Renal Failure

Definition of Renal Failure

Renal Failure is a serious medical problem associated with Kidneys. In this conditions Kidneys fail to properly remove and filter waste products from the Blood to outside the Body. In short Urine formation fails. It is also known as Kidney Failure or Renal Insufficiency.

It is of two types :

Acute Renal Injury : It involves sudden onset of kidney injury and can be reversible.
Chronic Kidney Disease (CKD) : It involves gradual loss of kidney function and mostly irreversible.

Both these forms arise due to an underlying cause like disease or mechanical injury etc.

Cause of Renal Failure

Renal Failure can manifest itself in two forms as described above and both forms have separate underlying causes.

Acute Renal Injury : It involves a number of causes which lead to damage to the kidney in form of reduced blood supply or increased amount of toxins. It can be caused by :

Accidental Injury to Kidney or its blood supply.
Surgery or its complications leading to reduced blood supply to the kidneys.
Drug Overdosage which can be accidental or suicidal. It results in increased toxic amount of drug or its byproducts to filtered from kidneys and can cause damage. (Drugs and their byproducts can be directly toxic to the kidney in their normal amounts too)
Toxins like Mercury etc.
Crush Syndrome. In this case when a limb is injured by a crushing pressure, its blood supply is compromised and leads to formation of toxic products in the absence of Oxygen (Ischemia). When the pressure is released suddenly all these toxic products in large amounts, go inside blood and reach kidney. Inside Kidney these toxic products cause clogging and damage to the organ leading to the Acute Renal Failure.

Chronic Kidney Disease : In this condition different kind of injurious stimuli result in gradual damage to the tissues of the kidney. Thus irreversible injury develops with slowly decreasing functioning ability of the Kidney. It can be caused by :

Diabetes Mellitus
Hypertension (Increased Blood Pressure)
Polycystic Kidney Disease
Drug overuse for long time. For example Aspirin, Acetaminophen etc.
Infectious Diseases can cause Chronic Kidney Disease. For example Hantavirus infection.

Signs and Symptoms of Renal Failure

There are a number of symptoms associated with the Renal Failure. Some of them can vary according to the type of the failure or cause involved. However some of them are as follows :

Nausea, Diarrhea, Vomiting
Nocturnal Urination (urinating while sleeping at night)
Abnormal amount, frequency and colour of Urine
Blood in Urine
Difficulty in Urination

Other signs and symptoms not related to Urinary System directly but caused by Renal Failure are :

Ion imbalance leads to Bone Damage, Muscle Paralysis, Itching and Abnormal Heart Rate or Rhythm.
Fluid imbalance leads to swelling and edema of legs and feet. Shortness of Breath may result by accumulation of fluid in Lungs.
Anemia caused by decreased amount of production of Erythropoietin. Erythropoietin is a substance released by kidneys which stimulates the production of Red Blood Cells when there is reduced Oxygen supply.
Difficulty Sleeping
Loss of Appetite

Risk Factors for Renal Failure

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Risk factors involved in Renal Failure are :

Diabetes Mellitus
Hypertension
Obesity
Smoking
Heart DIsease
Drug Addiction
Family History of Kidney Disease
Age above 65 years

Diagnosis of Renal Failure

Diagnosis of Renal Failure is done step by step as follows :

History of the patient reveals risk factors and certain signs and symptoms of the condition
Clinical Examination is performed further to check for the evidence of the disease
At last Laboratory Tests are performed to confirm the Diagnosis. Most important approach in Laboratory testing is to calculate Glomerular Filtration Rate (GFR) which is the ability of the kidney to filter out fluid from the blood. It is assessed by measuring Creatinine levels in the blood of the patient. If the diagnosis is confirmed further tests are done to estimate the stage of Renal Failure and amount of waste products present inside the blood. One such test is Blood Urea Level which gives amount of Urea (waste product filtered by kidney) in the blood.

Prevention from Renal Failure

Renal Failure is a serious medical condition and should best be avoided. One can avoid it by taking following preventive measures :

Maintain a healthy lifestyle. Eat healthy food on proper time. Avoid use of Alcohol.
Always follow instructions of a doctor regarding a particular medicine. Do not use medicine without prescription of a doctor.
If having family history or suffering from Renal Disease always keep in contact with your doctor and follow his instructions to avoid developing Renal Failure.
Avoid Smoking.
If you are suffering from Diabetes or Hypertension try keeping them normal as much as possible.

Treatment of Renal Failure

Treatment of the Renal Failure differs according to the type involved.

Acute Renal Injury : In this type of Renal Failure doctors first manage the cause of the condition. Later intravenous fluids are given to maintain normal blood flow through the kidneys. However if there is already fluid retention fluids are not given. Medications are usually given to correct different ion and other blood chemical levels. Patient can be put on Dialysis (blood filtration by an artificial kidney machine) to give rest to the kidneys till they return to the normal working condition.

Chronic Kidney Disease : Patients with CKD are at increased risk of permanent kidney damage hence they are managed properly by following steps :

Regular Medical checkups and maintenance of Blood Pressure and Blood Sugar levels etc.
Diet containing low amounts of Protein and Salts
Medication to treat abnormal level of ions or other chemicals in the Blood

If all such measures fail patient may be put on Dialysis to give rest to kidneys. In some cases when kidney damage is more severe and permanent Dialysis becomes compulsory and permanent. Only cure for fully damaged Kidneys however is Kidney Transplant.