Illness and Disease Management CKD Care Plan

Betsy Quinones

February 20, 2021

NSG4055- Illness And Disease Management across a Lifespan

Professor Amber Mccall



Chronic Kidney Disease Care Plan


Chronic kidney disease describes the gradual loss of kidney function. The role of the kidney is to filter excess fluids and wastes from the blood. The advanced stage of chronic kidney disease results in the build-up of high levels of waste in the blood that may lead to complications such as anemia, high blood pressure, poor nutritional health, bone weakness, and nerve damage. Chronic kidney disease occurrence is interrelated with other conditions such as high blood pressure, blood vessel and heart diseases, diabetes, and other disorders.

The rationale of selecting the condition

Among the United States population, more than 1 in 7 adults may have chronic kidney disease. According to the Healthy People 2030 report, the prevalence of this condition is highest among low-income and minority ethnic groups. Establishing awareness of this condition is very important since most people with chronic kidney disease do not know they have it. People with CKD have a high chance of developing stroke and heart disease that leads to early death, therefore, a lot of focus has recently been placed on the diagnosis, prevention, and treatment of chronic kidney disease.

Good public awareness of CKD is important to help manage risk factors like high blood pressure and diabetes and to develop strategies of early screening and diagnosis and diagnosis of high-risk groups so that they can get the necessary treatment. About 10 % of the global population is affected by CKD and millions of people die each year due to poor or lack of management or treatment of this condition. The mortality and morbidity associated with this condition is a massive loss in the global economy due to reduced productive medical expenses.

Questionnaire of acquiring information for creating a care plan

1. Does the patient have a family history of cardiovascular disease or diabetes?

2. What is the patient’s level of awareness about CKD?

3. What is the degree of kidney damage, and are there any complications that have been developed?

4. When did the patient start experiencing symptoms?

5. Does the patient have hypertension or postural changes?

6. Does the patient experience any chest pain? If yes, what are the location, nature of radiation, and severity?

7. What does the laboratory result reveal about the patient’s fluid and electrolyte balance?

8. Is the patient undergoing dialysis? If yes, then for how long?

9. What is/are the possible cause of the patient’s CKD?

10. Which type of treatments or drugs is the patient receiving currently, and what is the response?

11. Are the patient’s caregivers adequately aware of the evidence-based management practices of CKD?

12. What are the results obtained from evaluating heart sounds, peripheral pulses, vascular congestion, capillary refill, and temperature measurement?

13. What is the level of the patient’s activity intolerance?

14. How has the patient’s condition affected his/her thought processes?

15. What is the level of pain experienced by the patient?

Morbidity and comorbidity of chronic kidney disease.

Chronic kidney disease is a debilitating disease that affects various organs and organ systems in the body and is related to an increased risk of cardiovascular mortality and morbidity. The three most common comorbidities of chronic kidney disease include diabetes, hypertension, and hyperlipidemia. About 41.9% of patients with CKD are multi-morbid and can present with more than one comorbid condition.

The other comorbid conditions associated with CKD include; malignancies, liver disease, gout, cerebrovascular disease, ischemic heart disease, congestive heart failure, gout, tuberculosis, and anemia. Studies have revealed that smoking, age, and proteinuria are highly associated with the increased risk of multi-morbidity. Comorbidities in CKD patients should be treated to lower the burden of the disease and to slow down the deterioration of renal function.

Diabetes and hypertension can be considered to be concordant comorbidities that cause CKD while heart failure and coronary disease are often accompanied by CKD. There is, however, a limit that is known about the burden of mental health and discordant conditions. In 2017, it was estimated that CKD caused 1.2 million deaths and was the leading cause of mortality worldwide. CKD was also estimated to have caused 35.8 million disability-adjusted life years. It has been established that old age, low educational status, and smoking are the greatest risk of multi-morbidity. Determining the number of comorbidities in patients ensures there are simple, valid, and readily applicable methods for predicting renal outcomes in patients.

Impact of chronic kidney disease on patient morbidity to the overall national health.

CKD impacts the life of a patient in so many ways. This condition promotes an additional risk of cardiovascular disease and death. Management of chronic kidney failure and the associated conditions may become very expensive to the patients and their families. The condition in its advanced stage causes patient disability leading to patient dependency, loss of social, and economic function. CKD being a complex condition may affect a patient’s access to medical or health insurance due to insurers’ fear of increased cost.

CKD may subject the patient to uncomfortable situations i.e. having to use multiple pharmacological drugs to manage CKD and its comorbid conditions such as diabetes and hypertension as well as dialysis. As far as the overall national health is concerned, the impact is largely socioeconomic. The association of this condition with morbidity and comorbidities hence causing disability and social and economic impairment. Studies conducted by a total of 37 studies estimated that societal and healthcare costs of CKD ranged from $1600 to $25037 for patients with stages 1-3 of CKD. The high cost diverted to CKD and associated conditions paralyzes other national issues hence causing an imbalance in national programs and development.

Healthy People 2020 goals and objectives

The healthy people 2020 goals and objects include:

· Elimination of disparities among kidney disease patients

· A reduction in the kidney disease burden

· Longer lives and improved quality of life for people with CKD


Chronic kidney disease is costly to manage and many times patients become non compliant because they may not have insurance, the copayment, and/or a ride to the dialysis center. Many times patients also get fed up and tired with getting dialysis. With the care plan questions provided and the Healthy People 2020 goals I hope to be able to better manage patients with chronic kidney disease.











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Wen-Chin Lee, Y.-T. L.-C.-Y.-H.-T.-C.-Y.-T. (2018). The Number of Comorbidities Predicts Renal Outcomes in Patients with Stage 3–5 Chronic Kidney Disease. J Clin Med. Retrieved from,prevalence%20of%20hypertension%20approached%2090%25 .

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