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Care Plan for End Stage Renal Failure

End stage renal failure (also known as end stage kidney disease or ESRF) is characterized by the nearly complete loss of kidney function. Healthy kidneys are responsible for a diverse range of essential bodily tasks such as waste removal, urine production and electrolyte balancing. When the kidneys reach the end stage they can no longer perform these tasks effectively. Often people diagnosed with end stage renal failure already had chronic renal failure due to underlying conditions such as diabetes. As of 2009, the only possible ESRF treatments are a kidney transplant or dialysis.

  1. Dialysis

    • Dialysis is a process by which devices do what your kidney can no longer manage, such as waste removal. Some forms of dialysis require you to visit a doctor's office a few times a week. Other types of dialysis are self-administered at home. All types of dialysis require a procedure to insert a catheter into your abdominal cavity. During peritoneal dialysis, a solution known as dialysate is pumped into your peritoneal membrane. After chemicals and waste mix with the solution, the dialysate is drained out. Another form of dialysis known as hemodialysis circulates your blood through a machine that filters it.

      Continuous ambulatory peritoneal dialysis is the most convenient form of dialysis. A bag of dialysate enters your peritoneal membrane through the catheter. After a few hours, you drain the dialysate and empty the bag. Next you refill your peritoneal membrane with solution and repeat the whole process. CAPD does not require hospital visits. A similar form of dialysis is known as continuous cyclic peritoneal dialysis. Like CAPD, CCPD does not require a hospital visit. Each night you will hook your catheter up to a machine to fill and drain your abdomen with dialysate. Finally, intermittent peritoneal dialysis also uses a machine but the filling/draining is administered by a doctor in a hospital a few times a week.

    Kidney Transplant

    • Although dialysis is an effective treatment for end stage renal failure, it's quite time consuming and may leave you constantly tired and weak. Thus, some people opt for a kidney transplant. Since people only need one kidney to live, you may receive a healthy kidney from a family member or anyone else who has your same blood type rather than have to wait for a healthy organ from a deceased person (as with a liver transplant). While a transplanted kidney should work just like your original kidney, it requires major surgery for both you and any healthy donor. Furthermore, you will need to take medication for the rest of your life to prevent your immune system's rejection of the new organ. Even with medication, some people still experience rejection and may need a new kidney.

    Underlying Condition Treatment

    • While dialysis and kidney transplant are the two available ways to treat the most serious complications of ESRF, you will also want to treat any condition that led to the ESRF. Treatment of underlying conditions will ensure that your kidney does not lose even more functioning. In the case of a kidney transplant, treatment of underlying conditions will ensure that your new kidney does not fail as well. Diabetes, high blood pressure and congestive heart failure are all common conditions that may cause or result from ESRF. Talk to your doctor about medication and lifestyle changes to ensure that you address these underlying conditions related to ESRF.

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