Renal and Urological Nursing
Renal and urological nursing is the area of medical-surgical nursing concerned with caring for adults who have disorders of the kidneys, the fluid and electrolyte systems the kidneys regulate, and the urinary tract. It spans the assessment and supportive care of people with acute and chronic kidney disease, disturbances of fluid balance, urinary tract problems and incontinence, and those receiving dialysis or preparing for transplantation.
Definition
Renal and urological nursing is the practice of assessing, monitoring, educating, and supporting patients with diseases of the kidneys and urinary tract and with the fluid-electrolyte disturbances that accompany them, across acute, chronic, and renal-replacement settings.
Scope
This entry orients the reader to the renal and urological domain of adult medical-surgical nursing. It frames how the topics below fit together: kidney disease as the central organ failure, fluid and electrolyte balance as the physiology nursing monitors most closely, urinary tract disorders and continence as common functional problems, and dialysis and renal replacement therapy as the principal life-sustaining interventions. It is a reference overview, not a care protocol.
Sub-topics
Key concepts
- Acute kidney injury and chronic kidney disease
- Glomerular filtration rate and kidney function markers
- Fluid volume and electrolyte balance
- Urinary continence and lower urinary tract function
- Dialysis and renal replacement therapy
- Vascular and peritoneal access care
- Patient self-management and treatment-modality education
Mechanisms
The kidneys filter blood, regulate fluid volume and electrolyte and acid-base balance, and excrete nitrogenous waste; when function fails acutely or progressively, these regulatory roles are lost, producing the uremic, volume, and electrolyte disturbances that define renal illness (Meyer & Hostetter, 2007; Bellomo et al., 2012). Urological disorders instead disrupt the storage and voiding of urine. Nursing care across this area centres on detecting these disturbances early, supporting the physiology when it fails, and helping patients live with long-term conditions and their treatments.
Clinical relevance
Renal and urological problems are common across medical and surgical wards, critical care, and community settings, so this knowledge underpins much general adult nursing. The area describes how kidney and urinary-tract conditions are recognised, monitored, and supported as a body of reference knowledge; it is not a substitute for individualised clinical assessment or for the protocols of a treating service.
Epidemiology
Chronic kidney disease affects a substantial fraction of the adult population worldwide and rises steeply with age, diabetes, and hypertension (Webster et al., 2017), while acute kidney injury is common among hospitalised and critically ill patients (Bellomo et al., 2012). Urinary incontinence and lower urinary tract disorders are likewise highly prevalent, particularly in older adults, making these among the conditions adult nurses encounter most often.
History
Care of people with kidney failure was transformed in the mid-twentieth century by the development of practical hemodialysis and, later, kidney transplantation, which created a long-term patient population requiring sustained nursing support. Standardised terminology for lower urinary tract function (Abrams et al., 2002) and consensus definitions for acute and chronic kidney disease subsequently gave renal and urological nursing a shared clinical vocabulary.
Related topics
Seminal works
- meyer-2007
- abrams-2002
Frequently asked questions
- What does renal and urological nursing cover?
- It covers the nursing care of adults with kidney disease, fluid and electrolyte disturbances, urinary tract disorders and incontinence, and those treated with dialysis or transplantation.
- How does this area relate to general medical-surgical nursing?
- It is a focused area within medical-surgical nursing; because kidney, fluid-balance, and urinary problems are common across many wards, its core concepts inform much of general adult nursing practice.