Signs And Symptoms Of Kidney Failure

Kidney Failure

Statistics from the US Department of health and human services indicate that one in ten American adults, more than 20 million, have some level of chronic kidney disease, and millions of others are at increased risk. So what is kidney failure?

Kidney failure can be acute or chronic, acute kidney injury (AKI) is defined as a rapid decline in renal filtration function. The condition is usually marked by a rise in the blood creatinine level and blood urea nitrogen concentration.

Acute Kidney Injury, previously known as acute renal failure (ARF) occurs, when the kidneys are no longer able to filter waste product from the blood stream. The failure to clear waste product from the body results in a build up of waste material in the circulation with an imbalance of blood chemical.

Acute renal injury develops rapidly, occurring in a matter of hours or days. This condition is most common in hospitalized patients; the intensive care patients are most at risk.
Although the disease can be fatal, it is reversible if the individual is in relatively good health. Most intensive care in the UK are equipped with several very expensive filtration machines that can do the job of the kidneys, allowing the organs sufficient time to recover.

The Kidneys

The kidneys are two bean-shaped organs that filter toxins and waste product from the bloodstream and excretes them with water as urine. The kidneys also help to regulate blood flow around the body. This two small organs filter about 45 gals (180 l) of blood daily, because of the high volume, the kidneys are more exposed to toxic substances in the blood and are very vulnerable to injury from them.

Urine produced by the kidneys flow through the ureters and into the bladder where it accumulates before it is expelled. Damage to the kidneys means that they do not perform these functions properly resulting in a wide range of symptoms.

In the human species, the kidneys can be located in the posterior or back of the abdomen one on each side of the spine with the right kidney sitting just below the liver slightly lower than the left, which lies below the diaphragm adjacent to the Spleen.

The kidneys consist of tiny units known as nephrons; there are around a million nephrons in each of the two kidneys, this is the functional part of the kidney. Each nephron consists of renal tubule called the glomerulus containing a network of capillaries that filters the blood to produce urine.

The glomerulus acts rather like a sieve, keeping cells and protein in the bloodstream while allowing the extra fluids and waste to pass through.
Other complex chemical changes are also occurring but are simply explained in the accompanying video. Therefore, I will not go into detail here.

Kidney failure
In kidney failure, the kidneys are unable to function effectively due to injuries, disease or poisoning which damages the nephrons causing them to lose the ability to filter.

Most kidney diseases work slowly, damaging the nephrons over a period of years resulting in chronic renal failure (CRF). Unfortunately, most kidney diseases also tend to attack both kidneys simultaneously. The two most common causes of kidney disease are diabetes and high blood pressure. The nephrotoxic injury caused by drugs also plays a part in Kidney failure, but this will be looked at in another article.

People who have a family history of kidney problems may also have a high risk of kidney disease.

Signs and Symptoms

As a rule, kidney disease does not usually cause any symptoms until the damage becomes severe. It can be many years before damages become apparent at which time the damage is irreversible and severe

The signs and symptoms when it occurs may include:

  • Proteinuria (urine test shows protein in the urine) the healthy kidney filter waste from the bloodstream but not protein, protein in the urine is indicative of an impaired or damaged filter.
  • Increase in urea and other nitrogenous waste products, creatinine and ammonia, accumulate in the bloodstream. Diagnosed by a blood and urine test where possible.


  • Reduced urine output or no urine output


  • Fatigue


  • Tiredness and Lethargy


  • Sleep disturbances


  • Cognitive or memory deficits, e.g. Confusions


  • Loss of appetite


  • Headaches


  • itchy skin


  • Pallor Rash, bruising and nose bleed


  • Erectile dysfunction


  • Nausea and vomiting


  • Abdominal pain


  • Diarrhea


  • Seizures and coma (may occur in extremely severe cases of acute renal injury)


  • Raise potassium levels (this can lead to irregularities in the heart beat which can be life threatening)


  • Fluid imbalance


Gastrointestinal bleed occurs in approximately 1/3 of patients with AKI, although most episodes are mild, it accounts for 3-8 percent of fatality in these patients. The heart can also be affected as a result of fluid effusion resulting in cardiac tamponade.

Cardiac arrest occurs in as many as 35 percents of people with AKI, usually due to high potassium in the blood.

Causes of Kidney Failure

Prerenal

  • Reduction of fluid, e.g. Bleeding, extreme vomiting, severe diarrhoea, burns, excessive use of diuretics)
  • Cardiac failure, oedema, cirrhosis, nephrotic syndrome, Hypotension due to carcinogenic shock, sepsis, anaphylaxis
  • Cardiovascular e.g. Severe cardiac failure, arrhythmias and Renal hypoperfusion

Intrinsic (AKI)

  • Glomerular disease
  • Tubular injury
  • Acute interstitial nephritis
  • Vascular disease
  • Eclampsia


Postrenal

  • Calculus (kidney stones)


  • Blood clots


  • Papillary necrosis


  • Urethral stricture


  • Prostatic hypertrophy or malignancy


  • Bladder tumour


  • Radiation fibrosis


  • Pelvic malignancy


  • Retroperitoneal fibrosis


Diagnosis

Acute kidney failure is defined as a critical drop in urine output volume known as oliguria. Test such as blood urea nitrogen (BUN) or serum creatinine value can be compared and reviewed with available previous levels for a relatively quick decision on whether or not the condition is acute or chronic.

Diabetic Kidney Disease

Over time diabetes can cause damages to small blood vessels that lead to the kidneys, causing damage and failure.

Damage to the kidneys can start within approximately one year of type 1 diabetes, and may be present at the time of diagnosis in type two. However, it usually takes 5-10 years before it becomes apparent. Poor glucose control and hypertension can increase the risk of worsening kidney disease. People of Asian or Afro-Caribbean origin are twice as likely to develop diabetic kidney disease.


Hypertension and kidney disease

The kidneys have an important role to play in maintaining blood pressure in a healthy range, conversely, the blood pressure also affects the health of the kidneys. High blood pressure can damage the kidneys leading to chronic kidney disease.

Hypertension or high blood pressure causes the heart to work harder; this can damage the blood vessels throughout the body.

When the blood vessels in the kidneys are damaged, the ability to remove waste product and fluids is significantly reduced or may cease altogether. The result is a build-up of fluid in the vessels that can cause an elevation in the blood pressure to a level that is dangerous.

High blood pressure is one of the leading causes of kidney failure also known as end stage renal disease (ESRD). Individuals with kidney failure will require a kidney transplant or regular dialysis (blood cleaning treatment). Almost all of us have some risk of developing kidney failure from high blood pressure.

However, those of us of African origin are six times more likely than Caucasians to develop hypertension-related kidney failure.

We should aim to maintain a blood pressure around 130/80. Early intervention and management of blood pressure are especially important for African Americans and Afro-Caribbeans with diabetes.

There are two groups of medication angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) that can lower blood pressure and also have a protective effect on the kidneys.

Action for Maintaining Good Kidney Function

  • Maintain a healthy weight
  • Eating a healthy, well-balanced diet
  • Exercise, keep physically active
  • No smoking
  • Maintain proper hydration
  • Maintain good compliance with treatment for high blood pressure and diabetes management
  • Get advice, help and support from your health care professional.


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Comments 30 comments

oceansnsunsets profile image

oceansnsunsets 8 months ago from The Midwest, USA

Thank you, this was very helpful.


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

Ann, thanks! I think? :)


Ann Nkiroteh francis 2 years ago

nyc article n educating wan...


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Mary, so sorry to hear about the kidney problem, but luckily, God in his wisdom gave us a pair :). My husband suffered from kidney stones also, he had to undergo Lithotripsy treatment, this is where the stones are pulverized with shock waves. That was some time ago, so far so good. Good luck, and take good care of the remaining kidney.

Thank you for stopping by, my best to you.


mary615 profile image

mary615 3 years ago from Florida

I took my kidneys for granted. Just never thought much about them until I discovered I had a stone in one that had completely taken over the kidney. It was not functioning, and had to be removed. So, now I try and take good care of my one kidney

Very informative Hub. I voted Up, etc.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Thanks Michelle, much appreciated, as always.


midget38 profile image

midget38 4 years ago from Singapore

A very informative hub, Jo. It will help those who suspect that they have kidney failure as well. Thanks for sharing, and I share as well.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Shermanblake, many thanks for the visit and comment, I'm happy to know that you liked my hubs. However, please, don't ponder too much. :) it is sensible to maintain a healthy body and mind, but all things in moderation. My best wishes to you.


shermanblake profile image

shermanblake 4 years ago from Rio de Janeiro, Brazil

I like your hubs on health. Though every time I read them I ponder my own mortality and better yet think I need to go on a juice diet or complete body cleanse. Thanks for the info and the inspiration!


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Girishpuri, thank you very much for finding this, and for the kind comment. All my best to you.


girishpuri profile image

girishpuri 4 years ago from NCR , INDIA

very good tips, a very useful hub, voted up.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Max, I do hope you're in good health, and of course you're right, this condition is not easy to pick up on, and when you do, the damage has already been done.

Keeping the kidneys healthy should be part of out healthy living choice, and especially if we are part of a high risk group.

Thank you for stopping by and for the comment.

Take care now.


BeyondMax profile image

BeyondMax 4 years ago from Sydney, Australia

Jo, such an awesome informative hub! Usually people miss all the warnings until it's too late (take me, for example). It's a great idea to raise awareness, great job!


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Mhatter99, what ever the problem may be I hope it's not too serious, just keep on smiling, you always manage to make me smile.

rjsadowski, welcome and I'm so glad you found this useful, all my best to you.

scooterport, very nice to see you, sorry about the kidney stones, it can be very painful. Thank you for the visit and comment much appreciated, I hope you're having a wonderful day. My best to you.

Irish, always a pleasure, always appreciated.

Bless.


scooterport profile image

scooterport 4 years ago from Summerville, Georgia

Very good hub! As a man who has kidney stones in the past I know how important taking care of your kidneys are. Voted up on your hub!


shiningirisheyes profile image

shiningirisheyes 4 years ago from Upstate, New York

Informative article and thoroughly researched. Thanks for posting this friend.


rjsadowski profile image

rjsadowski 4 years ago

Great hub filled with a lot of useful information.


Mhatter99 profile image

Mhatter99 4 years ago from San Francisco

Thank you for sharing this informative report. Kidney failure is the least of my problems. but I keep smiling.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

harliquinn, your friend was very fortunate, this is a very big problem and we don't always see it coming, but forewarned as the saying goes, is forearmed.

Thank you very much for stopping by and for the comment.


harliquinn profile image

harliquinn 4 years ago

This was a very detailed hub and I think it made it a lot easier (for me for sure) to understand how important the Kidneys are and how serious kidney failure is. I have a friend who is diabetic and there was a time where the doctors were sure her kidneys would start failing. They ended up being able to fix the problem, but it was terrifying to even imagine that it was going to happen.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Billy, this problems really isn't much fun at all, my fingers are crossed also, for both of us :) to your very good health.


billybuc profile image

billybuc 4 years ago from Olympia, WA

Well, this doesn't sound like any fun at all. Fingers crossed that I never experience this. Very good information!


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Snowdrop, you're very welcome, we all need a little reminder now and again, I know I do. Many thank for stopping by.


snowdrops profile image

snowdrops 4 years ago from The Second Star to the Right

Jo, thank you thank you for this very informative and useful hub.. reminds me to take care of my kidneys.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Frank, many thanks, I hope it will prove to be useful.

Best wishes.


Frank Atanacio profile image

Frank Atanacio 4 years ago from Shelton

wow very good share my friend.. it was clear easy to follow and informative voted up and useful :)


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Don, very nice to see you, many thanks for the visit and comment.

Best wishes to you


Don Bobbitt profile image

Don Bobbitt 4 years ago from Ruskin Florida

Good Article. Very Informative.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Hi Unknown, lovely to see you, many thanks for comment and visit.

my best to you.


unknown spy profile image

unknown spy 4 years ago from Neverland - where children never grow up.

Thank you for this very informative hub Jo. it is important that we're all aware of the kidney failure symptoms and causes. all my votes.

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