As a patient progresses from chronic kidney disease to end stage renal disease the need for dialysis becomes more imminent. When the kidneys are no longer able to filter the blood alone you will see problematic metabolic acidosis since they kidneys can’t excrete excess acids that are in the blood. During kidney failure, excess potassium isn’t excreted and levels will start to rise. The kidneys help remove certain medications from the body, and when they aren’t working, toxicity can occur even with normal doses. Patients with ESRD become fluid overloaded due to inadequate urine production. Uremia will occur as the body can’t excrete enough urea.
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