Kidney Failure Causes and Treatment
The kidney acts to remove waste products from the body and to retain the correct amount of water in the body. If the kidney fails to work correctly, the patient may become very ill. There are two quite separate forms of kidney (or renal) failure - the acute form which occurs rapidly, and the chronic form which develops over many months or years.
Acute Kidney Failure
The patient notes a sudden dramatic reduction in the output of urine, associated with a loss of appetite, nausea, tiredness and vomiting. A doctor will note a raised blood pressure. After a few days or weeks, the kidney usually starts to work again, and the patient starts to pass copious quantities of clear urine. Over a few more weeks, the urine and kidney function gradually return to normal.
Acute renal failure may be triggered by a severe injury (particularly crush injuries), major surgery, poisons (e.g. mercury, dry cleaning fluid, mushrooms), heart attacks, severe burns, severe infections, and a number of rarer causes. It may also occur as a complication of pregnancy. The diagnosis can be confirmed by blood and urine tests, which will show excess waste products in the blood and very dilute urine.
In treating the condition, any specific cause of the renal failure should also be treated (e.g. resuscitate a patient with severe burns). In severe cases, an artificial kidney machine may be needed to clean the blood in a process known as dialysis. The amount of fluids that the patient drinks must be very carefully regulated, and a strict diet that limits the number of waste products in the body is given. Infections are a common complication, and these must be treated appropriately.
The outcome will depend upon the cause, and although some patients will die within a couple of days of the disease starting, most can be managed in a good hospital to a successful outcome. There is usually no long-lasting kidney damage, and the patient can lead a normal life.
Chronic Kidney Failure
The slow, gradual failure of the kidneys is called chronic renal failure or uraemia. Because of its slow onset, patients may not present to a doctor until the condition is well advanced. The symptoms include weakness, tiredness, lack of appetite, weight loss, nausea, headaches, passing urine frequently and at night, and in advanced cases itchy skin and vomiting.
Chronic kidney failure can be caused by many diseases, including a damaged blood supply to the kidney from hardened arteries, poisons, infections, the body trying to reject the kidney in auto-immune conditions such as systemic lupus erythematosus, and a large number of rarer diseases. Old age is a common cause of very gradual renal failure.
Doctors will note that the patient usually has high blood pressure and abnormal results for both blood and urine tests. Anaemia is a common finding. Further investigations are always carried out in an attempt to discover the cause of the kidney failure. Treatment involves treating any detectable cause of the condition, a strict diet (low in protein), and control of all fluids that are drunk.
Patients with renal failure must be very careful about any medications that they take, as they are likely to be far more effective and last longer in the body than normal. This means that side effects and toxicity problems are more likely to occur.
Unless the cause of the kidney failure can be corrected, the only treatment available is long-term treatment with an artificial kidney machine (dialysis), or a kidney transplant operation. Patients can be maintained for many years on dialysis, in which they hook themselves up to a kidney machine at a hospital or their own home for 6 to 12 hours several times a week. Blood is taken from a vein in the patient's arm, passed through the kidney machine, and back to the patient.
Kidney transplants have more than an 80% success rate and effectively cure the condition, but they are only practical in otherwise healthy young and middle-aged victims.
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