Nursing management: acute renal failure and chronic kidney disease

Renal failure is the partial or complete impairment of kidney function resulting an inability to excrete metabolic waste products and water, as well as functional disturbances of all body systems. Renal failure is classified as acute or chronic. Acute renal failure (ARF) has a rapid onset. Although ARF is potentially reversible, the mortality rate for intrarenal ARF remains at least 20% despite advances in treatment over the last 30 years. Chronic kidney disease (CKD) usually develops slowly over months to years and necessitates the initiation of dialysis or transplantation for long-term survival. The focus in chronic kidney disease has changed from treating a terminally ill patient to caring for a person with a manageable chronic disease that requires long-term care. The change in focus is a result of technical advances, improved surgical techniques and more effective immunosuppressive therapy, and the collaboration of professionals and industry leaders whose efforts are changing the outcomes of patients with CKD.