Kidney failure , also known as end-stage renal disease , is a medical condition in which the kidneys are no longer functioning. It is divided into acute renal failure (rapidly developing case) and chronic (long-term) renal failure. Symptoms can include leg swelling, fatigue, vomiting, loss of appetite, or confusion. Acute disease complications may include uremia, high blood potassium, or excessive volume. Complications of chronic illness may include heart disease, high blood pressure, or anemia.
Causes of acute renal failure include low blood pressure, blockage of the urinary tract, certain drugs, muscle damage, and haemolytic uremic syndrome. The causes of chronic renal failure include diabetes, high blood pressure, nephrotic syndrome, and polycystic kidney disease. The diagnosis of acute illness is often based on a combination of factors such as decreased urine production or serum creatinine enhancement. The diagnosis of chronic diseases is usually based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. This is also equivalent to stage 5 chronic kidney disease.
Treatment of acute illness usually depends on the underlying cause. Treatment of chronic diseases may include hemodialysis, peritoneal dialysis, or renal transplantation. Hemodialysis uses a machine to filter blood outside the body. In a specific peritoneal dialysis fluid is placed into the abdominal cavity and then dried, with this process repeated several times per day. Kidney transplantation involves surgery placing kidneys from others and then taking immunosuppressant drugs to prevent rejection. Other recommended actions of chronic illness include staying active and changing certain diets.
In the United States, acute illness attacks about 3 per 1,000 people per year. Chronic illness affects about 1 in 1,000 people with 3 per 10,000 new people developing this condition every year. Acute illness is often reversible while chronic illness is often not. With the right treatment, many people with chronic diseases can continue to work.
Video Kidney failure
Classification
Kidney failure can be divided into two categories: acute kidney injury or chronic kidney disease. The type of renal failure is differentiated by a tendency in serum creatinine; Other factors that may help distinguish acute kidney injury from chronic kidney disease include anemia and renal size in sonography as chronic kidney disease generally lead to anemia and small renal size.
Acute kidney injury
Acute renal injury (AKI), previously known as acute renal failure (GGA), is a rapidly progressive loss of renal function, commonly characterized by oliguria (decreased urine output, calculated less than 400 mL per day in adults, less than 0, 5 mL/kg/h in children or less than 1 mL/kg/h in infants); and fluid and electrolyte imbalances. AKI can be generated from a variety of causes, generally classified as prerenal , intrinsic , and postrenal . Many patients with paraquat poisoning have AKI, sometimes requiring hemodialysis. The underlying cause should be identified and treated to withstand progress, and dialysis may be necessary to bridge the time gap necessary to treat this underlying cause.
Chronic kidney disease
Chronic kidney disease (CKD) can also develop slowly and, initially, show few symptoms. CKD can be a long-term consequence of acute irreversible disease or part of disease progression.
Acute-to-chronic renal failure
Acute kidney injury may present above chronic kidney disease, a condition called acute-on-chronic renal failure (AoCRF). The acute part of AoCRF may be reversible, and treatment goals, such as MMR, are to return the patient to an initial renal function, usually measured by serum creatinine. Like MMR, AoCRF can be difficult to distinguish from chronic kidney disease if the patient has not been monitored by the doctor and no basic blood work (ie, passing) is available for comparison.
Maps Kidney failure
Signs and symptoms
Symptoms can vary from person to person. A person in early stage kidney disease may not feel pain or notice the symptoms that occur. When the kidneys fail to filter properly, waste builds up in the blood and body, a condition called azotemia. Very low levels of azotaemia may produce few, if any, symptoms. If the disease develops, the symptoms become apparent (if failure is enough to cause symptoms). Kidney failure accompanied by real symptoms is called uraemia.
Symptoms of renal failure include the following:
- High levels of urea in the blood, which can lead to:
- Vomiting or diarrhea (or both) that can cause dehydration
- Nausea
- Weight
- Nighttime urination
- More frequent urination, or more than usual, with pale urine
- More frequent urination, or in smaller amounts than usual, with dark urine
- Blood in the urine
- Pressure, or difficulty urinating
- Unusual amount of urination, usually in large amounts
- The buildup of phosphate in the blood that the kidney pain can not filter can cause:
- Itch
- Bone damage
- Nonunion with broken bone
- Muscle cramps (caused by low calcium levels that can be attributed to hyperphosphatemia)
- The accumulation of potassium in the blood that kidneys can not filter (called hyperkalemia) can cause:
- Abnormal heart rhythm
- muscle paralysis
- Kidney failure to remove excess fluid may cause:
- Swelling of the feet, ankles, feet, face, or hands
- Shortness of breath due to extra fluid in the lungs (may also be caused by anemia)
- Polycystic kidney disease, which causes many fluid-filled cysts in the kidneys and sometimes the liver, can cause:
- Pain in the back or sides
- A healthy kidney produces an erythropoietin hormone that stimulates the bone marrow to make oxygen-carrying red blood cells. When the kidneys fail, they produce less erythropoietin, resulting in a decrease in the production of red blood cells to replace the breakdown of naturally occurring red blood cells. As a result, blood carries less hemoglobin, a condition known as anemia. This can cause:
- Feeling tired or weak
- Memory problem
- Difficulty concentrating
- Dizzy
- Low blood pressure
- Typically, the protein is too large to pass through the kidneys, however, they are able to pass through when the glomeruli are damaged. It does not cause symptoms until extensive kidney damage occurs, after which symptoms include:
- Foaming or bubbly feces
- Swelling in hands, feet, abdomen, or face
- Other symptoms include:
- Loss of appetite, bad taste in mouth
- Difficulty sleeping
- Dark skin
- Excess protein in blood
- With high doses of penicillin, people with kidney failure may experience seizures
Cause
Acute kidney injury
Acute kidney injury (formerly known as acute renal failure) - or AKI - usually occurs when the blood supply to the kidneys is suddenly disturbed or when the kidneys become overloaded with toxins. Causes of acute renal injury include accidents, injuries, or complications of surgery in which the kidneys are deprived of normal blood flow for a long time. Cardiac bypass surgery is an example of one of these procedures.
Drug overdose, accidental or from chemical overuse of drugs such as antibiotics or chemotherapy, may also cause acute kidney injury. Unlike chronic kidney disease, the kidneys can often recover from acute kidney injury, allowing patients to resume normal life. People suffering from acute kidney injuries require supportive care until their kidneys recover, and they often remain at increased risk of developing future kidney failure.
Among the causes of accidental kidney failure is the crush syndrome, when large amounts of toxins are suddenly released in the blood circulation after the long compressed limb is suddenly released from the pressure blocking blood flow through the tissues, causing ischemia. Excess produced can cause kidney blockage and destruction. This is a reperfusion injury that arises after the release of the pressure of destruction. This mechanism is believed to be released into the bloodstream of muscle breaking products - especially myoglobin, potassium, and phosphorus - which is a product of rhabdomyolysis (breakdown of skeletal muscle damaged by ischemic conditions). Specific actions on the kidneys are not fully understood, but may be due to some nephrotoxic metabolites of myoglobin.
Chronic kidney disease
Chronic kidney disease (CKD) has many causes. The most common causes of CKD are diabetes mellitus and long-term uncontrolled hypertension. Polycystic kidney disease is one of the leading causes of CKD. The majority of people with polycystic kidney disease have a family history of the disease. Other genetic diseases also affect kidney function.
Excessive use of common medications such as ibuprofen, and acetaminophen (paracetamol) can also cause chronic kidney disease.
Some infectious disease agents, such as hantavirus, can attack the kidneys, causing kidney failure.
Genetic predisposition
The APOL1 gene has been proposed as a major genetic risk locus for the spectrum of non-dopedic renal failure in African-derived individuals, including HIV-associated nephropathy, primary nonmonogenic forms of segmental focal glomerulosclerosis, and renal disease-related hypertension chronic diseases not associated with any other etiology. Two variants of West Africa in APOL1 have been shown to be associated with late stage kidney disease in African American and Hispanic Americans.
Diagnostic approach
Measurement for CKD
- Stages of kidney failure
Chronic renal failure is measured in five stages, calculated using a patient's GFR, or glomerular filtration rate. Stage 1 CKD slightly decreases kidney function, with some obvious symptoms. Stages 2 and 3 require increased levels of supportive care from their medical providers to slow down and treat their kidney dysfunction. Patients at stages 4 and 5 usually require the preparation of patients towards active treatment for survival. Stage 5 CKD is considered a severe disease and requires some form of renal replacement therapy (dialysis) or kidney transplant whenever possible.
- Glomerular filtration rate
Normal GFR varies according to many factors, including gender, age, body size and ethnic background. Kidney professionals consider glomerular filtration rate (GFR) to be the best overall index of kidney function. The National Kidney Foundation offers an easy-to-use GFR calculator for anyone interested in knowing their glomerular filtration rate. (Serum creatinine levels, simple blood tests, are required to use a calculator.)
Use of the term uremia
Before the advent of modern medicine, kidney failure is often referred to as uremic poisoning. Uremia is a term for blood contamination with urine. This is the presence of excessive amounts of urea in the blood. Beginning around 1847, this included reducing the urine output, which was thought to be caused by mixing urine with blood instead of being removed through the urethra. The term uremia is now used for illnesses that accompany renal failure.
Treatment
Diet
In non-diabetics and people with type 1 diabetes, low-protein diets are found to have a preventive effect on the development of chronic kidney disease. However, this effect does not apply to people with type 2 diabetes. Whole foods, plant-based diets may help some people with kidney disease. High protein diets from either animal or plant sources seem to have a negative effect on renal function at least in the short term.
Slow down
People who receive prior referrals to a nephrology specialist, which means a longer time before they should start dialysis, have shorter hospitalizations and reduce the risk of death after commencement of dialysis. The authors highlight the importance of early referrals in slowing the progression of chronic kidney disease. Other methods of reducing disease progression include minimizing exposure to nephrotoxins such as NSAIDs and intravenous contrast.
References
External links
Source of the article : Wikipedia
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