Chronic Kidney Disease (CKD) Nursing Diagnosis & Care Plan – devshopsimplenursing

Chronic Kidney Disease (CKD) Nursing Diagnosis & Care Plan

Amanda Thomas Headshot
By Amanda Thomas
Updated On May 2025
Medically Reviewed by:
Angela Slater FNP, RN
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When the kidneys take a hit, the whole body feels it. 

From fluid overload to fatigue and everything in between, chronic kidney disease (CKD) doesn’t just show up. It stays a while. 

Nursing students need to know how to:

  • Recognize a CKD nursing diagnosis.
  • Understand the complications that come with chronic kidney damage.
  • Apply interventions that prevent further decline. 

Whether managing fluid imbalances or fine-tuning a chronic kidney disease care plan, precision and timely action matter.

What is Chronic Kidney Disease?

CKD is the gradual loss of kidney function over time, often progressing to end-stage renal disease (ESRD), which requires dialysis or a kidney transplant. 

It can result from conditions such as:

Signs and Symptoms of Chronic Kidney Disease

CKD symptoms can be subtle at first, but as kidney function declines, it’s important to recognize the following signs and symptoms.

  • Fatigue
  • Edema (peripheral and pulmonary)
  • High blood pressure
  • Anemia
  • Electrolyte imbalances (hyperkalemia, hyperphosphatemia)
  • Uremia (nausea, vomiting, confusion)
  • Decreased urine output
  • Muscle cramps
  • Itching
  • Shortness of breath

Nursing Process for Chronic Kidney Disease

The nursing process involves assessment, diagnosis, planning, implementation, and evaluation to address the physical and psychosocial needs of patients with CKD.

Chronic Kidney Disease Nursing Assessment

This phase focuses on identifying signs of progression and complications.

  • Assess fluid status (edema, weight changes, and blood pressure).
  • Monitor urine output and characteristics.
  • Evaluate laboratory values (BUN, creatinine, electrolytes, and hemoglobin).
  • Assess for signs of uremia and electrolyte imbalances.
  • Monitor dietary intake and nutritional status.
  • Assess for signs of infection.
  • Evaluate mental status for signs of uremic encephalopathy.
  • Monitor adherence to medication and dietary regimens.

Chronic Kidney Disease Nursing Diagnosis

Formulating an accurate nursing diagnosis for chronic renal failure involves connecting clinical findings with the patient’s functional needs. 

Here are three diagnoses commonly prioritized when developing a chronic kidney disease care plan:

  1. Excess fluid volume related to decreased renal function
  2. Impaired renal function related to chronic disease process
  3. Imbalanced nutrition: Less than body requirements related to dietary restrictions and anorexia

Chronic Kidney Disease Nursing Interventions

These interventions help slow CKD progression and prevent complications.

  • Monitor intake and output.
  • Educate on fluid and dietary restrictions.
  • Administer prescribed diuretics and antihypertensives.
  • Educate patients on the signs of fluid overload and when to seek medical care.
  • Monitor lab values and report abnormalities.
  • Provide dietary counseling on low-protein, low-potassium, and low-phosphorus diets.
  • Educate on medication adherence and potential side effects.

Nursing Goals and Expected Outcomes for Chronic Kidney Disease

Set achievable, measurable outcomes to support patient stability.

  • Maintain fluid balance and reduce edema.
  • Stabilize blood pressure within normal limits.
  • Maintain nutritional status.
  • Prevent complications such as hyperkalemia and acidosis.
  • Enhance patient knowledge of disease management.

Nursing Care Plans for Chronic Kidney Disease

Each care plan addresses a specific clinical focus for patients with CKD, from fluid overload to poor nutritional intake. 

These examples help translate a CKD nursing diagnosis into structured, goal-oriented care that supports improved outcomes and reduces the risk of complications.

Care Plan #1 – Fluid Volume Excess

Diagnostic Statement

Excess fluid volume related to compromised renal function as evidenced by edema, hypertension, and oliguria

Expected Outcomes

  • The patient will maintain stable weight and reduced edema.
  • Blood pressure will be within the target range.
  • Urine output will increase to within normal limits.

Assessment

  • Monitor daily weight and vital signs.
  • Assess for edema (peripheral and pulmonary).
  • Monitor intake and output.
  • Assess respiratory status for signs of fluid overload.

Interventions

  • Restrict fluid intake as prescribed.
  • Administer diuretics as ordered.
  • Educate on fluid and salt restriction.
  • Elevate edematous limbs.
  • Monitor serum electrolytes.

Care Plan #2 – Impaired Renal Function

Diagnostic Statement

Impaired renal function related to chronic kidney damage, as evidenced by elevated creatinine and BUN

Expected Outcomes

  • Stabilization of renal function markers (BUN and creatinine)
  • Absence of symptoms of uremia
  • Patient will verbalize understanding of the renal diet

Assessment

  • Monitor renal function tests regularly.
  • Assess for signs of uremia (confusion, fatigue, nausea).
  • Evaluate adherence to the renal diet.

Interventions

  • Educate the patient about a low-protein and low-sodium diet.
  • Monitor fluid and electrolyte balance.
  • Administer medications as ordered (phosphate binders or antihypertensives).
  • Encourage adherence to the prescribed treatment plan.

Care Plan #3 – Imbalanced Nutrition: Less than Body Requirements

Diagnostic Statement

Imbalanced nutrition: Less than body requirements related to dietary restrictions and decreased appetite, as evidenced by weight loss and muscle wasting

Expected Outcomes

  • The patient will maintain or gain weight within a healthy range
  • Demonstrates improved appetite and adequate nutritional intake
  • Verbalizes understanding of dietary modifications

Assessment

  • Monitor weight and BMI.
  • Assess dietary intake and eating patterns.
  • Monitor lab values for signs of malnutrition (albumin).

Interventions

  • Offer small, frequent, nutrient-dense meals.
  • Educate on renal-friendly high-calorie foods.
  • Encourage protein intake as per dietary guidelines.
  • Monitor for symptoms of malnutrition (fatigue, muscle loss).

Patient Education and Discharge Planning

Effective discharge planning improves long-term outcomes.

  • Educate on medication adherence and potential side effects.
  • Stress the importance of regular follow-up and lab tests.
  • Teach self-monitoring of blood pressure and weight.
  • Educate on dietary restrictions and meal planning.
  • Provide information on dialysis and transplant options if applicable.
  • Offer resources for social and emotional support.

Recommended Resources on Chronic Kidney Disease

Looking for more clinical insight? 

These trusted resources offer patient education tools, clinical updates, and care recommendations.

Nursing Care Plan Resources

Supporting CKD Paients Start with Smarter Interventions

Building an effective chronic kidney disease care plan means going beyond lab values. 

It requires understanding how CKD affects each system. It also requires understanding how interventions like fluid monitoring can prevent complications and keep patients stable.

Recognizing the right CKD nursing diagnosis and applying it early helps improve patient outcomes. Whether it’s refining a diet or adjusting meds, little shifts in care can lead to long-term progress.

References and Sources

  1. American Association of Kidney Patients. (n.d.). Chronic kidney disease (CKD) – Pre-dialysis. Retrieved April 6, 2025.
  1. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2025). Nursing care plans: Guidelines for individualizing client care across the life span (11th ed.). F.A. Davis Company.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Health information for professionals: Kidney disease. U.S. Department of Health and Human Services. Retrieved April 5, 2025.
  2. National Kidney Foundation. (n.d.). Chronic kidney disease (CKD). Retrieved April 6, 2025.