DataObjective Data

20. Excess fluid Volume related to compromised Excess fluid Volume related to compromised
regulatory mechanism.regulatory mechanism.
Decrease Cardiac Output related to fluid Decrease Cardiac Output related to fluid
overload, fluid shifts, fluid deficit.overload, fluid shifts, fluid deficit.
Risk for Imbalanced Nutrition: Less than Body Risk for Imbalanced Nutrition: Less than Body
Requirements.Requirements.
Risk for Infection related to reverse renal Risk for Infection related to reverse renal
function.function.
Knowledge deficit related to disease process Knowledge deficit related to disease process
and treatment plan. and treatment plan.