Kidney Failure occurs when one or both kidneys are not able to perform
their usual functions. The kidneys are two bean-shaped organs in the lower back.
Their main function is to remove waste from the body and to balance the water
and mineral content of the blood by removing water. The waste and water combine
to form urine.
Acute Kidney Failure – sudden loss of kidney function
Chronic Kidney Failure – slow, gradual loss of kidney function
If kidney function is reduced to 20% of normal function, serious health problems
develop. When kidney function gets to 10% to 15% of normal, dialysis or a
transplant is needed to maintain life.
Causes
Kidney diseases cause the tiny filters in the kidneys (called nephrons) to
lose their filtering ability. Damage to the nephrons may occur suddenly after an
injury or poisoning. However, many kidney diseases take years or even to decades
to cause damage that is noticeable.
The two most commons causes of
Kidney Failure are:
- Diabetes – high blood sugar that results from diabetes damages the
nephrons
- High blood pressure – damages the capillaries in the kidneys
Others causes of
Kidney Failure include:
- Pyelonephritis
- Glomerulonephritis
- Polycystic kidney disease
- Lupus
- Birth defects
- Poisoning
- Severe trauma
- Long-term use of medicines that contain:
- Aspirin
- Acetaminophen
- Ibuprofen
- Shock
- Blockage of the urinary tract due to:
- Bladder or colon tumor
- Large kidney stone
- Enlarged prostate
- Build-up of abnormal substances within the kidneys, such as:
- Kidney stones
- Amyloidosis
- Protein buildup
- Toxic reaction to drugs or x-ray dyes
- Systemic diseases, including:
- Systemic lupus erythematosus (lupus)
- Polyarteritis
- Wegener's and Goodpasture's granulomatosis
- Conditions that severely decrease circulating fluid/blood volume, such as:
- Severe blood loss
- Burns
- High calcium levels due to diabetes insipidus
- Pancreatitis
- Peritonitis
- Sepsis
- Heart failure
- Liver disease
Risk Factors
A risk factor is something that increases your chance of getting a disease or
condition.
- Diabetes
- High blood pressure
- Lupus
- High blood cholesterol
- Long-term use of painkillers in high doses
- Liver failure, jaundice
- Respiratory failure
- HIV
- Cancer
- Recent open heart surgery
- Recent surgery on an abdominal aortic aneurysm
- Misuse of diuretic medications
Symptoms
Some kidney diseases begin without any symptoms at all. As
Kidney Failure
progresses, some of the following symptoms may develop:
- Fluid retention
- Swollen hands and feet
- Numbness of hands and feet
- Itchy skin
- Fatigue
- Low urine output
- Frequent urination
- Loss of appetite, malnutrition
- Sores, bad taste in the mouth
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Muscle cramps and twitches
- Shortness of breath
- Pericarditis
- Swelling throughout the body
- High blood pressure
- Weak, brittle bones
- Yellowish-brownish skin tone
Symptoms
The symptoms of
Pulmonary Embolism vary in type and severity depending
on the size and location of the blockage, and the area affected by the lack of
blood. Symptoms may include:
- Shortness of breath that starts suddenly for no obvious reason
- Chest pain, especially when breathing or coughing
- Feeling faint
- Cough, sometimes with bloody phlegm
- Rapid heartbeat
- Rapid breathing
- Anxiety
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a
physical exam.
Tests may include:
Blood Tests – to see if the kidneys are working properly. If they are not
working properly, blood will contain creatinine and urea.
Urine Tests – to see if the kidneys are working properly. If they are not
working properly, urine will contain protein. You may be asked to collect urine
in a special container over a 24-hour period. This will show whether your
kidneys are clearing creatinine at a normal rate. The amount of urine produced
in Kidney Failure is usually quite low, or may be completely absent.
Renal Imaging – use of ultrasound, magnetic resonance imaging (MRI), or
computed tomography (CT scan) to take a picture of the kidneys. These pictures
will show whether there is a blockage in the flow of urine or a growth on the
kidney.
Biopsy – removal of a tiny piece of kidney tissue to see how kidney cells
are functioning.
Treatment
Kidney disease cannot be cured, but the following are treatments that may be
recommended to help preserve as much kidney function as possible, and to try to
reverse some of the ill effects of
Kidney Failure.
General measures:
- Fluid restriction
- Daily weight checks
- High carbohydrate diet
- Low protein diet
Medications:
Use of all medications should be carefully reviewed, to avoid using any
medications that are normally filtered or converted by the kidneys. Medications
include:
- Diuretics, such as furosemide or mannitol - help to flush out the kidneys,
increase urine flow, and rid the body of excess sodium
- Dopamine, Atrial natriuretic peptide (ANP) - dilates blood vessels in the
kidneys, increases urine flow, flushes out sodium
- Angiotensin-Converting Enzyme Inhibitors
- Blood pressure medications
Dialysis - filters potentially toxic waste from the blood. Takes over
for the kidneys. May be performed temporarily, until kidney function improves,
or until a kidney transplant is available.
Balancing of Electrolytes, Anemia, and Low Platelet Counts- Sodium,
potassium, calcium, red blood cells, hematocrit, and other blood elements should
be monitored regularly and adjusted as necessary. Transfusion of red blood cells
or other blood products may be necessary to achieve normal blood counts and
avoid a bleeding tendency.
Kidney Transplant - a measure of last resort, but can be curative.
Success of a kidney transplant depends on whether the underlying cause of the
kidney damage is still present, and may ultimately threaten the transplanted
kidney.
Lifestyle Changes
The following are steps to make your kidneys last longer:
- Have your blood pressure checked regularly and use appropriate medication
to control high blood pressure.
- If you are diabetic, make sure to control your blood sugar carefully.
- Avoid pain medications.
- You may need to limit your intake of protein. A dietitian can help you
adjust your diet.
- Limit cholesterol intake. Cholesterol is present in foods that come from
animals, such as meat and dairy products, including eggs.
- Limit sodium salt intake.
- Limit sodium potassium intake (contained in fruits, vegetables, nuts, and
seeds).
- Treat anemia with iron supplements or a medication recommended by your
doctor.
Prevention
In some cases, you cannot prevent
Kidney Failure. But there are some
steps you can take that will lower your risk of
Kidney Failure.
- Maintain normal blood pressure.
- If you are diabetic, control your blood sugar.
- Avoid long-term exposure to toxic substances such as lead and solvents.
- Do not abuse alcohol or over-the-counter pain medication.
- If you have chronic kidney failure, consult your doctor before you become
pregnant.