The small bean shaped organs that are organized on either side of the spine, just below the lowest ribs are kidneys. The filtered fluids and electrolytes from the blood are collected in the kidneys. The function of the kidneys is to regulate the excessive water in the body and allows it to pass into the bladder in the form of urine, maintaining the levels of electrolytes in the blood. When both or either of the kidneys fails in their ability to filter water and waste from the blood, it results in a kidney failure. This rapid condition of failure is called Acute Kidney Failure or previously named as Acute Renal Failure.
Acute renal failure results in the sudden malfunctioning of the kidneys wherein they lose their ability in removing waste and creating urine without the loss of electrolytes.
Renal Failure can be categorized into acute and chronic. Acute renal failure is the condition where the functioning of the kidney decreases, proceeding from days to weeks. It may be identified with the symptoms like nausea, vomiting, seizures and coma. Excessive fluid is collected in the lungs with brown color urine at this stage.
Chronic renal failure or chronic kidney failure is the severe condition where there is non-functioning of the kidneys. It occurs from mild to severity over many years. In its later stage this condition leads to end-stage renal disease (ESRD). Common symptoms like frequent urination at night, mental confusion, weakness, vomiting and piling waste materials in the blood are observed in a patient with CRF.
The symptoms might not be serious in the initial stages but may happen with the following occurrences:
- Decreased urine concentration
- Swelling in the body
- Feeling lethargic
- Severe pain in the abdomen
- Metallic taste in the mouth
- Bloody stool
- Changes in mental attitude
- Loss of appetite
- Decreased sensation in the feet
- Nose bleeding
- Severe hiccups
- Prolonged bleeding
- Increase in blood pressure
- Slow movements
- Changes in urine- decrease of urine or excessive urination at night
- Seizures, coma in severe cases
- Odors in breath
- Nose bleeding
- Flank pain
Three stages of classification emphasize the cause of Acute Renal Failure. The Prerenal stage of renal failure is caused due to low blood volume, low blood pressure, heart failure or heart attack and liver failure. Severity in prerenal results in renal artery stenosis and renal ischaemia. The Intrinsic renal stage occurs when there is a defect in glomeruli, renal tubules or interstitium resulting to acute tabular necrosis and acute interstitial nephritis. The Postrenal stage is an outcome of the obstruction caused in the kidneys due to kidney stones, benign prostatic hyperplasia, bladder stone, bladder ureteral or obstructed urinary catheter.
Infections that damage the kidneys like acute pyelonephritis and septicemia may be the cause for kidney failure. Placenta abruptio and Placenta previa developed during pregnancy might result in renal diseases. However, heart disease, diabetes and hypertension are the most important causes for the chronic stage of kidney disease.
Acute renal failure can be detected by a series of urine and blood tests. Tests involved in the diagnosis of renal kidney failure include BUN, Creatinine clearance, Serum creatitine, Serum potassium and Urinalysis. A kidney or abdominal ultrasound is the most suitable examination to check kidney failure. Abdominal X-ray, abdominal CT scan or abdominal MRI identifies the blockage in the urinary tract. Blood tests may show metabolic changes in the acid levels of blood. In cases of severity, a biopsy which includes removal of a sample from kidney tissue is a part of the diagnostic process.
The initial treatment given to the patient with renal failure is to prevent fluids and wastes from collecting in the body. Consumption of water, Na, K intake is controlled while providing adequate protein. Nephrotoxins are usually avoided. Infections can be prevented with the usage of antibiotics. Diuretics(water pills) proves to be a good remedy to maintain kidney fluid. Potassium levels in the blood are checked with the help of insulin given through the vein. Dialysis is the filtering process used to control hyperkalemia, metabolic acidosis and symptoms of urination. Hemodialysis is the method used to clean the blood with the help of an artificial kidney. This treatment can be given either at home or a hospital and is not considered as a cure. It is only a replacement therapy and serves as an alternative until the defective kidney is transplanted. In cases of acute kidney failures, kidney transplantation is advised to achieve long term benefit.
A wider range of complications tend to occupy its space when a patient develops renal failure. Kidney failure may end up in cardiac failure, liver failure and end stage renal disease over a long period. Some common complications are heart failure, high blood pressure, imbalances in electrolytes, bone weakness and fractures, being affected by infections and bleeding and nervous disorders.
Dialysis treatments might cause the risk of malnourishment, air embolism, pericarditis and pneumonia.
Controlling the levels of diabetes, hypertension and blood pressure are the most essential methods of prevention. Low protein diet and frequent blood tests to balance electrolytes might also be helpful. Consumption of drugs need at most care as they are exposed to various side-effects. Kidney stones, if checked at an early stage might prevent further damage to the kidneys.
In addition to the above preventive tips, people with hereditary kidney disease might need good advice from any genetic specialist so as to reduce the risk of transferring these diseases to further generations.