|
Chronic renal failure Causes and Risks:
Unlike acute renal failure with its sudden reversible failure of kidney function, chronic renal failure is slowly progressive. It most often results from any disease that causes gradual destruction of the kidneys. It can range from mild dysfunction to severe kidney failure . Progression may continue to end-stage renal disease . Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly destroyed. In the early stages, there may be no symptoms. In fact, progression may be so gradual that symptoms do not occur until kidney function is less than one-tenth of normal.
Chronic renal failure occurs in approximately 2 out of 10,000 people. Causative diseases include glomerulonephritis of any type (one of the most common causes), polycystic kidney disease , hypertension , Alport syndrome , reflux nephropathy , obstructive uropathy , kidney stones and infection, and analgesic nephropathy . Diabetes mellitus is a major cause of chronic renal failure.
Chronic renal failure results in the accumulation of fluid and waste products in the body, causing azotemia and uremia . Azotemia is the build-up of nitrogen waste products in the blood. It may occur without symptoms. Uremia is the state of ill health resulting from renal failure . Most body systems are affected by chronic renal failure. Fluid retention and uremia can cause many complications (see Complications).
Prevention:
Treatment of the underlying disorders may help prevent or delay development of chronic renal failure. Diabetics should control blood sugar and blood pressure closely and should refrain from smoking .
Symptoms:
INITIAL SYMPTOMS (may be nonspecific)
LATER SYMPTOMS Additional symptoms that may be associated with this disease:
Signs and Tests:
Blood pressure may be high, with mild to severe hypertension . A neurologic examination may show polyneuropathy. Abnormal heart or lung sounds may be heard with a stethoscope.
A urinalysis may show protein or other abnormalities. An abnormal urinalysis may occur 6 months to 10 or more years before symptoms appear.
Changes that indicate chronic renal failure, including both kidneys being smaller than normal, may be seen on: This disease may also alter the results of the following tests:
Treatment:
Treatment focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.
Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension , congestive heart failure , urinary tract infections , kidney stones , obstructions of the urinary tract, glomerulonephritis , and other disorders should be treated as appropriate.
Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia .
Fluid intake may be restricted, often to an amount equal to the volume of urine produced. Dietary restrictions may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea & vomiting . The amount of protein in diet is often low, with high carbohydrates levels to make up calories. Salt, potassium, phosphorus, and other electrolytes may be restricted.
Dialysis or kidney transplant may be required eventually.
Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See kidney disease - support group .
Prognosis:
There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease . Lifelong treatment may control the symptoms of chronic renal failure.
Complications:
Call Your Healthcare Provider:
Call your health care provider if nausea or vomiting persists for more than 2 weeks.
Call your health care provider if decreased urine output or other symptoms of chronic renal failure occur.
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production. The gross anatomical structure of the kidney is illustrated.
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
White nail syndrome may also be called leukonychia. Leukonychia can occur with arsenic poisoning, heart disease, renal failure, pneumonia, or hypoalbuminuria.
|
