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 Interventions Rationale
Establish rapport. To get the cooperation of the patient and SO.
Monitor and record vital signs. To obtain baseline data.
Assess pt’s general condition To 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 elimination To assess degree of interference.
Palpate bladder To assess retention
Investigate pain, noting location To investigate extent of interference
Determine client’s usual daily fluid intake To help determine level of hydration.
Note condition of skin and mucous membranes, color of urine. To assess level of hydration.
Observe for signs of infection To help in treating urinary alterations
Encourage to verbalize fear/concerns Open expression allows client to deal with feelings and begin problem solving.
Emphasize the need to adhere with prescribe diet To prevent aggravation of disease condition.
Emphasize importance of having good hygiene. To promote wellness.
Emphasize importance of adhering to treatment regimen To promote wellness

See Also

You may also like the following posts and care plans:

Genitourinary Care Plans

Care plans related to the reproductive and urinary system disorders:


  1. 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!

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