International Journal of Health Sciences & Research (www.ijhsr.org) 268 Vol.8; Issue: 9; September 2018 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Review Article Implications for Clinical Practice for Patients with End Stage Renal Disease Eilean Victoria Lazarus 1 , Melba Sheila D’Souza 2 1 PhD, MScN, BScN, RN, Department of Adult Health And Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman. 2 RN, Sultan Qaboos University, Muscat, Sultanate of Oman Corresponding Author: Melba Sheila D’Souza ABSTRACT Background: Patients with end-stage renal disease (ESRD) are encountered in the Emergency Department with problems related to the metabolic complications of renal disease or dialysis complications. Methods: This review of literature highlights the concerns related to patients with ESRD and implications for clinical practice. Results: The concept of illness perceptions and locus of control regarding ESRD is useful in understanding the impact of ESRD and of dialysis treatment on the health related quality of life. Conclusion: Delayed diagnosis of ESRD and failure of recognition of renal disease lead to slow progression of renal failure result in a predominantly young ESRD population leads to poor coping and depression among patients with ESRD. Key-words: chronic renal disease, ESRD, dialysis, renal impairment, prevention, rehabilitation. INTRODUCTION Chronic renal failure (CRF) requiring dialysis or transplantation is known as end-stage renal disease (ESRD) (Cabañas et al., 2010; Montgomery et al., 2009). In the United States, diabetic nephropathy, hypertension and glomerulonephritis are common causes of CRF with 75% of all adult cases. All major organ systems are affected by renal failure. Prevalence of symptoms is a function of the glomerular filtration rate (GFR), which averages 120 mL/min in a healthy adult. As the GFR falls to less than approximately 20% of normal, symptoms of uremia may begin to occur. They almost are invariably present when the GFR decreases to less than 10% of normal. Signs and symptoms of renal failure are due to overt metabolic derangements resulting from inability of failed kidneys to regulate electrolyte, fluid, and acid-base balance; they are also due to accumulation of toxic products of amino acid metabolism in the serum. The principle causes of ESRD are diabetic nephropathy, hypertensive nephropathy, chronic pyelonephritis, autosomal polycystic kidney disease and obstructive uropathy (Mani, 2003). Over 50% of these diseases possibly could be prevented if an effort was made; millions of Indians suffer from diabetes and hypertension and are unaware of their illness. Even if they know they have one of these diseases, there are often few symptoms, and they therefore do not take treatment. The significance of CKD is attributable to five factors: the rapid increase in its prevalence, the enormous cost of treatment, recent data indicating that