Master Chronic Kidney Disease Late Symptoms Assessment with Picmonic for Nursing RN

Uremia is a clinical syndrome resulting from the accumulation of nitrogenous waste products due to severe renal dysfunction. It is commonly seen in end-stage renal disease when the glomerular filtration rate falls below 10 mL/min. Uremia leads to multisystem dysfunction, including metabolic acidosis, fluid overload, electrolyte imbalances, and systemic toxicity.

When renal filtration is compromised, excess potassium is not excreted, and levels can become dangerously elevated. When serum potassium levels are elevated, cardiac arrhythmias can occur.

Both sodium retention and reduced excretion of fluid due to renal damage can cause fluid retention. Retention of fluid can lead to complications such as edema and worsening of hypertension. Patients should be monitored for signs of fluid overload.

CNS depression in chronic kidney disease refers to neurological impairment caused by electrolyte imbalances, metabolic acidosis, and the accumulation of nitrogenous waste products (uremia). This condition leads to progressive cognitive dysfunction, lethargy, dizziness, confusion, and, in severe cases, seizures or coma. Uremic encephalopathy is a life-threatening manifestation requiring urgent dialysis.

Damaged kidneys do not produce enough erythropoietin to stimulate adequate red blood cell production. As a result, patients with chronic kidney disease may become anemic. These patients also have a tendency to bleed due to impaired platelet aggregation.

A decrease in glomerular filtration rate ultimately leads to a decrease in urine output. Oliguria occurs when a patient produces less than 400mL of urine per day. As the kidneys continue to fail, urine output may continue to decrease, until a patient becomes anuric, or produces less than 100mL of urine in 24 hours.

The accumulation of waste products in the body, due to reduced renal filtration, can lead to intense itching. Calcium and phosphorus deposits in the skin are thought to be one of the primary causes of pruritus in patients with chronic renal disease. In rare cases, a condition called uremic frost can develop when blood urea nitrogen (BUN) levels are exceptionally elevated (over 200mg/dL). In this condition, urea forms crystals on the skin.

ESRD is the final stage of renal failure in which dialysis or a transplant is needed for the patient to survive; the kidneys can no longer function on their own.

Glomerular filtration rate (GFR) is a value that describes how efficiently the kidneys are working. In patients diagnosed with ESRD, GFR is less than 15 mL/min.