Renal failure, both acute and chronic, has an impact on both your health and your lifestyle. What are things you should know?
The kidneys act as the body's cleansing system, filtering waste and excess water while keeping electrolytes in balance. People can live knowing that these organs will always do their job. Even so, it is easy to overlook their true value. One may not understand it until he or she understands kidney failure, also called renal failure.
Chronic Renal Failure
When people think of renal failure, they think of chronic renal failure, the type that is more permanent and tends to develop more gradually. Causes include diabetes, high blood pressure, and various autoimmune conditions (e.g., lupus). As an example, suppose a patient gradually develops renal failure from one of these causes. Early on, he or she would feel just fine. There would mainly be lab test abnormalities, particularly the creatinine level being higher than normal because the kidneys freely clear this by-product of muscle. The patient may also have too much protein in the urine where there is normally little to none. He or she would not know this until a doctor orders these tests.
At some point, the patient may be referred to a kidney doctor, called a nephrologist. This physician may give a medication like PhosLo to keep the patient's blood phosphorous level under control since the kidneys normally clear it from the body. If the blood hemoglobin level gets low enough, the patient may need iron and injections of erythropoetin, a hormone normally made by the kidney to boost production of red blood cells. Then there are dietary changes. The doctor would advise restriction of how much sodium, potassium, phosphorous, protein, and water the patient consumes.
The nephrologist may also calculate the glomerular filtration rate, which tells how much fluid is filtered from the patient's blood by the kidneys per minute. The lower it is, the worse the kidney function. Problems eventually stem from this. The patient may retain excess fluid in the body, making it difficult to breathe if it accumulates in the lungs. The level of potassium may get too high and trigger dangerous heart rhythms. Levels of phosphorous, acid, and nitrogenous waste products may increase and cause adverse effects of their own.
Maybe the patient won't suffer from these complications, but he or she may be at risk if the GFR is low enough. In any event, it would be time to start dialysis, the process of artificially cleaning the blood in place of the failing kidneys. Hemodialysis and peritoneal dialysis are the two main types. Kidney transplant is also an option, but it is only pursued when the benefits are likely to outweigh the risks of transplantation in relation to the patient's medical history. The details of these options are beyond the scope here.
Acute Renal Failure
Acute renal failure is the type that tends to be more reversible. Its causes involve depleting the kidneys of blood flow (e.g., massive bleeding), direct injury to the kidneys (e.g., certain medications), and obstruction of the urinary tract (e.g., kidney stone). The treatment is simply addressing the root cause. Hemodialysis can be done urgently for complications, but often the kidney function is restored and hemodialysis is not needed. Even if it is done, it is usually only temporary.
Final Words
For anyone who has kidney failure, this may all sound familiar. Otherwise, this may provide a basic understanding to what kidney failure is like. Taking care of the kidneys allows them to do the same in return.
