Overview – What is it?
Kidney failure, also known as end stage kidney disease (ESKD), is a decrease in kidney function due to damage caused to the kidneys by health conditions like diabetes and high blood pressure. Some of the symptoms for kidney failure include swelling of the legs, itching and loss of appetite. It can be diagnosed through blood tests, imaging tests, and other tests.
The treatment of kidney failure depends on the severity of the condition and can include dialysis and kidney transplant. Prevention of kidney failure focuses on reducing the risk factors by, for example, not smoking or using illegal drugs like cocaine.
Causes – What causes it?
There are two major types of kidney failure. These are:
- Acute kidney or renal failure/injury: This is kidney failure that happens suddenly causing your kidney functions to decline rapidly. The possible causes for this type of kidney failure include:
- Blockage of blood flow to the kidneys due to infection, liver failure, certain medications such as aspirin, heart failure, dehydration or blood pressure medications.
- Urine not leaving the kidneys due to bladder, prostate, cervical or colon cancer, kidney stones, blood clots in the urinary tract, nerve damage to the bladder or medications that can cause damage to the kidney such as antibiotics and those used in chemotherapy.
- Kidney damage due to cholesterol deposits, inflammation of kidney filters or blood clots.
- Chronic kidney or renal failure or disease: This type of kidney failure, on the other hand, involves the slow and progressive decline of kidney functions. This can be due to:
- Conditions like diabetes, hypertension and polycystic kidney disease, among other conditions that can affect the kidney.
- Pyelonephritis which is a recurrent kidney infection that causes the kidneys to swell and may cause permanent damage.
- Interstitial nephritis which is the inflammation of the kidney tubules and the surrounding structures.
- Inflammation of kidney filters due to glomerulonephritis.
- Prolonged urinary tract obstruction from conditions such as kidney stones and some cancers like prostate cancer.
- Systemic lupus erythematosus which involves the body’s immune system attacking the kidneys.
Other risk factors include:
- Injury to the kidney due to a sharp blow or physical injury.
- Over-exposure to some toxins such as lead
- Smoking and abuse of other drugs such as cocaine and heroine
- Cardiovascular conditions
- Abnormal structure of the kidney
- Old age
- Family history of kidney disease
Symptoms – What do you feel?
In both acute and chronic kidney failure, the symptoms depend on the underlying cause and how severe your condition is. However, in acute kidney failure the symptoms will also depend on how fast you lose your kidney function. In most cases the symptoms become noticeable when the condition has advanced. These are some of the common symptoms you may experience:
- Persistent itching
- Nausea and vomiting
- Loss of appetite
- Swelling of the feet
- Confusion and decrease in mental sharpness
- Shortness of breath
- Swelling of the legs, ankles and feet
- Chest pain and pressure
- Changes in urination
- Twitching of muscles
Diagnosis – How do you diagnose it?
Diagnosis of kidney failure begins with discussing your symptoms, medical history and family history with a doctor, after which a physical exam is done to check for visible symptoms such as swelling of the legs and ankles and to check whether your heart or blood vessels are functioning properly. A neurological exam can also be carried out to determine whether your nervous system is impaired.
Tests to diagnose kidney failure include:
- Blood test: This is used to determine the level of waste products in the blood such as creatinine and urea which rises if the kidney is not functioning well.
- Imaging tests: They are used to check whether there are any abnormalities such as enlargement of the kidneys or blockage of urine flow. They can be done using a computerised tomography (CT) scan, an angiogram, or a magnetic resonance imaging (MRI) scan.
- Urine test: It is used to test for presence of blood and protein in the urine which can also help in identifying the cause of kidney failure.
- Biopsy: This involves taking a sample of tissue from the kidney, which makes it possible to determine the cause of the kidney problem.
Treatment – How do you treat it?
The treatment of kidney failure depends on the cause of the condition. Acute kidney failure can go away on its own but chronic kidney failure cannot be cured.
Treatments of acute kidney failure are:
- Drugs: You may be asked to take medicine to regulate the amount of phosphorus and potassium in your body and this may help reduce the problem with your kidneys.
- Diet: Limiting the amount of potassium and salt intake as both of them are eliminated from the body by the kidney.
- Dialysis: This is treatment that involves using a machine to clean your blood. If the condition gets better, then you will only need the dialysis for a short while but if it doesn’t you may require dialysis as a long-term treatment.
Treatment for chronic kidney failure:
Treatment is based on correcting the cause of the kidney failure such as medications used for hypertension, to lower cholesterol and to treat anaemia, among other conditions that may be causing the kidney failure. Treatments include the following:
- Medication: This can be used to treat the symptoms such as to relieve swelling and to protect your bones from becoming weak.
- Using a diet low in proteins to minimize waste products in your blood and thereby reduce the work of the kidneys.
- Dialysis: This is used to remove waste products from the blood using a machine that filters the waste and excess fluids from the blood when the kidneys are unable to function properly.
- Kidney transplant: This is the surgical removal of the damaged kidney or kidneys and their replacement with a healthy kidney(s) from a donor.
Prevention – How do you prevent it?
You can only prevent yourself from getting kidney failure by reducing your risk of the disease. This can be done by:
- Taking medications correctly as instructed by your doctor or pharmacist
- Maintaining a healthy diet rich in vegetables and fruits
- Maintaining a healthy body weight
- Not smoking or using other drugs like heroin
- Managing your medical conditions that can damage your kidney such as diabetes
- Limiting exposure to chemicals like pesticides