Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss in renal function over a period

of months or years. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and e periencing a reduced appetite. !ften, chronic kidney disease is diagnosed as a result of screening of people known to "e at risk of kidney pro"lems, such as those with high "lood pressure or dia"etes and those with a "lood relative with chronic kidney disease. Chronic kidney disease may also "e identified when it leads to one of its recogni#ed complications, such as cardiovascular disease, anemia or pericarditis.$%& 't is differentiated from acute kidney disease in that the reduction in kidney function must "e present for over ( months. Chronic kidney disease is identified "y a "lood test for creatinine. )igher levels of creatinine indicate a lower glomerular filtration rate and as a result a decreased capa"ility of the kidneys to e crete waste products. Creatinine levels may "e normal in the early stages of CKD, and the condition is discovered if urinalysis (testing of a urine sample) shows that the kidney is allowing the loss of protein or red "lood cells into the urine. To fully investigate the underlying cause of kidney damage, various forms of medical imaging, "lood tests and often renal "iopsy (removing a small sample of kidney tissue) are employed to find out if there is a reversi"le cause for the kidney malfunction.$%& *ecent professional guidelines classify the severity of chronic kidney disease in five stages, with stage % "eing the mildest and usually causing few symptoms and stage + "eing a severe illness with poor life e pectancy if untreated. ,tage + CKD is often called end stage renal disease (ESRD), end stage renal failure (ESRF), or end-stage kidney disease (ESKD) and is synonymous with the now outdated terms chronic kidney failure (CKF) or chronic renal failure (C*-)

Lydia Hall (Care, Core and Cure

heory)

.ccording to )all, nursing is participation in care, where C.*/ is the sole function of nurses, whereas the C!*/ and C0*/ are shared with other mem"ers of the health team. The ma1or purpose of care is to achieve an interpersonal relationship with the individual that will facilitate the development of the core. The theory contains of three independent "ut interconnected circles2 %. the core -3 the person therapeutic use of self 4. the care -3 the intimate "odily care (. the cure -3 the disease seeing through the medical care ' have chosen 5ydia )all6s Care, Core and Cure theory "ecause it can also "e seen and identified in the hemodialysis setting. 7atients undergoing hemodialysis for end stage renal disease (/,*D) e periences pro"lems such as physical vulnera"ility, feeling of "eing a "urden to the family and "eing hopeless. 8eing a nurse one should use therapeutic communication when dealing with the patient, and family, provide proper "eing done.