Kidney Failure



Introduction

We are surrounded by people who have kidney failure or had died from kidney failure. There are many more people in our society today who rely on dialysis for survival. The kidneys are very important organs in the human body. They are responsible for filtering the blood to get rid of harmful waste products such as urea, excess protein and uric acids from the body. The kidneys do not only filter the blood to get rid of waste products, but they play a key role in balancing the electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells.
 

The kidneys are two bean-shaped organs about five-inches long, three-inches wide and one-inch thick located in your back on each side of your spine. They are situated above your waist, with the left kidney a little higher and a little larger than the right kidney. The two kidney are protected by the lower ribs. Inside the kidneys are tiny units called Nephrons in which filtering of the blood takes place. There are about 1.3 million nephrons in each kidney.

  

What is kidney failure?
Kidney failure occurs when the kidneys are unable to perform their core functions (ie. filter the blood to remove waste materials). In simple terms, we say that the kidneys have stopped working. Kidney failure can either be acute or chronic

  • Acute Kidney Failure: Acute kidney failure occurs when the kidneys suddenly stop working. Acute kidney failure develops rapidly over few hours or few days and it is most common in people who are already hospitalized or those in intensive care units. Acute kidney failure can be fatal and requires immediate care. But it is worth noting that acute kidney failure may be reversible depending on early identification and treatment.
  •  Chronic Kidney Failure: Unlike acute kidney failure, chronic kidney failure is the gradual, progressive and irreversible loss of kidney function in the body. When chronic kidney failure reaches an advanced stage, dangerous waste products accumulate in the blood causing serious health problems.
Causes of kidney failure
     A.     Acute kidney failure
There are many possible causes of acute kidney damage. They include:
     1.      Impaired or decreased blood flow to the kidneys. The decrease in blood flow may occur as a result of any of the following:
  • Severe blood or fluid loss (eg. Bleeding)
  • Severe dehydration
  • Severe burns
  • Certain medications such as Blood pressure medications, and Ibuprofen.
  • Heart attack
  • Infection
  • Liver diseases
  • Severe allergic reaction (anaphylaxis)
     2.      Direct damage to the kidneys. Direct damage to the kidneys may be caused by:
  • Blood clots in the veins and arteries in and around the kidneys
  • Cholesterol deposits that block blood flow in the kidneys
  • Inflammation of the tiny filters in the kidneys (Glomerulonephritis)
  • Premature destruction of red blood cells.
  • Infection
  • Toxins, such as alcohol, heavy metals and cocaine
  • Inflammation of the blood vessels (Vasculitis)
      3.      Blockage of urine in the kidneys: Conditions that block the passage of urine out of the body and can lead to acute kidney failure include the following.
  • Bladder cancer
  • Blood clots in the urinary tract
  • Cervical cancer
  • Colon cancer
  • Enlarged prostate
  • Kidney stones
  • Nerve damage involving the nerves that control the bladder
  • Prostate cancer
     
     B.      Chronic Kidney Failure
Diabetes (high blood sugar) and Hypertension (High blood pressure) are the major causes of chronic kidney failure. Other diseases and conditions that commonly cause chronic kidney disease include the following:
  • Autoimmune disorders (Disorders that cause the body cells to fight and destroy each other. e.g. systemic lupus erythematosus and scleroderma)
  • Birth defects of the kidneys such as polycystic kidney disease
  • Some toxic chemicals like alcohol
  • Injury to the kidney
  • Kidney stones
  • Kidney infections
  • Problems with the arteries feeding the kidneys with blood
  • Some medicines such as pain and cancer drugs
  • Backward flow of urine into the kidneys (reflux nephropathy)
  • Other kidney diseases
  • Prolong obstruction of urine in the body caused by enlarged prostate, kidney stones and some cancers.

 Signs and symptoms
Signs and symptoms of kidney failure are often nonspecific to kidney failure. This is because; other diseases may also cause these signs and symptoms.
     
      A.     Acute kidney failure
  • Decreased urine output, although occasionally urine output remains normal
  • Fluid retention causing swelling in your legs, ankles or feet
  • Drowsiness
  • Shortness of breath
  • Fatigue
  • Confusion
  • Nausea
  • Seizures or coma in severe cases
  • Chest pain or pressure
  • Breath odour and metallic taste in the mouth
  • Changes in mental status or mood
  • Decreased appetite
  • Decreased sensation especially in the hands or feet
  • Flank pain (Pains between the ribs and hips)
  • Hand tremor
  • High blood pressure  
  • Persistent hiccups
  •  Seizures

     B.      Chronic Kidney failure
Because the kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. The Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly.
The early symptoms of Chronic Kidney Disease include:
  • Appetite loss
  • General ill feeling and fatigue
  • Headaches
  • Itching (pruritus) and dry skin
  • Nausea
  • Weight loss without your own efforts to lose weight
Symptoms that may occur when kidney function has gotten worse include:
  • Abnormally dark or light skin
  • High blood pressure that is difficult to control.
  • Bone pain
  • Drowsiness or problems concentrating or thinking
  • Numbness and swelling in the hands and feet
  • Muscle twitching or cramps
  • Breath odour
  • Easy bruising, or blood in the stool
  • Excessive thirst
  • Changes in urine output.
  • Chest pains if the fluid builds up around the lining of the heart.
  • Frequent hiccups
  • Problems with sexual function
  • Menstrual periods stoppage (amenorrhea)
  • Shortness of breath
  • Sleep problems
  • Vomiting which often occurs in the morning 




Treatment
It is very important for all those who experience these symptoms to visit the hospital immediately for assessment and treatment. Treatment of acute and chronic kidney disease is very important for survival. Without treatment, the individual will eventually die. Treatment include Dialysis, Kidney transplant and medications. The appropriate treatment depends the type of kidney failure (Acute or Chronic kidney failure)


Prevention
The following are some of the ways to prevent kidney failure.
  •  It is very important for those who have high blood pressure and diabetes to get adequate treatment because they are at a higher risk of developing kidney failure.
  • Report any changes you see in your urine and urine output to your doctor.
  • Drink more water to prevent dehydration that can cause acute kidney failure.
  • Eating healthy foods such as fresh fruits, fresh vegetables and whole grains. 
  • Reduce intake of fat and dairy foods 
  • Cut back or reduce salt intake 
  • Limiting or avoid alcohol consumption
  • Exercise your body
  • Maintain a healthy weight by losing weight if you are overweight or obese
  • Avoid self-medication (Taking drugs without a prescription from a qualified health professional)
  • Take your medicines as prescribed by a qualified health professional.
  • Quit smoking
  • Visit the hospital regularly for medical check-up.
  • Limit intake of red meat. This is because foods high in protein (especially those with animal protein) may harm the kidneys. Red meat also has in high quantities saturated fat.
  • Reduce sugar intake. Consuming too much sugar can result in diabetes or obesity both of them linked to kidney disease.

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