CNeph(C) Nephrology Nursing key terms

The volume of plasma filtered by the glomeruli per unit time, usually expressed in mL/min. It is the best overall index of kidney function and falls as nephron mass is lost.

A calculated approximation of GFR derived from serum creatinine or cystatin C plus age, sex, and sometimes race-free equations. It guides CKD staging, dosing decisions, and referral timing.

A waste product of muscle creatine metabolism cleared mainly by glomerular filtration. Rising values suggest reduced filtration, but levels are influenced by muscle mass, diet, and some drugs.

A small protein produced at a steady rate by nucleated cells and filtered freely by glomeruli. Its blood level estimates kidney function with less dependence on muscle mass than creatinine.

Classification of CKD by GFR category (G1 to G5) and albuminuria category (A1 to A3). Staging predicts risk of progression, cardiovascular events, and need for kidney replacement therapy.

A spot urine test comparing albumin with creatinine to correct for urine concentration. Persistent elevation signals kidney damage and independently predicts progression and cardiovascular risk.

Excess protein in urine, a marker of glomerular barrier injury or tubular disease. Persistent proteinuria accelerates kidney scarring and raises cardiovascular risk, so it is a treatment target.

A clinical picture of heavy proteinuria, low serum albumin, edema, and high cholesterol caused by glomerular injury. Nurses monitor weight, edema, clotting risk, and infection risk closely.

An abrupt decline in kidney function over hours to days, shown by rising creatinine, falling urine output, or both. Causes are grouped as prerenal, intrinsic renal, and postrenal obstruction.

Reduced kidney perfusion from volume loss, low cardiac output, or vasodilation, with structurally intact tubules. It usually improves quickly when blood flow and volume are restored.

The percentage of filtered sodium excreted in urine, calculated from paired serum and urine sodium and creatinine. Low values suggest prerenal states; high values suggest tubular injury.

Damage to tubular epithelial cells from prolonged ischemia, sepsis, or nephrotoxins, causing muddy-brown casts and impaired sodium reabsorption. Recovery depends on regenerating tubular cells over days to weeks.

Slow, continuous extracorporeal blood purification used for hemodynamically unstable critically ill patients. It removes fluid and solutes gently over many hours, improving tolerance of treatment.

Extracorporeal therapy that removes solutes and fluid by diffusion and ultrafiltration across a semipermeable membrane. It requires a vascular access capable of high blood flow.

A surgically joined artery and vein, usually in the forearm, that enlarges to carry high blood flow for dialysis. It is the preferred access because it lasts longest and infects least.

A synthetic tube connecting an artery and vein to provide dialysis access when native vessels are unsuitable. It matures faster than a fistula but has higher infection and clotting rates.

A tunneled or nontunneled catheter placed in a large central vein to provide immediate vascular access. It carries the highest risk of bloodstream infection and central vein stenosis.

Return of already dialyzed blood directly into the arterial line, reducing treatment efficiency. It occurs with inadequate needle spacing, low flow, or access stenosis and shows as low urea clearance.

A dimensionless measure of dialysis dose combining dialyzer clearance (K), treatment time (t), and urea distribution volume (V). Higher values indicate more effective urea removal.

The percentage fall in blood urea nitrogen across a dialysis session, calculated from pre- and post-treatment samples. It is a simpler surrogate for delivered dialysis dose than Kt/V.

Removal of plasma water across a dialysis membrane driven by a pressure gradient. Controlling the rate is essential because rapid fluid removal can cause hypotension and cramping.

The body weight at which a dialysis patient has no excess fluid yet remains normotensive and symptom-free. Nurses reassess it as nutrition and residual kidney function change.

A symptomatic fall in blood pressure during dialysis, often with cramping, nausea, or dizziness. Causes include fast fluid removal, eating during treatment, and impaired cardiac reserve.

Replacement of kidney function by instilling dialysate into the peritoneal cavity, where the peritoneal membrane acts as a filter. It is performed at home, usually daily.

A structured test comparing dialysate and blood solute concentrations during a dwell to classify membrane transport status. Results guide prescription of dwell times and solution strength.

Infection of the peritoneal cavity, usually from touch contamination during exchanges, causing cloudy effluent and abdominal pain. Prompt culture and intraperitoneal antibiotics preserve the catheter.

Routine cleansing, dressing, and inspection of the skin where a dialysis catheter exits. Consistent technique and observation for redness or drainage reduce bloodstream infection.

A bloodstream infection attributed to a central catheter, confirmed by cultures from the catheter and a peripheral vein. Prevention relies on hand hygiene, skin antisepsis, and prompt removal when indicated.

Comparison of donor and recipient HLA antigens to reduce immune recognition of a transplanted kidney. Closer matching lowers rejection risk, especially in living related donation.

The percentage of a donor pool to which a transplant candidate has preformed antibodies. High values mean fewer compatible donors and longer waiting times.

Immune attack on a transplanted kidney occurring days to months after surgery, with rising creatinine, fever, or graft tenderness. Early treatment with immunosuppression often reverses it.

A drug class including tacrolimus and cyclosporine that blocks T-cell activation to prevent graft rejection. Therapeutic drug monitoring is essential because levels vary and toxicity affects kidneys and nerves.

Kidney damage caused by a drug, contrast agent, or toxin through reduced blood flow, direct tubular injury, or obstruction. Nurses screen for risk factors and monitor creatinine and urine output.

A drug such as furosemide that blocks sodium reabsorption in the thick ascending limb, producing strong diuresis. Nurses monitor weight, electrolytes, blood pressure, and hearing with high doses.

Serum potassium above the normal range, dangerous because it can cause fatal cardiac arrhythmias. In kidney disease it arises from reduced excretion and from drugs that impair potassium balance.

A low blood pH from acid accumulation or bicarbonate loss, common in advanced kidney disease. Persistent acidosis worsens bone and muscle health and is treated with alkali supplements.

An oral medication taken with meals that binds dietary phosphate in the gut so it is not absorbed. Consistent timing with food is essential for controlling phosphate in dialysis patients.

A prescribed limit on daily fluid intake used when urine output is low or fluid overload persists. It includes all liquids and foods that melt at room temperature, and thirst strategies improve adherence.

A person's ability to obtain, understand, and use health information to make decisions. Low health literacy in kidney disease predicts poor self-management and requires plain-language teaching and teach-back.

A teaching technique in which the patient explains information back in their own words. It reveals misunderstandings so the nurse can reteach before the patient self-manages at home.

Coaching and tools that help people with kidney disease manage diet, medications, appointments, and symptoms. It builds confidence and problem-solving rather than simply giving instructions.

A collaborative process where clinicians and patients discuss options, benefits, and preferences before choosing care. It is central to decisions such as dialysis modality, conservative care, and transplantation.

A patient's voluntary agreement to treatment after receiving and understanding information about risks, benefits, and alternatives. Nurses verify understanding and that consent is given without coercion.

Ongoing discussion and documentation of a person's values and preferences for future care. In kidney disease it guides decisions about dialysis initiation, stopping treatment, and palliative care.