Clinical meaning
Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function over months to years. As nephrons are destroyed, the remaining nephrons undergo compensatory hyperfiltration, which initially maintains function but eventually accelerates further damage. The kidneys lose their ability to filter waste products, regulate fluid and electrolytes, produce erythropoietin (causing anemia), activate vitamin D (causing bone disease), and maintain acid-base balance. Hyperkalemia, fluid overload, and uremia develop as GFR declines. The nurse monitors vital signs, dietary compliance, fluid balance, and reports changes in the patient's condition.
Exam relevance
Risk factors: - Diabetes mellitus (most common cause) - Hypertension (second most common cause) - Glomerulonephritis - Polycystic kidney disease - Recurrent pyelonephritis - Prolonged NSAID use - Lupus nephritis - Family history of CKD
Diagnostics: - Monitor vital signs and report hypertension - Monitor and report daily weights and fluid intake/output - Report signs of fluid overload: edema, dyspnea, crackles - Monitor for signs of hyperkalemia: muscle weakness, irregular pulse - Report changes in urine output or appearance - Monitor for signs of uremia: confusion, nausea, pruritus