Kidney failure is a serious disease which can have a major impact on life, and can ultimately be fatal. However, it can be successfully treated.
What do the kidneys do?
In order for blood to perform its essential functions of bringing nutrients and oxygen to the cells of the body, and carrying waste materials away from those cells, the chemical composition of the blood must be carefully controlled.
The kidneys play a crucial role in this process by filtering the blood under high pressure and removing potential toxins, which are excreted from the body in the urine.
Every day the kidneys filter the body’s entire blood volume seven or eight times.
When the kidneys start to fail, toxins are not f & iltered out of the blood, and start accumulate in the tissues. This can lead to a range of problems.
Build up of two waste products, urea and creatinine, can lead to tiredness, weakness, loss of appetite and vomiting.
Accumulation of acid generated during the body’s metabolic processes can lead to a condition called metabolic acidosis.
Failure to get rid of phosphate, causes the blood phosphate level to increase and calcium level to fall.
When calcium level is low, bones will become brittle.
The kidney may also lose its ability to produce erythropoietin, resulting in anaemia.
Kidney failure is also associated with an increase in the volume of water in the body which can result in a swelling of the tissues.
Excess salt and water retention may cause high blood pressure, swelling of the legs, face, abdomen and breathlessness.
What causes kidney failure?
There are many possible causes of kidney damage or kidney failure. They include:
* Decreased blood flow, which may occur with extremely low blood pressure caused by trauma, surgery, serious illnesses, septic shock, hemorrhage, burns, or dehydration
* Acute tubular necrosis (ATN)
* Infections that directly injury the kidney such as acute pyelonephritis or septicemia
* Urinary tract obstruction (obstructive uropathy)
* Autoimmune kidney disease such as interstitial nephritis or acute nephritic syndrome
* Disorders that cause clotting within the thin blood vessels of the kidney
o Idiopathic thrombocytopenic thrombotic purpura (ITTP)
o Transfusion reaction
o Malignant hypertension
o Hemolytic-uremic syndrome
o Disorders of childbirth, such as bleeding placenta abruptio or placenta previa
The most common causes of kidney failure are glomerulonephritis (inflammation of the kidney) and diabetes mellitus.
What are the symptoms?
As the kidneys begin to fail the following symptoms can begin develop:
* Decrease in amount of urine (oliguria)
* Urination stops (anuria)
* Excessive urination at night
* Ankle, feet, and leg swelling
* Generalized swelling, fluid retention
* Decreased sensation, especially in the hands or feet
* Decreased appetite
* Metallic taste in mouth
* Persistent hiccups
* Changes in mental status or mood
o Delirium or confusion
o Mood changes
o Trouble paying attention
* Slow, sluggish, movements
* Hand tremor (shaking)
* Nausea or vomiting, may last for days
* Brusing easily
* Prolonged bleeding
* Bloody stools
* Flank pain (between the ribs and hips)
* Breath odor
* High blood pressure
* pale and sallow complexion
* shortness of breath
* body itch
* sometimes nausea and vomiting
* swelling of the face and legs
* disruption of urination patterns
How it is diagnosed?
Exams and Tests:
Examination and testing can help diagnose acute kidney failure and help rule out other problems that can affect kidney function.
Many patients have generalized swelling caused by fluid retention. The doctor will use a stethoscope to listen to the heart and lungs. A heart murmur, crackles in the lungs, inflammation of the lining of the heart (pericarditis), or other related to extra fluid may be heard.
The results of laboratory tests may change suddenly (within a few days to 2 weeks).
* Urine tests (urinalysis) may be abnormal.
* Serum creatinine, BUN, creatinine clearance, and serum potassium levels may increase.
* Arterial blood gas and blood chemistries may show metabolic acidosis.
* Kidney or abdominal ultrasound are preferred tests, but abdominal x-ray, abdominal CT scan, or abdominal MRI can tell if there is a blockage in the urinary tract.
* Blood tests may help reveal the underlying cause of kidney failure.
How is it treated?
Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal. Usually, you have to stay overnight in the hospital for treatment.
The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the build-up of toxins normally handled by the kidneys. This diet may be high in carbohydrates and low in protein, salt, and potassium.
You may need antibiotics to treat or prevent infection. Diuretics (“water pills”) may be used to help the kidneys lose fluid.
It will be very important to avoid dangerous hyperkalemia (increased blood potassium levels) by using IV (intravenous) calcium, glucose/insulin, or potassium exchange resin (Kayexalate).
Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your serum potassium is dangerously high. Dialysis will also be used if your mental status changes, your potassium level starts to rise, you stop urinating, develop pericarditis, become overloaded with fluid, or cannot eliminate nitrogen waste products from your body.
The most common treatment is by dialysis, a technique which artificially mimics the action of the kidneys.
What is dialysis?
There are two types of dialysis.
Haemodialysis is the most frequently prescribed type of dialysis treatment….CLICK & SEE
It involves circulating the patient’s blood outside of the body through a series of tubes.
The blood is filtered in a way similar to that used by the kidneys by using a chemical bath to draw out waste products.
Most haemodialysis patients require treatment three times a week, for an average of 3-4 hours per dialysis.
Less common is a technique known as peritoneal dialysis, in which the lining of the abdomen acts a blood filter.….CLICK & SEE
Is a transplant an option?….CLICK & SEE
For the right patient at the right time, a transplant is the best treatment for kidney failure.
If it works well the patient will be totally free from dialysis. Many patients with kidney failure are suitable for a transplant.
While acute kidney failure is potentially life-threatening and may require intensive treatment, the kidneys usually start working again within several weeks to months after the underlying cause has been treated.
In cases where this does not happen, chronic renal failure or end-stage renal disease develops. Death can occur, but is most common when kidney failure is caused by surgery, trauma, or severe infection in someone with heart disease, lung disease, or recent stroke. Old age, infection, loss of blood from the intestinal tract, and progression of kidney failure also increase the risk of death.
Possible Complications :
* Loss of blood in the intestines
* Chronic (ongoing) kidney failure
* End-stage renal disease
* Damage to the heart or nervous system
* Hypertension (high blood pressure)
Prevention: Treating disorders such as high blood pressure can help prevent acute kidney failure. Unfortunately, prevention is not always possible.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
BBC NEWS:OCT 15, 2001