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

Imbalanced Nutrition: Less than Body Requirements

Nursing Diagnosis

  • Imbalanced Nutrition: Less Than Body Requirements: Due restricted foods and prescribed dietary regimen, an individual experiencing renal problem cannot maintain ideal body weight and sufficient nutrition. At the same time patients may experience anemia due to decrease erythropoietic factor that cause decrease in production of RBC causing anemia and fatigue


  • Anorexia
  • Anemia
  • Fatigue
  • Reported inadequate food intake less than recommended daily allowance


  • Altered Nutrition: Less than body Requirement R/T Catabolic state, Anorexia and Malnutrition 2O to Renal Failure


  • Patient will display normalization of laboratory values and be free of signs of malnutrition.
  • Patient will demonstrate behaviors, lifestyle change to regain and maintain an appropriate weight.
Nursing InterventionsRationale
Establish rapportTo gain patient’s trust.
Assess general appearance and monitor vital signs.To establish baseline data.
Identify patient at risk for malnutrition.To assess contributing factors.
Ascertain understanding of individual nutritional needs.To determine what information to provide the patient.
Assess weight, age, body build, strength, rest level.To provide comparative baseline.
Assist in developing individualized regimen.To control underlying factors.
Provide diet modification as indicated.To establish a nutritional plans.
Determine whether patient prefers more calories in a meal.To establish a nutritional plans.
Avoid high in sodium-rich food.To prevent further increase in sodium level.
Promote relaxing environment.To enhance intake.
Provide oral care.To prevent further spread of dental caries.
Provide safety.To prevent injury.
Maintain bed rest.To decrease metabolic demand.
Change position every 2 hours.To prevent ulcerations.
Position the bed into semi-fowler’s position.To enhance lung expansion.
Limit fluid intake as ordered.To prevent water retention.
Encourage to do Passive range of motion exercise.To have proper circulation of blood.
Encourage early ambulation.To prevent muscle atrophy.
Regulate Intravenous line as Ordered.To maintain hydration status.
Administer Medications as ordered.To prompt treatment.

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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