The authors use a case study to review the pathophysiological changes that occur when the kidneys fail, resulting in admission to the critical care unit. The immediate interventions and the expected outcomes are also presented.

Despite the improved diagnosis and treatment of kidney disease, late diagnosis with resultant permanent damage to the kidneys still occurs. A work group established by the National Kidney Foundation, the Kidney Disease Outcome Quality Initiative (KDOQI), was asked to develop clinical practice guidelines and a uniform classification system for chronic kidney disease (CKD). CKD is a public health issue because of its increasing incidence and the high cost of interventions.1 An additional concern is the increasing incidence of kidney disease in African Americans and Native Americans.2 

According to the 2004 report from the US Renal Data System,3 the number of patients with CKD receiving therapy in 2002 was 431284. This number is...

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