Kidney Failure

Kidneys are a pair of organs located at the lower back of the human body. Each kidney is about 11 centimeters in length. They are helpful in passing the waste from the body as urine. They also filter blood before sending it back to the heart. They remove all toxins from the body and send them to the bladder which can be later removed during urination. Kidneys perform some vital functions like maintaining overall fluid balance, filtration of waste material and toxic substances from the body, creation of hormones that help produce red blood cells and regulates blood pressure.

What is kidney failure?

Kidney failure is a medical condition in which the kidneys no longer function. They lose the ability to filter the blood and do not remove waste products from the blood in such a condition. It affects the overall balance of salt and water in the body. If kidney failure is severe, the production of urine becomes less or stops completely. This leads to accumulation of toxins and waste material in the body.

Types of kidney failure

Kidney failures can be divided into three major categories.

Acute renal failure

It is a condition in which the kidneys stop functioning rapidly. They do not take a long time period and get affected suddenly. There can be various reasons behind it like certain medication, sudden illness or a certain medical condition.

Chronic kidney disease

In chronic kidney failure, kidney failure develops gradually over a period of months or years. It can happen due to many reasons like diabetes, high blood pressure or kidney inflammation. It can also happen due to consumption of a certain drug which affects kidney for a long time.

End-stage kidney disease

This is the final stage of kidney disease when dialysis or kidney transplant is the only option to save a person's life. It usually occurs in people with a longstanding chronic disease.

The symptoms of kidney failure depend on the severity of the disease. A person with kidney failure may experience the following symptoms:

Symptoms of acute kidney failure include:

• High blood pressure
• Nausea and vomiting
• A rapid decrease in urination
• Swelling of ankle and feet because of salt and water overload
• Lethargy or drowsiness because of the accumulation of toxins or waste products in the body, which further affects the brain function

Symptoms of chronic kidney failure include:

• Unintended weight loss
• Loss of appetite
• Continuous feeling of illness or tiredness
• Itching and dry skin
• Nausea and vomiting
• Change of skin colour

Symptoms of the brain and nervous system include

• Difficulty in concentration or thinking
• Numbness in the hands, feet or other areas
• Feeling drowsy or confused
• Muscle twitching or cramps
• Decreased alertness or mental sharpness
• Swelling of feet and ankle
• Nausea and vomiting mostly in the morning
• Changes in urine

Doctors perform a series of tests and procedures for proper diagnosis of kidney failure. Kidney diseases are sometimes diagnosed accidentally during routine blood and urine tests. The tests and procedures are often advised when a person notices any abnormal kidney function. Doctors try to diagnose the disease at an early stage just after a few signs and symptoms so that it can be cured on time. Following test are conducted to detect kidney failure:

Urine tests 

Urine tests are done to detect kidney failure. The test includes measurement of protein, the presence of abnormal cells or measurement of the concentration of electrolytes in urine. Protein is not present in the urine. If the urine contains protein, it hints that the kidneys are not functioning properly. Presence of other things is also monitored like casts (abnormal aggregations of red and white blood cells) in the urine.

Blood test

Blood tests are helpful in measuring the level of waste products in the blood which is removed by the kidneys such as creatinine and urea. A rapid rise in these levels may indicate acute kidney failure. 

Imaging

If signs and symptoms of kidney failure are clearly visible then the doctor will recommend imaging tests such as ultrasound, MRI scan or CT scan to study the kidney structure and size.

Ultrasound

Ultrasound uses high-frequency sound waves to obtain information about structures inside the body. The radiologist can easily differentiate between a normal and abnormal kidney and other problems with the help of the picture. It can also show the presence of stones, scars in kidney and many other abnormalities. In people with advanced kidney disease, the kidneys are shrunken and may have an uneven shape.

MRI and CT scan

These scans provide visual details of the particular body part that is being examined. It can show smaller lesions and other pathologies in the kidney as compared with ultrasound.

Kidney biopsy

In this test sample of kidney tissue is taken for testing. A thin needle is inserted into the skin and into the kidney to extract the tissue. The tissue sample is examined to determine the cause as well as the severity of the disease.

Treatment of kidney failure depends on the cause as well as the severity of the disease. The doctor will determine the best treatment option after the full investigation of the case. Kidney failure treatment options include:

Dialysis

Dialysis is a process in which a machine performs the function of the kidneys. The machine filters and purifies the blood. It can be done in two ways, the patients may be connected to a large machine or can be given a portable catheter bag.

Kidney transplant

When the kidneys are completely damaged and they do not function at all, kidney transplant is advised in such cases. But the patient needs to search for a donor which may take time. After kidney transplant, the new kidney works well but it may be unsuccessful in some cases. After the surgery, the patient has to take immunosupportive drugs. The patient will no longer require dialysis. 

Treatments for complications of kidney failure

Doctors prescribe various medications to treat all possible complications of kidney failure. Treatments may include:

Medications to control high blood pressure

High blood pressure is a common complication of chronic kidney failure. If the patients suffer from high blood pressure, medications are given to lower the blood pressure level. The commonly prescribed medications include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. Both these drugs help to preserve kidney function.

Treatment to lower cholesterol levels

Medications are given to lower the levels of bad cholesterol. Levels of bad cholesterol are often high in people with chronic kidney failure, which can increase the risk of heart disease.

Treatment of swelling

In the advanced stages of kidney failure, the patient may retain fluids, which can lead to swelling in the arms and legs and high blood pressure. Medications are given to increase urination which will help in maintaining the balance of fluids in the body.

Protection of bones

Chronic kidney diseases can lead to weakening of bones. Calcium and vitamin D supplements are given in chronic kidney disease to prevent weak bones and lower the risk of fracture.

Complete cure of chronic kidney disease is not possible. The progression of the disease can be prevented with proper medical care and treatment. Following measures can prevent and slow further damage to the kidneys:

Take medicines carefully

Kidney patients should take medicines prescribed by the doctor only. They should be very careful before taking any other medicine, especially nephrotoxic drugs. High doses can increase the level of toxins in the body, which will affect the kidneys. The medicines prescribed by the doctor to control blood pressure and to protect the kidney should be taken regularly.

Adopt a healthy lifestyle

Diet of kidney patients must include foods which promote kidney health. A low protein diet is recommended to kidney patients because foods rich in protein produce waste material that the kidneys must filter. So to reduce the work of kidneys a low protein diet is recommended. Some foods which are good for the kidneys are- cauliflower, blueberries, egg whites, red grapes, garlic, olive oil, cranberries, and pineapple. Along with a healthy diet smoking and alcohol should be avoided.

Get screened regularly

A person with kidney disease should get screened annually. This will help to diagnose the progress of the disease as well as the results of the treatment. It will help the doctor to treat the patient before the occurrence of any irreversible damage.