Bladder training for patient with chronic kidney disease

Abstract

Chronic Kidney Disease (CKD), also known as chronic kidney failure, is characterized by progressive and irreversible damage to the kidneys, impairing their ability to perform essential functions. One of the significant nursing challenges in patients with CKD is the occurrence of urinary incontinence, which manifests as an inability to control urine elimination, leading to varying urine output—sometimes just a few drops, or, in other cases, excessive amounts. Urinary incontinence can be addressed through several interventions, including the placement of a urinary catheter to help train the bladder to manage sensations of urgency and to urinate according to a predetermined schedule rather than solely in response to the urge. Additionally, non-pharmacological therapies, such as bladder training, are effective in managing and preventing urgency urinary incontinence. The application of bladder training was implemented over three consecutive 24-hour periods, consisting of three shifts: morning (11:45 AM to 1:45 PM), afternoon (7:00 AM to 7:00 PM), and night (11:15 PM to 1:15 AM). Daily evaluations were conducted to monitor progress. On the first day, the urine bag contained 200 cc, with the patient reporting no sensation of urgency and no noticeable difference after the initial bladder training session. By the second day, the urine bag filled with 500 cc, indicating an increase in urinary output. The patient’s frequency of urination also improved, and they reported a heightened sensation of needing to urinate, suggesting that the bladder training was effective. In summary, the application of bladder training has demonstrated significant effectiveness in alleviating urgency urinary incontinence in patients with chronic kidney disease. Regular implementation of this intervention can enhance bladder control, increase urinary output, and improve the overall quality of life for patients facing this common complication.

Keywords: Bladder training; nursing care; chronic kidney disease; hospital care; adult nursing