Renal patients: IRIS scores, nursing care plans and care bundles

Clinical symptoms of renal dysfunction (polydipsia, polyuria) are not evident until a large portion of renal tissue has been destroyed, until then many cases can remain undiagnosed. Chronic renal failure (CRF) has many physiological effects, these include the decreased ability to excrete nitrogenous waste (and thus build-up of azotaemia), sodium and phosphorus, and an increased loss of potassium and water-soluble vitamins. Other clinical symptoms also include systemic hypertension, secondary hyperparathyroidism and non-regenerative anaemia (Lane, 2005), these aspects should therefore be monitored as part of the nursing clinic.

Most veterinary practices offer owners renal screening for older patients, as part of senior clinics, pre-anaesthetic screening or before the start of pharmaceutical regimens (such as osteoarthritis treatments).

Early identification of these CRF cases is required in order to establish management of the different stages of CRF. Guidelines set out by The International Renal Interest Society (IRIS) help to establish the types of management that are required at the different disease stages. These guidelines can be utilised as part of care bundles to formulate a nursing care plan (NCP) (Box 1).