17 Chronic Renal Failure Nursing Care Plans


Chronic renal failure (CRF) or chronic kidney disease (CKD) is the end result of a gradual, progressive loss of kidney function. The loss of function may be so slow that you do not have symptoms until your kidneys have almost stopped working.

The final stage of chronic kidney disease is called end-stage renal disease (ESRD). At this stage, the kidneys are no longer able to remove enough wastes and excess fluids from the body. At this point, you would need dialysis or a kidney transplant.

Nursing Care Plans

The nursing care planning goal for with chronic renal failure is to prevent further complications and supportive care. Client education is also critical as this is a chronic disease and thus requires long-term treatment.

Below are 17 nursing care plans (NCP) and nursing diagnosis for patients with chronic renal failure or chronic kidney disease:

  1. Risk for Decreased Cardiac Output
  2. Risk for Ineffective Protection
  3. Disturbed Thought Process
  4. Risk for Impaired Skin Integrity
  5. Risk for Impaired Oral Mucous Membrane
  6. Deficient Knowledge
  7. Excess Fluid Volume
  8. Acute Pain
  9. Impaired Renal Tissue Perfusion
  10. Impaired Urinary Elimination
  11. Imbalanced Nutrition: Less than Body Requirements
  12. NEW Activity Intolerance
  13. NEW Disturbed Body Image
  14. NEW Anticipatory Grieving
  15. NEW Risk for Infection
  16. NEW Risk for Injury
  17. Other Possible Nursing Care Plans

Impaired Urinary Elimination

Nursing Diagnosis

  • Impaired Urinary Elimination: Renal Failure is a problem which results to loss of kidney functions and as GFR decrease, the kidney cannot excrete nitrogenous product and fluid causing impaired in Urinary elimination and together with prolonged use of medications such as NSAIDs this will lead to further kidney destruction which may thus decreasing the glomerular filtration and destroying of the remaining nephrons. This will result in to inability of the kidney to concentrate urine which makes the patient to have a nursing diagnosis of impaired urinary elimination.


Patient may manifest: 

  • Increase in Lab results (BUN, Creatinine, Uric Acid Level)
  • Oliguria
  • Anuria
  • Hesitancy
  • Urinary Retention


  • Impaired Urinary Elimination R/T failing glomerular filtration AEB Impaired excretion of nitrogenous products secondary to Renal Failure


  • Patient will verbalize understanding of condition
  • Patient will participate  in measures to correct/compensate for defects
Nursing InterventionsRationale
Establish rapport.To get the cooperation of the patient and SO.
Monitor and record vital signs.To obtain baseline data.
Assess pt’s general conditionTo know what problem and interventions should be prioritize.
Review for laboratory test for changes in renal function.To assess for contributing or causative factors.
Establish realistic activity goal with client.Enhance commitments to promoting optimal outcomes.
Determine clients pattern of eliminationTo assess degree of interference.
Palpate bladderTo assess retention
Investigate pain, noting locationTo investigate extent of interference
Determine client’s usual daily fluid intakeTo help determine level of hydration.
Note condition of skin and mucous membranes, color of urine.To assess level of hydration.
Observe for signs of infectionTo help in treating urinary alterations
Encourage to verbalize fear/concernsOpen expression allows client to deal with feelings and begin problem solving.
Emphasize the need to adhere with prescribe dietTo prevent aggravation of disease condition.
Emphasize importance of having good hygiene.To promote wellness.
Emphasize importance of adhering to treatment regimenTo promote wellness

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • Thank you Matt :) This helped me understand how to do a care plan. I was asked to do one without them showing us a sample first so I was completely lost. Thank you!

  • Hi Matt,
    I’m an RN BSN WCC x 25 years. What you’re doing is great. Keep up the good work. Only suggestion is to broaden examples of applicable POC’s in the community. Community nursing is becoming highly skilled. Especially with Covid. In many cases of CKD, in the community, the CG becomes a huge part of the POC. Teach and Assess must be added to POC.
    Keep going! Its not enough for our nursing students to pass the boards. They need to understand critical thinking, and be creative/problem solve now more than ever.

    • Hi Sue,

      We’ll do our best to include your suggestion on our nursing care plans (which we are currently updating). And I agree: thinking critically is a must skill. Thank you so much for your kind words!

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