What is kidney failure?
The main function of the kidneys is to remove excess fluid and waste from the blood. When the kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in the body, leading to a condition known as “kidney failure” or “kidney failure.” This can be due to a variety of factors, including infections, autoimmune diseases, diabetes mellitus, high blood pressure and kidney stones. Kidney failure usually occurs late in the course of the disease.Once kidney failure occurs, immediate treatment is required, and even then the prognosis is often unsatisfactory unless a kidney transplant is performed. That's why it's important for people at risk to know the symptoms, diagnosis and treatment of kidney failure.
Types of Kidney Failure
There are two main types of kidney failure: acute kidney injury (AKI) and chronic kidney disease (CKD). Each of these types can be classified based on their causes and characteristics.
Acute kidney failure (AKF)
Acute kidney failure is a sudden and often reversible loss of kidney function that occurs over a short period of time, usually hours to days.It can be caused by several factors, including:
Prerenal AKF: This type is caused by problems that affect blood flow to the kidneys, such as: B. severe dehydration, low blood pressure or heart problems.
Intrarenal AKF: This type results from damage to the kidney tissue itself, often due to conditions such as acute glomerulonephritis, kidney infections, or toxic substances (e.g., medications, contrast media).
Postrenal AKF: Postrenal AKF occurs when there is a blockage in the urinary tract that prevents the flow of urine from the kidneys.This can be due to conditions such as kidney stones, tumors or an enlarged prostate.
Chronic kidney disease (CKD)
Chronic kidney disease is a chronic disease characterized by the gradual loss of kidney function over months or years. It is usually caused by underlying health conditions or factors that damage the kidneys over time. CKD is classified according to the severity of kidney damage: stage 1 is mild and stage 5 is end-stage renal disease (ESRD). The most common causes of CKD include:
Diabetes: High blood sugar levels can damage the small blood vessels in the kidneys over time.Hypertension (high blood pressure): Prolonged high blood pressure can strain the blood vessels in the kidneys and cause kidney damage.
Glomerulonephritis: Inflammation of the filtering units of the kidney (glomeruli) can be caused by infections or immune system disorders.
Polycystic kidney disease (PKD): A genetic disorder characterized by the growth of cysts in the kidneys, leading to enlargement and loss of function of the kidneys.
End-stage renal disease (ESRD)
ESRD is the end stage of chronic kidney disease when kidney function has deteriorated to the point where the kidneys barely function or no longer function at all. Patients with ESRD require continuous dialysis or a kidney transplant to stay alive.
Nephrotic syndrome
Nephrotic syndrome is a condition characterized by excessive leakage of protein into the urine (proteinuria), low levels of protein in the blood, high cholesterol, and swelling (edema). It can be a result of various kidney diseases, including glomerulonephritis and diabetic nephropathy
Hemolytic uremic syndrome (HUS)
HUS is a rare disease that can cause acute kidney injury. It often follows an infection, such as an E. coli infection, and can cause a variety of symptoms, including kidney failure.Obstructive Uropathy
Obstructive uropathy is a blockage of the urinary tract that can lead to kidney damage and potentially kidney failure. Causes include kidney stones, tumours, and congenital abnormalities.
These are the main types of kidney failure, each with its own causes, characteristics, and treatment approaches. Early detection and management of kidney disease can help prevent.
Symptoms Of Kidney Failure
Whether acute or chronic kidney failure presents a spectrum of symptoms, varying in onset and severity. Common symptoms encompass:
Reduced Urine Output: A significant decrease in the urine volume produced could indicate kidney issues.This symptom may be accompanied by urine that is darker than usual.
Generalized swelling of the body: This condition, known as edema, results from excessive fluid accumulation due to impaired kidney function. There is often significant swelling on the hands, feet, face or stomach.
Blood in the urine: If there is kidney damage, hematuria or blood in the urine may occur.
Increased tiredness and fatigue: Kidney problems can cause a buildup of waste products in the blood, leading to tiredness and weakness.Nocturia (increased urination at night): Frequent urination at night, known as nocturia, can disrupt sleep and may be related to kidney problems.
Vomiting, edema and high blood pressure: Severe kidney problems can cause complications such as vomiting, worsening edema (swelling) and high blood pressure. These symptoms require immediate medical attention.
Loss of appetite: Kidney problems can affect appetite and lead to a lack of interest in food, which contributes to weight loss.
Causes of Kidney Failure
Kidney failure, a critical medical condition, can be caused by a variety of factors.However, several other factors can contribute to this condition, putting individuals at risk.
Diabetes: This is the most prevalent cause of kidney failure.
High Blood Pressure: Often referred to as hypertension, high blood pressure is the second leading cause of kidney failure.
Autoimmune Diseases: Conditions like lupus and IgA nephropathy can damage kidneys.
Genetic Diseases: Genetic disorders inherited from one or both parents, like polycystic kidney disease, can result in kidney failure.Nephrotic syndrome: This condition can also lead to kidney problems.
Urinary tract problems: Problems in the urinary tract, including kidney stones, can affect kidney function.
Smoking: Tobacco smoking is a lifestyle factor that can worsen kidney damage.
Diagnosis of Kidney Failure
Diagnosis of kidney failure, whether acute kidney failure (AKF) or chronic kidney disease (CKD), requires a combination of medical examinations and tests. Below is an overview of the diagnostic process:
History and physical examination: A healthcare provider begins the diagnostic process by taking a detailed medical history from the patient. This includes inquiries about any previous illnesses, medications the patient is taking, the patient's family history and any symptoms the patient may have. A thorough physical examination is then performed to look for signs of kidney disease in the patient, such as swelling, hypertension (high blood pressure), and fluid retention.
Blood tests: Blood tests are essential to assess kidney function. Blood tests commonly performed include:
Serum creatinine: Elevated levels may indicate kidney failure.Blood urea nitrogen (BUN): Elevated levels may indicate kidney dysfunction.
Glomerular Filtration Rate (eGFR): This is a calculation based on creatinine levels that provides an estimate of kidney function.
Complete blood count (CBC): This test looks for anemia, which may be associated with kidney disease.
Electrolyte levels: Imbalances can occur due to kidney dysfunction.
Urine Tests: Urine tests are used to assess kidney function and detect any abnormalities.Common urine tests include:
Urinalysis: This test detects the presence of blood, protein or other substances in the urine. Urine albumin creatinine ratio (ACR) of : The amount of albumin (a type of protein) in urine may indicate kidney damage.
Imaging Studies: Imaging studies such as ultrasounds, CT scans, or MRIs may be used to visualize the kidneys and detect structural abnormalities, tumors, or blockages.
Kidney biopsy: In certain cases, when the cause of kidney disease is unclear or a more detailed examination of the kidney tissue is required, a kidney biopsy may be recommended. It is important to note that this procedure is relatively invasive and is usually only performed in certain cases.Additional tests: Depending on the suspected cause of kidney disease, your doctor may consider other special tests, such as: B. Autoimmune antibody tests or genetic tests.
Treatment of kidney failure
Treatment of kidney/kidney failure depends on whether it is acute kidney injury (AKI) or chronic kidney disease (CKD) and the underlying cause. These are the main approaches to treating kidney disease:
Treating acute kidney failure
Treating the underlying cause: The main focus in AKF is identifying and treating the underlying cause. This may include stopping kidney-damaging medications, treating infections, or clearing urinary tract blockages.
Fluid and Electrolyte Balance: Managing fluid and electrolyte imbalances is critical.This often requires adjusting fluid intake, monitoring electrolyte levels, and administering intravenous (IV) fluids as needed.
Medication: Depending on the specific cause and symptoms, medications may be prescribed. For example, diuretics may help remove excess fluid, and medications may be needed to control blood pressure or treat infections.
Dialysis: In severe cases, particularly if the kidneys are not functioning, hemodialysis or peritoneal dialysis may also be required temporarily to remove waste products and excess fluid from the blood.
Blood pressure control: High blood pressure (hypertension) is common in chronic kidney disease and should be well controlled. Medication and lifestyle changes are often used to control blood pressure.
Manage Medication: Depending on the stage of chronic kidney disease and specific complications, various medications may be prescribed. These may include medications to control anemia, control calcium and phosphate levels, and protect the kidneys.
Diet Changes: A registered dietitian can work with people to create a kidney-friendly eating plan that addresses their dietary needs and restrictions.Dialysis: In advanced stages of chronic kidney disease, when kidney function is minimal or no longer functioning, dialysis (hemodialysis or peritoneal dialysis) may be necessary for long-term treatment.
Kidney Transplant: Kidney transplant is a viable option for eligible patients. A healthy kidney from a living or deceased donor replaces the defective kidney and offers the opportunity to lead a near-normal life.
Recovery from Kidney Failure
Recovery from kidney failure depends on several factors including the type, underlying cause and choice of a kidney hospital in Delhi or elsewhere. Acute kidney failure (AKI) often offers a good chance of recovery if treated promptly.In contrast, chronic kidney disease (CKD) is generally considered irreversible, but early interventions and lifestyle adjustments can slow its progression and lead to a better quality of life.
What is Chronic Kidney Disease (CKD)?
Life expectancy after kidney failure
The life expectancy of people with kidney failure, also known as end-stage renal disease (ESRD), is influenced by several factors. This includes age, general health, access to healthcare and available treatment options.
Reducing the Risk of Kidney Disease
To prevent kidney failure or reduce the risk of kidney disease, you must adopt a healthy lifestyle and treat underlying medical conditions.Here are some important preventive measures:
Control high blood pressure: Monitor and control hypertension (high blood pressure) through medications, dietary changes (e.g., low-sodium diet), exercise, and stress reduction techniques.
Pay attention to a healthy diet: Eat a balanced diet rich in fruit, vegetables, whole grain products and lean protein. Limit salt, saturated fat and processed foods.Monitor phosphorus and potassium intake if a person has kidney disease.
Stay hydrated: Drink an adequate amount of water daily to keep your kidneys adequately hydrated. For individual recommendations, consult a doctor.
Exercise regularly: Exercise regularly to maintain a healthy weight and improve overall cardiovascular health.
Administer medication: Take prescribed medications as directed and discuss possible side effects on the kidneys with your doctor.Avoid over-the-counter pain medications such as NSAIDs if they are not recommended for a person.
Maintain a healthy weight: Achieve and maintain a healthy body weight through diet and exercise. Obesity can increase your risk of kidney disease.
Avoid dehydration: Stay hydrated by drinking enough fluids, especially in hot weather or during physical activity.
Limit exposure to toxins: Minimize exposure to environmental toxins, chemicals and heavy metals that can damage kidney function.Kidney screening: If a person has risk factors or has a family history of kidney disease, consider screening for kidney function, including blood pressure checks and urine protein tests.
Conclusion:
Kidney disease and kidney failure are a major health challenge across the world, including in India. While the exact numbers may vary, it is estimated that between 17 and 20% of the Indian population suffers from kidney disease. This frightening statistic is attributed to the rising incidence of non-communicable diseases such as diabetes and high blood pressure, both of which are potential harbingers of kidney problems. That is why it is extremely important to see an experienced kidney specialist if any of the symptoms mentioned in the article persist.