Chronic Renal Failiure
The Facts on Chronic
Renal Failiure
Treatment for chronic kidney failiure focuses
on slowing the progression of the kidney damage, usually by controlling the
underlying cause. Chronic kidney failiure can progress to end-stage kidney
disease, which is fatal without artificial filtering (dialysis) or a kidney
transplant
Chronic
renal failure, or chronic kidney disease (CKD), is a slow and progressive
decline of kidney function. It's usually a result of a complication from another
serious medical condition. Unlike acute renal failure, which happens quickly
and suddenly, chronic renal failure happens gradually - over a period of weeks,
months, or years - as the kidneys slowly stop working, leading to end-stage
renal disease (ESRD).
The
progression is so slow that symptoms usually don't appear until major damage is
done. The kidneys play three major roles:
- removing waste
products from the body, keeping toxins from building up in the bloodstream
- producing hormones
that control other body functions, such as regulating blood pressure and
producing red blood cells
- regulating the
levels of minerals or electrolytes (e.g., sodium, calcium, and potassium)
and fluid in the body
It's
entirely possible to live a full, healthy life with only one kidney - one
fully functioning kidney can do the work of two - but it's essential to
watch for signs of any problems with the remaining kidney.
When
kidneys get to the point where they can't function at all, kidney dialysis or a
transplant is the only way to remove the body's waste products.
Causes of Chronic Renal
Failure
The
most common causes of chronic renal failure are diabetes mellitus (type
1 or type 2 diabetes) and high blood pressure. The most common cause
of end-stage renal failure worldwide is IgA nephropathy (an inflammatory
disease of the kidney).
One
of the complications resulting from diabetes or high blood pressure is the
damage to the small blood vessels in the body. The blood vessels in the kidneys
also become damaged, resulting in CKD.
Other
common causes of chronic renal failure include:
- recurring
pyelonephritis (kidney infection)
- polycystic kidney
disease (multiple cysts in the kidneys)
- autoimmune
disorders such as systemic lupus erythematosus
- hardening of the
arteries, which can damage blood vessels in the kidney
- urinary tract
blockages and reflux, due to frequent infections, stones, or an anatomical
abnormality that happened at birth
- excessive use of
medications that are metabolized through the kidneys
Symptoms and
Complications of Chronic Renal Failure
Chronic
renal failure can be present for many years before you notice any symptoms. If your doctor suspects
that you may be likely to develop renal failure, he or she will probably catch
it early by conducting regular blood and urine tests. If regular monitoring
isn't done, the symptoms may not be detected until the kidneys have already
been damaged. Some of the symptoms - such as fatigue - may have been
present for some time, but can come on so gradually that they aren't noticed or
attributed to kidney failure.
Some
signs of chronic renal failure are more obvious than others. These are:
- increased
urination, especially at night
- decreased urination
- blood in the urine
(not a common symptom of chronic renal failure)
- urine that is
cloudy or tea-coloured
Other
symptoms aren't as obvious, but are a direct result of the kidneys' inability
to eliminate waste and excess fluid from the body:
I HAD ALL THESE
- puffy eyes, hands,
and feet (called edema)
- high blood pressure
- fatigue
- shortness of breath
- loss of appetite
- nausea and vomiting
(this is a common symptom)
- thirst
- bad taste in the
mouth or bad breath
- weight loss
- generalized,
persistent itchy skin
- muscle twitching or
cramping
- a yellowish-brown
tint to the skin
As
the kidney failure gets worse and the toxins continue to build up in the body,
seizures and mental confusion can result.
Being
diagnosed with chronic renal failure can be very frightening. The future of the
condition, however, depends on the medical problem that caused the kidney
failure, how much kidney damage has occurred, and what, if any, complications
are present.
Some
of these complications may include:
- anemia
- high blood pressure
(hypertension)
- increased risk of
bleeding
- increased risk of
infection
- fluid overload
(called edema)
- dehydration
- electrolyte
abnormalities (e.g., hyperkalemia, high levels of potassium in the
blood)
- mineral
abnormalities (e.g., hypercalcemia (high levels of calcium in the blood)
or hyperphosphatemia (high levels of phosphorus in the blood))
- brittle bones
- malnutrition
- seizures
Diagnosing Chronic Renal
Failure
Your
medical history is important in determining your risk factors for developing
kidney failure.
After taking a thorough history, your doctor will check any or all of the
following:
- blood pressure
(many people with chronic renal failure have high blood pressure)
- urine tests to
detect proteinuria (or excess protein in the urine)
- blood tests
- X-rays of the
kidneys
- abdominal CT or CAT
(computed tomography) scan
- abdominal MRI
(magnetic resonance imaging)
- abdominal
ultrasound
- renal scan
The
X-rays, scans, and ultrasounds check for abnormalities in the kidneys, such as
small size, tumours, or blockages. These various tests will allow the doctor to
recognize if any abnormal kidney function is present and to diagnose CKD.
Treating and Preventing
Chronic Renal Failure
Initially,
people with kidney failure are usually advised to make changes to their diet. A low-protein diet is
often recommended to help slow down the buildup of waste in the body and to
help limit the nausea and vomiting that can accompany chronic renal failure. A
qualified dietitian can help determine the proper diet. The underlying illness
or illnesses need to be considered when making any diet changes.
Because
the kidneys aren't eliminating body waste as effectively as they should, the
levels of electrolytes (sodium and potassium) and minerals
(calcium and phosphate) in your body may either rise too high (most common) or
be eliminated too quickly. These electrolytes and minerals are measured through
regular blood tests, and if the levels are not in balance, diet changes may be
recommended. Occasionally, a doctor suggests taking supplements or medications
to help manage the imbalance.
If
the kidneys aren't allowing the body to get rid of the excess fluid, fluid
intake may need to be restricted. This is so that the kidneys and heart don't
have to work as hard. The amount of fluid allowed can be determined ahead of
time, but often a day's allotment is based on the amount of urine put out the
day before. For example, someone who puts out 500 mL of urine in one day
might be allowed to drink 500 mL of fluid over the following 24 hours, and
so on. Fluid restrictions are usually only used in severe cases of swelling or
if the renal failure has progressed to end-stage renal failure and dialysis has
become necessary. Dietitians can help arrange diets around fluid restrictions,
and teach what is allowed and what should be avoided.
If,
despite treatment, the kidneys continue to get worse, dialysis or a kidney
transplant becomes necessary.
There
are two types of dialysis: peritoneal dialysis and hemodialysis. Dialysis is a process
that removes excess fluids and waste using a membrane instead of a kidney as a
filter. The type of dialysis depends on many factors including a person's
lifestyle. Dialysis isn't a cure, and people who are on dialysis still must
follow special diets, reduce their fluids, and take medications as prescribed
by their doctors.
Peritoneal
dialysis
uses the natural membrane of the abdominal cavity as its filter. It can only be
used by people who have not had major abdominal surgery. Using a catheter
(a very small, flexible tube) that's been permanently placed into the abdomen,
the abdominal cavity is filled with a solution called dialysate, which
stays there for a set amount of time. The dialysate draws the waste and extra
fluid out of the bloodstream through the membrane. When finished, the
dialysate - now with the extra body fluid and waste mixed in - is
drained out and then replaced with fresh dialysate. Usually done at home, this
procedure is continuous and done in cycles. Peritoneal dialysis can be
performed by one's self or by a family member. It's done daily, but the
frequency of cycles during the day varies according to the type of peritoneal
dialysis being done. The cycles can occur as often as every few hours, or the
procedure can span the night with the use of a cycling machine that exchanges
the fluid automatically while the person sleeps.
Peritoneal
dialysis doesn't work for everyone and may eventually stop working effectively
for those who do use it. If this happens, hemodialysis is necessary.
Hemodialysis is a procedure that
must be done in a hospital or special clinic setting. With hemodialysis, the
waste and excess body fluid is filtered out through the blood using a dialyser,
a coiled membrane made up of hundreds of hollow fibers. A dialysis machine
pumps the blood through the dialyser. The blood stays on one side of the
membrane, while the dialysate is on the other side of the membrane. As
with the peritoneal dialysis, the dialysate draws the extra body fluid and
waste through the filter and then the filtered blood is pumped back into the
body. The process of hemodialysis is quicker than peritoneal dialysis, and the
cycle is generally complete in about four hours. It's usually done about three
times a week.
A
kidney transplant is a solution for some people with chronic renal failure. Everyone with the
condition is assessed for a kidney transplant. However, some who have other
serious conditions may be at an increased risk of complications from surgery or
antirejection medications so a transplant may not be a suitable option for
them. A kidney can be transplanted from a living donor (often a relative) or a
donor who has recently died and left his or her organs for donation. With a
successful transplant and proper medical care, a kidney recipient can go on to
lead a healthy life for many years.
Chronic
renal failure often causes anemia, a condition where there are not enough
healthy red blood cells in the body. For some people with anemia caused by
chronic renal failure, their doctor may advise them to take medications that
treat anemia by stimulating the body to produce more red blood cells.
Prevention
of chronic renal failure must begin long before any signs of kidney failure are
noticed.
Many people with CKD will develop cardiovascular disease. Because chronic renal
failure and cardiovascular disease share some of the same risk factors, for
example, diabetes and high blood pressure, it becomes important to manage these
risk factors of cardiovascular disease to effectively manage CKD. This involves
maintaining good blood pressure control and keeping blood sugar levels under
control if you have diabetes. Doctors may also suggest making certain lifestyle
changes, such as quitting smoking, maintaining a healthy diet (e.g., reducing
salt intake), and exercising regularly.
People
who are at high risk of developing chronic renal failure should be aware of the
potential risks.
They should also be taught how to take steps to avoid the onset of kidney
failure and how to recognize some of the warning signs. While there's no cure,
there are steps that can be taken to reduce the complications and symptoms.
Some
ways to prevent or slow down the onset of chronic renal failure are:
- manage
cardiovascular disease risk factors such as:
- avoid smoking -
for people with diabetes, smoking can speed up damage to the small blood
vessels in the body
- monitor blood
pressure regularly and ask what your target blood pressure should be
- maintain a healthy
diet and get regular exercise
- limit alcohol
intake
- follow recommended
treatments for chronic diseases such as diabetes, lupus, and hypertension
- don't abuse
prescription or over-the-counter medications - ask the pharmacist which
medications are safe to use and won't cause further damage to the kidneys
- get treatment for
urinary tract infections or any type of urinary problems as soon as
possible
Treatment for chronic kidney failure focuses
on slowing the progression of the kidney damage, usually by controlling the
underlying cause. Chronic kidney failure can progress to end-stage kidney
disease, which is fatal without artificial filtering (dialysis) or a kidney
transplant
I DID NOT GO FOR DIALYSIS.NEITHER DID I HAVE A KYDNEY TRANSPLANT.
MINE IS NOT A MEDICAL MIRACLE.IF MEDICINE CAN PERFORM MIRACLES , WHY ARE THE HOSPITALS SO FULL OF KYDNEY PATIENTS? WHY ARE PEOPLE DYING OF KYDNEY DESEASE?
