Management of Fluid Overload in Chronic Renal Failure

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Management of Fluid overload in Chronic Renal Failure (CRF)

Chronic Renal Failure is a long term serious irreversible condition, described as the gradual loss of kidney function (McCarthy, et al 2009). The number of patients suffering from CRF in United Kingdom (UK) is rising rapidly. Ferenbach and Wood (2005, p.16) state that in UK, about 6000 people are commencing dialysis treatment per year. Fluid overload is a frequently observed finding in renal failure patients. About one third of the patients receiving dialysis for Chronic Renal Failure have fluid overload despite advice to restrict their oral fluid intake (Roderick, et al 2004).
This assignment will examine the clinical effectiveness of the management of fluid overload in
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In the beginning, his renal functions were relatively stable. Unfortunately in 2007, his blood urea showed deteriorating renal function.
For this reason, the physician suggested that he ‘might’ require dialysis in a couple of years. He attended for dialysis counselling so that he would know what action would be taken in case his condition deteoriated. It is preferable to have preparation for dialysis as early as possible and the patient should have confidence in the whole dialysis team (Thomas, 2004). Goldberg and Scoble (2005) also urge the importance to begin the preparation at least six months before they need the dialysis. But even in the best situation, adjusting to the effects of kidney failure may be difficult for the patient and the family. Following a phase of acceptance, he agreed for an appointment with a predialysis nurse.
Since then I have been caring for this patient. The main problem for Mr. Frank is the fluid overload and its related complications. About 30% of the patients above 65 years are fluid overloaded even after dialysis (Lindley, 2009, p. 11). Some patients cannot follow the instructions and gain about 4-5 kg between dialyses and this patient is one among them. The average volume increase necessary for the signs of fluid overload is around 3 kg in a 70 kg patient, which can be sufficient to cause elevated blood pressure (Hoenich and Pearce, 2005, p. 21). Mr.Frank’s dry weight is 71.3kg and his body weight ranges between 75 and 77 kg.
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