080 6801 6801
080 6801 6901
Cardiac Sciences
Bone and Joint
Gastrointestinal Sciences
Neurosciences
Renal Sciences
Maa Kauvery (Women and Child Health)
Robotic Surgery
Accident and Emergency Care
Anaesthesiology
Arthroplasty (Joint Replacement Surgeries)
Arthroscopy
Bariatric Surgery
Cardiology
Cardiothoracic and Vascular Surgery
Critical Care and ICU
Dermatology
Diabetes and Endocrinology
ENT
Medical Gastroenterology
General Surgery
Hand Surgery
Monday, 11 November, 2024
Kidney failure, also known as renal failure, is a severe medical condition where the kidneys lose their ability to filter out excess fluid and waste products from the blood. This condition causes harmful waste and fluids in the body, which can have serious adverse effects on health. In addition to removing waste and excess fluids from the body, kidneys are vital for producing red blood cells, balancing electrolytes, controlling blood pressure, and maintaining bone health.
Understanding what is kidney failure and its types, causes, signs, and treatments is crucial for managing this condition effectively. This blog provides a comprehensive overview of kidney failure, including the stages of kidney failure, diagnosis, treatment options, and preventive measures.
What Happens When The Kidneys Fail?
Kidney failure can result in a wide range of symptoms and complications due to the kidneys' inability to filter waste and excess fluid from the blood. Decreased urine output is one of these signs, however it sometimes stays the same. Fluid retention is a common symptom that typically appears as edema, or swelling in the face, ankles, and legs. In extreme circumstances, fluid buildup in the lungs can result in pulmonary edema, which is characterized by shortness of breath and breathing difficulties and calls for prompt medical intervention. Waste materials can accumulate in the blood and cause nausea, vomiting, gastrointestinal distress, and appetite loss.
Another important symptom is fatigue, which is caused by waste and toxins accumulating up in the body and weakening it. The buildup of fluids and salts frequently leads to high blood pressure, which puts additional strain on the cardiovascular system. Additionally, erythropoietin, a hormone that promotes the synthesis of red blood cells, is impaired by kidney failure, worsening fatigue and resulting in anemia. In addition, deficiencies in calcium and phosphorus can cause bone illnesses such as osteodystrophy, which gradually weakens bones. Unbalances in potassium, sodium, and calcium electrolytes can cause major problems, such as heart problems. Lastly, abnormalities in waste products and electrolytes that impact brain function might result in cognitive problems including disorientation or trouble focusing.
Types of Kidney Failure
Acute Kidney Failure
First let's understand what is acute renal failure? Acute kidney injury is characterized by an abrupt and frequently reversible loss of kidney function. This type of kidney failure may develop quickly, often in a matter of hours or days, and is often caused by an acute occurrence. Some most common causes of acute kidney failure include:
Severe Dehydration
Acute kidney damage can result from dehydration brought on by vomiting, diarrhea, or profuse perspiration
Infections
Sepsis and other severe infections can harm and compromise the kidneys' ability to function.
Urinary Tract Obstruction
Kidney damage can result from obstructions in the urinary tract that limit urine flow, such as kidney stones or an enlarged prostate.
Nephrotoxic Medications
Certain medications, particularly those that are toxic to the kidneys, can lead to acute renal failure.
What are the first signs of kidney failure?
In acute cases, the signs can be sudden and severe, including reduced urine output, swelling, confusion, and rapid accumulation of waste products in the blood. Prompt treatment is essential to address the underlying cause and prevent further damage.
Chronic Kidney Failure
Wondering what is chronic renal failure? Chronic kidney failure, or chronic kidney disease (CKD), develops gradually over time, often due to long-term conditions such as diabetes or high blood pressure. Unlike acute kidney failure, chronic kidney failure progresses slowly and may result in irreversible kidney damage. Key causes of chronic kidney failure include:
Diabetes
High blood sugar levels damage the blood vessels in the kidneys, impairing their ability to filter waste and leading to chronic kidney disease.
High Blood Pressure
Chronic hypertension can damage the blood vessels in the kidneys, reducing their filtering capacity.
Glomerulonephritis
Inflammation of the kidneys' filtering units, known as glomeruli, can result from infections or autoimmune conditions, leading to chronic kidney damage.
Polycystic Kidney Disease
This genetic disorder causes the formation of multiple cysts in the kidneys, impairing their function over time.
Renal Kidney Failure
Now let’s understand what is renal kidney failure? This refers to kidney dysfunction caused by internal damage to the kidneys. This type of kidney failure can result from various conditions, including:
Chronic Infections
Persistent infections can damage kidney tissue and impair function.
Autoimmune Diseases
Conditions such as lupus or vasculitis can cause inflammation and damage to the kidneys.
Genetic Conditions
Genetic disorders like polycystic kidney disease can lead to renal failure by causing structural abnormalities in the kidneys.
Treatment for renal kidney failure may include medications to manage symptoms, lifestyle changes, and in severe cases, dialysis or surgical interventions to restore kidney function.
What causes kidney failure?
Understanding the causes of kidney failure is crucial for both prevention and treatment. Kidney failure can result from a range of factors such as:
Pre-renal
Anything that affects the blood supply to the kidney causes kidney failure. Most common example is in cases of severe Dehydration that is caused by prolonged vomiting, diarrhea, or excessive sweating, which causes the body to lose a substantial amount of fluid.
Renal
A host of insults can cause damage to the kidney itself. For example, infections and sepsis, can damage and cause inflammation the kidneys, Nephrotoxic Medications include some antibiotics, contrast material and over-the-counter painkillers. Even inside the kidney, various insults affect different parts of the kidney like the glomerulus (the filter), the interstitial tissue (the supporting structures), vessels or the tubules.
Post renal
Anything that impedes the flow of urine out of the kidney and causes urinary tract obstructions, thus causing back-pressure and hence damage to the kidney. The most common cause are kidney stones or an enlarged prostate.
By understanding these causes, you can take preventive measures and seek appropriate treatment from nephrologists in Bangalore to manage or potentially prevent kidney failure."
Symptoms of Kidney Failure
Recognizing the symptoms of kidney failure is crucial for early diagnosis and treatment. Common symptoms include:
Decreased Urine Output:
Although urine output may remain unchanged in some cases, a significant reduction in urine production can indicate kidney failure.
Edema (Swelling):
Legs, ankles, and face swelling are caused due to fluid retention. This occurs because the kidneys are unable to efficiently eliminate extra fluid.
Pulmonary Edema:
Trouble with breathing and shortness of breath may result from a build-up of fluid in the lungs. This is a serious condition that has to be treated immediately.
Nausea and Vomiting:
Waste products building up in the blood can lead to nausea and vomiting leading to poor appetite.
Fatigue:
The build-up of toxins and waste products contributes to persistent tiredness and weakness, impacting overall energy levels and quality of life.
High Blood Pressure:
Accumulation of salt and fluids can elevate blood pressure, exacerbating the cardiovascular system's strain.
Anemia:
Impaired kidney function reduces the production of erythropoietin, a hormone that stimulates red blood cell production, leading to anemia.
Bone Disease:
Calcium and phosphorus imbalances can cause bone problems including osteodystrophy, which can impair the health and strength of bones.
Electrolyte Imbalances:
Electrolyte imbalances, specifically those involving potassium, sodium, and calcium, can lead to serious health issues, including cardiac difficulties.
Confusion or Difficulty Concentrating:
Imbalances in electrolytes and waste products can affect cognitive function, leading to confusion or difficulty concentrating.
Symptoms of poor kidney function in the elderly might include increased confusion, difficulty managing daily tasks, and changes in appetite or weight. Recognizing these symptoms early can lead to timely intervention and improved outcomes.
What Are The Stages Of Kidney Failure?
Chronic kidney failure progresses through five stages and this is done by the estimated glomerular filtration rate (eGFR), i.e. an estimation of how well the kidney's filtration process is working and albuminuria or how much protein is leaking in the urine. This helps us understand the chronic kidney failure stages each indicating the severity of the condition and guiding treatment strategies.
Normally it is at 100, and if its value is 0, then this indicates that the kidneys have completely shut down.
Stage 1: Kidney Damage with Normal GFR
Mild kidney damage with a glomerular filtration rate (GFR) of 90 or higher. At this stage, kidney function is still relatively normal, but there is evidence of kidney damage.
Symptoms:
Often minimal or absent. Patients may not experience noticeable symptoms.
Management:
Lifestyle changes, such as adopting a healthy diet and regular exercise, and regular monitoring of kidney function.
Stage 2: Mild Kidney Damage with Reduced GFR
The GFR ranges between 60-89. Kidney damage is present with a slight reduction in kidney function.
Symptoms:
May include mild fatigue and slight swelling. Symptoms are often subtle and may not be immediately recognized.
Management:
Controlling underlying conditions, such as diabetes or hypertension, and monitoring kidney function regularly.
Stage 3: Moderate Kidney Damage
The GFR ranges between 30-59. Kidney function is significantly impaired, and damage is more pronounced.
Symptoms:
Noticeable symptoms may include swelling, fatigue, changes in urine output, and difficulty concentrating.
Management:
Close monitoring by a healthcare provider, medical intervention to manage symptoms, and lifestyle adjustments to slow disease progression.
Stage 4: Severe Kidney Damage
The GFR ranges between 15-29. Severe damage to the kidneys with a significant reduction in function.
Symptoms:
Severe fatigue, swelling, difficulty concentrating, and other symptoms of kidney failure. Patients may experience more pronounced health issues.
Management:
Preparation for dialysis or a kidney transplant, along with continued management of underlying conditions.
Stage 5: End-Stage Renal Disease (ESRD)
The GFR ranges below 15. This is the final stage of kidney failure, where kidney function is critically low.
Symptoms:
Severe symptoms, including persistent swelling, difficulty breathing, and other complications. Immediate medical intervention is required.
Management:
Dialysis or kidney transplantation is necessary for survival.
End stage renal failure symptoms before death can be severe and may include significant changes in consciousness, severe fluid retention, and multi-organ failure.
Kidney Failure Diagnosis
Diagnosing kidney failure involves a series of tests to assess the kidney’s function and detect any damage. The following diagnostic methods are commonly used:
Blood Tests:
Blood tests measure levels of waste products such as creatinine and blood urea nitrogen (BUN). Elevated levels of these substances may indicate impaired kidney function.
- Blood Urea Nitrogen (BUN): Measures the amount of nitrogen in your blood derived from protein breakdown.
- Serum Creatinine: Detects the accumulation of creatinine, a waste product from muscle metabolism.
Creatinine is measured in milligrams per deciliter (mg/dL). Here are the normal values by gender:
0.7 to 1.3 mg/dL for adult males
0.5 to 1.1 mg/dL for adult females
Estimated Glomerular Filtration Rate (eGFR): Estimates how well your kidneys filter waste, calculated based on creatinine levels, age and race.
Urine Tests:
Urine tests help identify abnormalities such as protein or blood in the urine, which can signal kidney damage.
- Urinalysis:Evaluates urine for the presence of blood, proteins, casts and other abnormalities
- Protein quantification: Estimates the level of protein leak in the urine. This can be done on a spot urine sample using protein to creatinine ratio or can be estimated by 24 hour urine collection.
Imaging Tests:
Imaging techniques such as ultrasound, CT scans, or MRI assess the size and structure of the kidneys. These tests can identify structural abnormalities, obstructions, or changes in kidney size that may indicate chronic kidney disease or other conditions.
Kidney Biopsy:
A kidney biopsy involves collecting a small sample of kidney tissue to be examined under a microscope. This test helps determine the underlying cause of kidney failure, such as glomerulonephritis, infections, or other kidney conditions.
Treatment for Kidney Failure
Treatment for kidney failure depends on the cause and stage of the condition. Management strategies include:
Acute Kidney Failure
Management: Treatment focuses on addressing the underlying cause of acute kidney failure. This may include:
- Rehydration: Administering fluids to restore hydration and improve blood flow to the kidneys.
- Discontinuing Nephrotoxic Drugs: Stopping medications that may have contributed to kidney damage.
- Relieving Obstructions: Removing or treating obstructions in the urinary tract to restore normal urine flow.
Recovery: Acute kidney failure is often reversible with prompt and appropriate treatment. Once the underlying cause is addressed, kidney function may return to normal.
Chronic Kidney Disease (CKD)
Management: Effective management of chronic kidney disease involves controlling underlying conditions, such as diabetes and high blood pressure. Treatment options include:
- Controlling Blood Sugar and Blood Pressure: Keeping blood sugar and blood pressure levels within target ranges to prevent further kidney damage.
- Adhering to a Kidney-Friendly Diet: Following a diet low in sodium, potassium, and phosphorus to reduce the strain on the kidneys.
- Avoiding Nephrotoxic Medications: Limiting the use of medications that can harm the kidneys.
Treatment Options:
- Dialysis: A treatment that filters and purifies the blood using a machine. Dialysis can be a temporary measure for acute kidney failure or a long-term treatment for chronic kidney failure.Life expectancy on dialysis varies based on individual health conditions, but dialysis can significantly extend life and improve quality of life for patients with end-stage renal disease.
- Kidney Transplant: A surgical procedure in which a healthy kidney from a donor is placed into the recipient's body. A kidney transplant is the best option for advanced chronic kidney disease and can provide a better quality of life.
Conclusion
Outcomes can be significantly improved by recognizing the early signs of kidney failure and seeking timely treatment from a Bangalore nephrology center. Maintaining a healthy lifestyle and routine monitoring can help stop the disease from getting worse for individuals who are at risk. staying aware about the cause and stages of kidney failure enables people to take control of their health. Maintaining kidney health and general well-being requires routine examinations and honest communication with healthcare providers.
Planning ahead for dialysis patients may include knowing how their treatment may affect their life expectancy and looking into alternatives like kidney transplants. Effective kidney failure management requires early discovery, proactive management, and adherence to recommendations for treatment. Patients can manage the complexity of their condition by following these steps and achieving the best possible outcomes.
FAQ’S
What happens if one kidney fails?
Most people who have one kidney can live a healthy life without any major problems. The remaining kidney can often compensate for the missing kidney.
What organs are affected by kidney failure?
Kidney Failure can affect many organs in the body including the heart, brain,lungs,liver & intestines.
What is the life expectancy of a person with kidney disease?
A person's life expectancy with kidney disease depends on a number of factors, including their age, sex, stage of kidney disease, and whether they receive dialysis or a kidney transplant:
- Without dialysis or a kidney transplant, a person may only survive a few days or weeks.
- Someone on dialysis is five to 10 years, but some people can live up to 30 years.
- The average life expectancy for someone who receives a kidney from a living donor is 12 to 20 years, while the average for a kidney from a deceased donor is eight to 12 years.
What are the five early warning signs of kidney failure?
Some early warning signs of kidney failure include:
- Urinary issues
- Itchy skin
- Swelling around your hands, ankles, or face
- Cramps (muscle spasms)
- Poor appetite or food may taste metallic
Consultant Nephrologist and Transplant physician
MBBS, MD, DrNB(Nephrology)
