Rehabilitation of patients with end-stage renal disease should involve more than just the maintenance of physiologic homeostasis. Nephrology health care teams must also strive to maximize patients' functional capacity and overall well-being. While end-stage renal disease cannot be completely cured, its treatment may comprise numerous aspects. Just some of these include the medical, psychological, occupational, and social therapeutic dimensions. Such comprehensive treatments can dramatically affect a person's lifestyle.
End-stage renal disease (ESRD) is a life-threatening condition with a variable etiology. For the most part, ESRD occurs whenever some pathophysiologic process causes the kidneys to stop functioning. Unless treatment is provided promptly, ESRD's consequences can be severe.
The World Health Organization (WHO) has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (Kutner, 1994, p. 321). This general definition has served to delineate certain health care objectives for the chronic diseases. Traditionally, health care providers focused on the clinical aspects of an individual's disease. The WHO's definition of health, however, suggests that caregivers should broaden their emphasis (Levinsky & Mesler, 1994, p. 244).
The pathologic processes of end-stage renal disease follow an evolving course. In adults, ESRD tends to be caused by multisystem disease, diabetes, and hypertension; whereas, in children, ESRD is typically related to congenital problems and "child-oriented" diseases such as renal tumors and the hemolytic-uremic syndrome (Morrin, 1983, p. 1). Symptoms of renal failure may span the range from being nonexistent to those associated with advanced uremia. Generally though, ESRD symptoms are diverse. Patients often suffer from fatigue, lethargy, and weakness. In addition, they may complain of nausea, vomiting, shortn...