I.

OBJECTIVES OF THE DISEASE STUDY

General objectives:
The case presentation aims to demonstrate the student's understanding of the patient's
overall health and illness status, including diagnosis, disease process, potential complications,
treatment plan, and medical and nursing interventions.

Specific objectives
 To know the Etiology of End-Stage Renal Disease
 To be able to define End-Stage Renal Disease
 To determine the cause and effect of the End-Stage Renal Disease
 To distinguish the relationship of the Gordon’s Health Functional pattern of the patient in
End-Stage Renal Disease
 To know the different kinds of management/ interventions for End-Stage Renal Disease
patients.

II. INTRODUCTION

End-Stage Renal Disease is the disease we have chosen to study because it helps us
understand how the disease is caused, how it develops, and how it is best treated. This case is
relevant to the topic that we are learning about in medical-surgical nursing, and because we have
further knowledge regarding the disease, we have decided to pursue it.

III. LITERATURE OF THE DISEASE

End-stage renal disease, also called end-stage kidney disease or kidney failure, occurs
when chronic kidney disease — the gradual loss of kidney function — reaches an
advanced state. In end-stage renal disease, your kidneys no longer work as they should to
meet your body's needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in
your urine. When your kidneys lose their filtering abilities, dangerous levels of fluid,
electrolytes and wastes can build up in your body.
 With end-stage renal disease, you need dialysis or a kidney transplant to stay alive. But
you can also choose to opt for conservative care to manage your symptoms — aiming for
the best quality of life during your remaining time.

Symptoms

Early in chronic kidney disease, you might have no signs or symptoms. As chronic kidney
disease progresses to end-stage renal disease, signs and symptoms might include:

 Nausea
 Vomiting
 Loss of appetite
 Fatigue and weakness
 Changes in how much you urinate
 Chest pain, if fluid builds up around the lining of the heart
 Shortness of breath, if fluid builds up in the lungs
 Swelling of feet and ankles
 High blood pressure (hypertension) that's difficult to control
 Headaches
 Difficulty sleeping
 Decreased mental sharpness
 Muscle twitches and cramps
 Persistent itching
 Metallic taste

Causes
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by
other illnesses. Because your kidneys can make up for lost function, signs and symptoms might
not appear until irreversible damage has occurred.

Kidney disease occurs when a disease or condition impairs kidney function, causing kidney
damage to worsen over several months or years. For some people, kidney damage can continue
to progress even after the underlying condition is resolved.

Diseases and conditions that can lead to kidney disease include:

  Type 1 or type 2 diabetes
 High blood pressure
 Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) — an inflammation of the
kidney's filtering units (glomeruli)
 Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's
tubules and surrounding structures
 Polycystic kidney disease or other inherited kidney diseases
 Prolonged obstruction of the urinary tract, from conditions such as enlarged
prostate, kidney stones and some cancers
 Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to
back up into your kidneys
 Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

Risk factors
Certain factors increase the risk that chronic kidney disease will progress more quickly to end-
stage renal disease, including:

 Diabetes with poor blood sugar control

 Kidney disease that affects the glomeruli, the structures in the kidneys that filter
wastes from the blood
 Polycystic kidney disease
 High blood pressure
 Tobacco use
 Black, Hispanic, Asian, Pacific Islander or American Indian heritage
 Family history of kidney failure
 Older age
 Frequent use of medications that could be damaging to the kidney

Complications
Kidney damage, once it occurs, can't be reversed. Potential complications can affect almost any
part of your body and can include:

 Fluid retention, which could lead to swelling in your arms and legs, high blood
pressure, or fluid in your lungs (pulmonary edema)
  A sudden rise in potassium levels in your blood (hyperkalemia), which could impair
your heart's ability to function and may be life-threatening
 Heart disease
 Weak bones and an increased risk of bone fractures
 Anemia
 Decreased sex drive, erectile dysfunction or reduced fertility
 Damage to your central nervous system, which can cause difficulty concentrating,
personality changes or seizures
 Decreased immune response, which makes you more vulnerable to infection
 Pericarditis, an inflammation of the saclike membrane that envelops your heart
(pericardium)
 Pregnancy complications that carry risks for the mother and the developing fetus
 Malnutrition
 Irreversible damage to your kidneys (end-stage kidney disease), eventually
requiring either dialysis or a kidney transplant for survival

Prevention
If you have kidney disease, you may be able to slow its progress by making healthy lifestyle
choices:

 Achieve and maintain a healthy weight

 Be active most days
 Limit protein and eat a balanced diet of nutritious, low-sodium foods
 Control your blood pressure
 Take your medications as prescribed
 Have your cholesterol levels checked every year
 Control your blood sugar level
 Don't smoke or use tobacco products
 Get regular checkups