Chronic Renal Failure
What is it?
Chronic renal failure is a condition in which kidney
function gradually declines, until the kidneys are unable
to filter wastes from the body, maintain the proper
balance of water and chemicals such as sodium and
potassium in the bloodstream, or produce urine.
Who gets it?
Chronic renal failure can occur in anyone with an
illness or injury that affects the kidneys. It is more
likely to affect people who are middle-aged and older.
What causes it?
The most common causes of chronic renal failure are
diseases or illnesses that damage the kidneys little by
little for many years. These include high blood pressure,
diabetes mellitus, polycystic kidney disease, obstructions
of the urinary tract, glomerulonephritis, certain cancers,
autoimmune disorders such as systemic lupus erythematosus,
and diseases of the heart or lungs. Using painkilling
medications for a long period time may also damage the
kidneys and cause chronic renal failure.
What are the symptoms?
Because chronic renal failure progresses gradually,
symptoms may be so mild that the patient doesn’t recognize
that he or she has a serious health problem. At first,
symptoms include frequent urination, especially at night.
The urine is dilute, which means it has a high water
content, making it appear pale to clear in color. As the
kidneys fail, waste products and fluids build up in the
bloodstream. The excess fluid causes swelling (edema),
usually in the hands, feet, face, and abdomen. The extra
fluid also causes the blood pressure to rise. Other
symptoms may include nausea, fatigue, confusion, foul
smelling breath, joint pain, reduced urination, blood in
the urine, seizures, headaches, itching, pain in the
kidney area, and a yellowish-brown appearance to the skin.
Chronic renal failure can lead to coma and death.
How is it diagnosed?
To diagnose chronic renal failure, your doctor will
review your medical history and symptoms to determine the
cause of your condition. He or she will perform a thorough
physical examination, checking specifically for any
enlargement or tenderness in the kidney area. You may be
referred to a nephrologist, who specializes in kidney
function. Your doctor will order blood and urine tests to
check levels of waste products, sodium, and potassium in
your bloodstream and urine. Levels of waste products
called creatinine and urea will be high in patients with
renal failure. He or she will check your bladder and may
need to insert a tube, called a catheter, into the bladder
to remove urine. Your doctor will also order ultrasound,
computed tomography (CT), or magnetic resonance imaging (MRI)
scans, which produce a picture of the kidneys and
surrounding structures. In some cases, a biopsy is
necessary. In this procedure, a small sample of kidney
tissue is removed for examination under a microscope.
What is the treatment?
Treatment for chronic renal failure depends upon the
cause. While treating any underlying disease may relieve
some of the strain on the kidneys, your doctor will also
recommend changes in your diet that will help prevent your
condition from becoming progressively worse. For example,
you may need to decrease your intake of sodium, potassium,
proteins, and fluids. You may need to take medications to
treat high blood pressure, anemia, or high cholesterol.
All patients in kidney failure are monitored for intake
and output of fluids so treatment and medications can be
adjusted as necessary. In severe cases, patients will need
dialysis, a procedure in which waste products are filtered
from the blood for the kidneys, or a kidney transplant.
Self-care tips
If you are at risk for chronic renal failure because of
kidney disease or other conditions that can affect the
kidneys, it is important to follow your doctor’s
recommendations for treatment and prevention of kidney
complications. If you have been diagnosed with chronic
renal failure, follow your doctor’s recommendations for
monitoring salt, protein, and fluid intake.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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