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Renal / Urinary System
Renal / Urinary System
Renal and urinary conditions, evidence, coding, tests, medications, and nursing diagnoses.
Major renal conditions
AKI
AKI is rapid decline in kidney function (KDIGO: creatinine rise ≥0.3 mg/dL in 48h or ≥1.5× baseline in 7d, or UO <0.5 mL/kg/h × 6h). Pre-renal (most common), intrinsic, post-renal.
CKD
CKD is kidney damage or GFR <60 mL/min/1.73m² for ≥3 months. Staged G1-G5 by GFR and A1-A3 by albuminuria. Complications: anemia, bone disease, hyperkalemia, hypertension, CVD.
ESRD
ESRD is kidney failure requiring renal replacement therapy (GFR <10). Options: hemodialysis, peritoneal dialysis, or kidney transplant. AV fistula is the preferred access.
UTI
UTI is bacterial infection of the urinary tract. Uncomplicated (cystitis): healthy non-pregnant women. Complicated: men, pregnancy, catheter, structural abnormality, immunocompromised.
Pyelo
Pyelonephritis is bacterial infection of the renal parenchyma. Presents with fever, flank pain, CVA tenderness, nausea/vomiting + UTI symptoms. E. coli most common organism.
Kidney Stones
Kidney stones are crystalline concretions in the urinary tract. Most common: calcium oxalate (80%). Presents with severe colicky flank pain radiating to groin, hematuria, nausea.
GN
Glomerulonephritis is inflammation of the glomeruli. Nephritic syndrome: hematuria, proteinuria, hypertension, AKI. IgA nephropathy is most common worldwide. RPGN requires emergent treatment.
PKD
PKD is genetic cyst formation in kidneys. ADPKD (autosomal dominant) most common hereditary kidney disease. Progressive CKD. Tolvaptan slows progression in rapidly progressing disease.
Electrolytes
Common renal electrolyte disorders: hyperkalemia (most dangerous — K+ >5.5), hyponatremia (Na+ <135), hyperphosphatemia, hypocalcemia in CKD. Require prompt correction.
Rhabdo
Rhabdomyolysis is skeletal muscle breakdown releasing myoglobin, causing AKI. Causes: trauma, statin myopathy, exertional, seizures, drugs. CK >1000 U/L. Aggressive IV hydration prevents AKI.
Related nursing diagnoses
Nursing Diagnoses & Care Plans
Open the NANDA tool to review nursing diagnoses and care-plan concepts related to renal conditions.