title: Uremic syndrome and end-stage renal disease: physical manifestations and beyond.
abstract: OBJECTIVE
  This review summarizes data concerning the incidence, definition, pathophysiology, and physical manifestations of patients with uremic syndrome.
  
  
  METHODS
  Data sources utilized in writing this article included the National Kidney Foundation Guidelines, the United States Renal Data System, textbooks of medicine and pathophysiology, and medical care and nursing journals.
  
  
  CONCLUSIONS
  Early identification of kidney disease in the early stages is essential to preserving kidney function for as long as possible. The progression of chronic kidney disease (CKD) and the manifestations of uremic syndrome leading to end-stage renal failure (ESRF) are often not addressed in the literature for nurse practitioners.
  
  
  CONCLUSIONS
  Patients with progressing CKD and ESRF often present in the primary care setting for treatment of acute and chronic conditions not pertaining to their renal status (e.g., viral upper respiratory infections, diabetes, hypertension). Nurse practitioners need to be knowledgeable about the subtle early presentation of uremic syndrome and ESRF, risk factors for kidney disease, assessment tools to make the diagnosis and stage the disease, treatment of this disease, as well as psychological, economic, and the social impact that ESRF imposes on individuals, families, communities, and the healthcare system as a whole when the chronic disease has progressed to end stage.
authors: Department of Nursing, Bloomsburg University, Millville, Pennsylvania 17846, USA. nchikota@bloomu.edu
authors: Noreen
authors: N
authors: Chikotas
authors: Annette
authors: A
authors: Gunderman
authors: Terina
authors: T
authors: Oman