title: The patients with progressive renal insufficiency and a failing renal transplant: a unique practice challenge.
abstract: Progressive renal insufficiency (PRI) is being diagnosed with increasing frequency as the care of patients with renal disease has evolved from acute care and maintenance dialysis to disease prevention and heath promotion. One subset of the population of patients with PRI is comprised of those patients with a failing renal transplant. The patient with PRI and a failing renal transplant presents unique challenges for the nephrology nurse. Declining renal function in the immunocompromised host creates a complex situation that requires careful clinical assessment and specific knowledge to provide appropriate nursing care. As the renal patient population changes and grows, so must the nephrology nurses' knowledge and practice. This article will explain how a failing renal transplant impacts the clinical presentation of PRI and will provide a detailed clinical assessment tool with suggestions for appropriate nursing interventions.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Clara D
authors.initials: CD
authors.lastname: Neyhart
mesh_terms: D058186:Acute Kidney Injury / Q000451:nursing*; D018450:Disease Progression; D004509:Education, Nursing, Continuing; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000451:nursing*; D016030:Kidney Transplantation / Q000451:nursing*; D009730:Nursing Assessment; D017211:Treatment Failure