Chronic Kidney Failure Symptoms
Signs and symptoms of chronic renal failure develop over time if kidney damage
progresses slowly. Signs and symptoms of chronic renal failure/chronic Kidney failure may include:
- Nausea,
- Vomiting,
- Loss of appetite,
- Fatigue and weakness,
- Sleep problems,
- Changes in urine output,
- Decreased mental sharpness,
- Muscle twitches and cramps,
- Hiccups,
- Swelling of feet and ankles,
- Persistent itching,
- Chest pain, if fluid builds up around the lining of the heart,
- Shortness of breath, if fluid builds up in the lungs,
- High blood pressure (hypertension).
Signs and symptoms of kidney disease are often nonspecific; they can also be caused by other illnesses. Because kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
| Mechanism | Description |
|---|---|
| Glomerulosderosis | Progressive, destructive hardening of glomerular capillaries initiated by adaptive changes in the nephrons, which are initially unaffected by a primary disease process. Epithelial and endothelial injury results in proteinuria. Hardening is due to mesangial cell proliferation, increased production of extracellular matrix, and intra glomerular coagulation. |
| Tubulointerstitial injury | Defects in tubular transport function associated with interstitial edema, leukocyte infiltration, and focal tubular necrosis. |
| Vascular injury | Diffuse or focal ischemia of the renal parenchyma associated with thickening, fibrosis, or focal lesions of renal blood vessels. Reduced blood flow may result in tubular atrophy and interstitial fibrosis as well as functional disruption (e.g., reduced glomerular filtration rate, proteinuria, and alteration of the medullary gradient with loss of concentrating ability). |
Tests and Diagnosis Chronic Renal Failure/Chronic Kidney Failure
Blood tests: Kidney function tests look for the level of waste products, such as creatinine and urea in blood. Higher levels of creatinine indicate a lower glomerular filtration rate and as a result a decreased capability of the kidneys to excrete waste products.
Urine tests: Testing of a urine sample shows that the kidney is allowing the loss of protein or red blood cells into the urine. It may reveal abnormalities that point to chronic kidney failure and help to identify the cause of chronic renal failure.
Treatments Chronic Renal Failure/ Chronic Kidney Failure
There are two treatments for kidney failure:
- Dialysis.
- Kidney transplantation
-
1) Dialysis:
Two different types of dialysis can be done.
- Hemodialysis (HD).
- Peritoneal Dialysis (PD).
(i) Hemodialysis Purpose: Hemodialysis cleans and filters blood using a machine to temporarily rid of the body from harmful wastes, extra salt and extra water. Hemodialysis helps to control blood pressure and helps body to keep the proper balance of important chemicals such as potassium, sodium, calcium and bicarbonate. Dialysis can replace part of the function of kidneys. Diet, medications and fluid limits are often needed as well. Diet, fluids, and the number of medications need will depend on treatment.
Hemodialysis Working: Hemodialysis uses a special filter called a dialyzer that functions as an artificial kidney to clean blood. The dialyzer is a canister connected to the hemodialysis machine. During treatment, blood travels through tubes into the dialyzer, which filters out wastes, extra salt and extra water. Then the cleaned blood flows through another set of tubes back into body. The hemodialysis machine monitors blood flow and removes wastes from the dialyzer.
(ii) Peritoneal Dialysis: Peritoneal dialysis is another procedure that removes wastes, chemicals, and extra water from body. This type of dialysis uses the lining of abdomen, or belly, to filter blood. This lining is called the peritoneal membrane and acts as the artificial kidney.
Peritoneal Dialysis Working: A mixture of minerals and sugar dissolved in water, called dialysis solution, travels through a catheter into belly. The sugar (dextrose) draws wastes, chemicals and extra water from the tiny blood vessels in peritoneal membrane into the dialysis solution. After several hours, the used solution is drained from abdomen through the tube, taking the wastes from blood with it. Then abdomen is refilled with fresh dialysis solution, and the cycle is repeated. The process of draining and refilling is called an exchange.
Dialysis is not a cure: Hemodialysis and peritoneal dialysis are treatments that help to replace the work kidneys did. These treatments help to feel better and live longer, but they do not cure kidney failure. Although patients with kidney failure may live longer than ever, over the years kidney disease can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility and malnutrition.
-
2) Kidney Transplant:
A kidney transplant involves surgically placing a healthy kidney from a donor into body. Transplanted patient may need to take medications for the rest of life to keep body from rejecting the new organ.
Treatments and Drugs: Chronic renal failure has no cure. In general, treatment consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If kidneys become severely damaged, may need treatment for end-stage kidney disease.
Treating Complications: Kidney disease complications can be controlled to make more comfortable.
Treatments may include:
High blood pressure medications: People with kidney disease may experience worsening high blood pressure. Recommend medications to lower blood pressure, commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, may need frequent blood tests to monitor condition.
Medications to lower cholesterol levels: Medications (statins) used to lower the cholesterol. People with chronic renal failure often experience high levels of bad
cholesterol, which can increase the risk of heart disease.
Medications to treat anemia: In certain situations, may recommend supplements of the hormone erythropoietin, sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia.
Medications to relieve swelling: People with Chronic renal failure may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Diuretics can help maintain the balance of fluids in body.
Medications to protect bones: Calcium and vitamin D supplements may be useful to prevent weak bones and lower risk of fracture.
| Treatment Mode | Description |
|---|---|
| Conservative Treatment: Protein restriction Tight glycemic control (in diabetics) | Protein intake restricted to 0.6-0.8 g/day. Frequent glucose testing with appropriate dose insulin, divided-oral hypoglycemic therapy, or dietary measures. |
| Angiotensin-converting enzyme inhibitors (e.g., captopril) | Drug therapy to interrupt the renin angiotensin aldosterone system, improving renal blood flow and protecting against hypertensive nephropathy. |
| Diuretics Erythropoietin | Drug therapy to augment sodium and water excretion. Use of recombinant erythropoietin to treat anemia due to defective production of this hormone in renal disease. |
| Low phosphate diet, calcium supplementation, vitamin D | Prevention and treatment of renal osteodystrophy. |
| Renal Replacement Therapy: Hemodialysis | Use of an extracorporeal circuit to create a blood flow rate of 200-400 mL/min through an artificial Kidney (dialyzer). Patient’s blood flows countercurrent to dialysate fluid, with exchange of water and solutes to effect normal fluid and electrolyte balance |
| Peritoneal dialysis | Use of the peritoneal membrane for exchange of water and solute between patient’s blood (in abdominal wall and visceral capillaries) and dialysate instilled into peritoneal cavity. |