Causes of Renal Failure Chronic (CRF)

Renal Failure Chronic (CRF) Inability of the kidneys to perform vital functions including excretion of toxins, electrolytes, fluids, and hydrogen ions.

Incidence: Affects more than 2 out of a 1000 people in the U.S. annually.

Onset: Gradual, over many years.

Etiology: Diabetes and HTN are the primary causes of CRF, accounting for 40% and 25%, respectively, of all cases. Other causes include trauma, autoimmune disorders, birth defects, drug OD, and genetic diseases.

Clinical Findings: Edema throughout the body, shortness of breath, fatigue, flank pain, oliguria (progressing to anuria), elevated BP, and pale skin.

Nursing Focus
■ Never take a BP or perform a venipuncture on an arm with a dialysis shunt.
■ Help minimize discomfort from frustrations with fluid restrictions by offering ice chips, frozen lemon swabs, diversional activities, and hard candies.
■ Provide routine skin care; uremia causes itching and dryness of skin.
■ Monitor blood urea nitrogen (BUN) and serum creatinine levels.
■ Monitor strict fluid intake and output; fluids are typically restricted to an amount equal to the previous day’s urine output plus 500–600 mL.
■ Perform frequent turning and ROM exercises to minimize skin breakdown.

Patient Teaching
■ Provide Pt and family with literature on CRF and/or dialysis.
■ Restrict sodium, water, potassium, phosphate, and protein intake as ordered.
■ Encourage compliance with secondary preventive measures.
■ Explain the actions, dosages, side effects, and adverse reactions of meds.