ACUTE RENAL FAILURE
What Is Acute Renal Failure?
Acute renal failure (also known as acute kidney injury (AKI)) means that kidneys suddenly can’t get rid of the body’s waste and balance chemicals in your body. Kidneys normally do this by making urine. When they fail, waste products and chemicals build up and are harmful.
What Causes Acute Renal Failure?
Conditions that reduce the blood supply to kidneys, block flow of urine after it leaves kidneys, or injure kidneys can cause renal failure. Diseases that predispose to acute kidney failure include chronic urinary infections, dehydration, and kidney damage from congestive heart failure, diabetes, or high blood pressure.
Causes of acute renal failure include illnesses that have an indirect effect on kidneys (e.g., low blood pressure), kidney blockage, and direct kidney injury (e.g., by drugs and x-ray dyes).
What Are the Symptoms of Acute Renal Failure?
An early symptom is often little or no urine output.
Later ones include nausea, vomiting, diarrhea, and appetite loss. Irritability, insomnia, convulsions, stupor, coma, severe itching, high or low blood pressure, unexplained bruising, and bleeding for no reason may be additional signs. In some forms of acute renal failure the kidneys continue to produce urine but it does not contain the waste products normally removed by the kidneys.
How Is Acute Renal Failure Diagnosed?
Blood and urine tests can measure how well kidneys work. A biopsy (taking a sample of tissue from kidneys) may be done in certain cases, as may x-rays of the chest, belly, kidneys, and ureters (tubes taking urine from kidneys to the bladder).
How Is Acute Renal Failure Treated?
Treatment depends on the reason for acute renal failure. In many cases, a hospital admission may be necessary to start treatment. Medicines may be given to help increase the amount of urine made, and an artificial kidney machine may be used for dialysis (hemodialysis). In another type of dialysis known as peritoneal dialysis, fluid (called dialysate) is placed in the abdomen (belly) to help clean waste products from the blood and is then removed with a special tube (catheter). The health care provider may suggest a reduced intake of protein, salt, and potassium and use of blood pressure pills and calcium supplements. In many cases, kidneys may recover completely, but recovery may take up to 6 weeks or longer.
DOs and DON’Ts in Managing Acute Renal Failure:
- DO follow a low-protein diet if your health care provider recommends it. A proper diet is critical to prevent complications. You may have to eliminate some fruit, chocolate, and nuts because of high potassium levels. When kidneys don’t work, high levels are dangerous for your heart.
- DO take medicines as prescribed.
- DO weigh yourself daily and keep a record of fluids you drink and the amount of fluid you pass if your health care provider asks you to.
- DO tell your health care provider of any exposure to toxic chemicals or drugs.
- DO keep to your fluid restriction to avoid fluid buildup in your lungs.
- DO tell your health care provider about all your medicines, including over-the-counter and herbal preparations.
- DO call your health care provider if you have chills, fever, vomiting, headache, muscle aches, or diarrhea.
- DO avoid anything poisonous to kidneys, such as some drugs.
- DO take care of medical disorders that might damage kidneys, such as high blood pressure, diabetes, congestive heart failure, and infections.
- DON’T stop taking your medicines before asking your health care provider. Don’t miss any doses.
- DON’T take over-the-counter medicines or herbal preparations unless you check with your health care provider.
Contact the following sources:
- National Kidney Foundation, Inc.
Tel: (800) 622-9010, (212) 889-2210
- National Institute of Diabetes, Digestive, and Kidney Diseases
CHRONIC RENAL FAILURE
What Is Chronic Renal Failure?
Kidneys are important in many ways. They control the amount of water and by-products of metabolism. They get rid of waste products (make urine). They control the body’s water, blood salt, and calcium levels. In renal failure (or kidney failure), kidneys can’t get rid of the body’s waste products. Waste products and chemicals build up in the body and are harmful. Chronic renal failure is also called Chronic Kidney Disease (CKD) or end stage renal disease (ESRD). Acute failure occurs suddenly. Chronic kidney failure occurs slowly.
What Causes Chronic Renal Failure?
The cause is any condition that reduces the blood supply to the kidneys, blocks urine after it leaves the kidneys, or injures the kidneys. Inflammation, urinary tract infections, congestive heart failure, diabetes, and high blood pressure can cause it. Medications used for other medical disorders can also damage the kidneys.
What Are the Symptoms of Chronic Renal Failure?
Chronic renal failure is often a silent disease and has no early symptoms. Later signs and symptoms may include nausea, vomiting, diarrhea, and appetite loss. Others are listless feelings; shortness of breath; mouth problems; stomach pain; numbness, tingling, and burning in legs and feet; lower sex drive; loss of menstrual periods; anemia; and muscle and bone pain. Being irritable, not sleeping well, depression, convulsions, stupor, and coma are seen; itching, abnormal blood pressure, and bleeding problems may also occur.
How Is Chronic Renal Failure Diagnosed?
The health care provider often finds impaired renal function at a routine examination that includes urine or blood tests. Additional tests will then be done to see how well the kidneys work. X-rays may also be done to check the size of the kidneys and exclude other disorders that can damage the kidneys and block flow of urine, such as kidney stones or tumors. Your health care provider may refer you to a kidney specialist (nephrologist) for additional evaluation.
How Is Chronic Renal Failure Treated?
Treatment can involve diet, medicine, dialysis, controlling diseases causing the failure, and transplantation. Foods containing potassium, phosphorous, and too much salt or protein should be avoided. Controlling blood pressure is important. Injections to correct anemia and calcium pills may be needed. Diuretics (water pills) can prevent gaining too much fluid. Your health care provider may recommend a kidney transplant. Certain drugs that can affect the kidneys must be avoided. High blood pressure, diabetes, congestive heart failure, and infections must be treated.
Some people need dialysis if other treatments don’t work. Dialysis removes waste products from the blood when kidneys can’t. Hemodialysis filters blood using a man-made filter and a machine. Peritoneal dialysis uses the natural lining of your abdomen as a filter. Dialysis may be done temporarily or permanently.
The health care provider will recommend seeing a kidney specialist on a regular basis. Another treatment for chronic kidney failure is a kidney transplant. It involves replacing the damaged kidney with a healthy one placed in your body.
DOs and DON’Ts in Managing Chronic Renal Failure:
- DO follow the diet that your health care provider suggests, including fluid restriction.
- DO take medicines exactly as prescribed. Don’t miss doses.
- DO weigh yourself daily. Keep records of fluid intake and output.
- DO exercise as much as you can but limit strenuous activities.
- DO stop smoking.
- DO call your health care provider if you have chills, fever, headache, muscle aches, shortness of breath, nausea, vomiting, or chest pains.
- DON’T become dehydrated, but don’t drink water or liquids in excess. Don’t get overtired.
- DON’T eat foods you should avoid. Too much potassium can make you very ill.
- DON’T take over-the-counter drugs without checking with your health care provider.
Contact the following sources:
- National Kidney Foundation
Tel: (800) 622-9010
- National Institute of Diabetes and Digestive and Kidney Diseases