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Symptoms of kidney function problems


Chronic kidney disease - Symptoms and causes

Overview

What is kidney disease? An expert explains

Learn more from kidney doctor Andrew Bentall, M.D.

I'm Dr. Andrew Bentall, a kidney doctor at Mayo Clinic. I look after patients with kidney disease, either in the early stages, or with more advanced kidney disease considering dialysis and transplantation as treatment options. In this video, we'll cover the basics of chronic kidney disease. What is it? Who gets it? The symptoms, diagnosis and treatment. Whether you are looking for answers for yourself or for someone you love, we're here to give you the best information available.

Chronic kidney disease is a disease characterized by progressive damage and loss of function in the kidneys. It's estimated that chronic kidney disease affects about one in seven American adults. And most of those don't know they have it. Before we get into the disease itself, let's talk a little bit about the kidneys and what they do. Our kidneys play many important roles keeping our bodies in balance. They remove waste and toxins, excess water from the bloodstream, which is carried out of the body in urine. They helped to make hormones to produce red blood cells, and they turn vitamin D into its active form, so it's usable in the body.

There are quite a few things that can cause or put you at higher risk for chronic kidney disease. Some of them are not things that can be avoided. Your risk is simply higher if you have a family history of certain genetic conditions like polycystic kidney disease or some autoimmune diseases like lupus or IgA nephropathy. Defects in the kidney structure can also cause your kidneys to fail, and you have an increased risk as you get older. Sometimes, other common medical conditions can increase your risk. Diabetes is the most common cause of kidney disease. Both type 1 and type 2 diabetes. But also heart disease and obesity can contribute to the damage that causes kidneys to fail. Urinary tract issues and inflammation in different parts of the kidney can also lead to long-term functional decline. There are things that are more under our control: Heavy or long-term use of certain medications, even those that are common over-the-counter. Smoking can also be a contributing factor to chronic kidney disease.

Often there are no outward signs in the earlier stages of chronic kidney disease, which is grouped into stages 1 through 5. Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little. However, these are usually in the later stages, but they can also happen in other disorders. So don't automatically interpret this as having kidney disease. But if you're experiencing anything that concerns you, you should make an appointment with your doctor.

Even before any symptoms appear, routine blood work can indicate that you might be in the early stages of chronic kidney disease. And the earlier it's detected, the easier it is to treat. This is why regular checkups with your doctor are important. If your doctor suspects the onset of chronic kidney disease, they may schedule a variety of other tests. They may also refer you to a kidney specialist, a nephrologist like myself. Urine tests can reveal abnormalities and give clues to the underlying cause of the chronic kidney disease. And this can also help to determine the underlying issues. Various imaging tests like ultrasounds or CT scans can be done to help your doctor assess the size, the structure, as well as evaluate the visible damage, inflammation or stones of your kidneys. And in some cases, a kidney biopsy may be necessary. And a small amount of tissue is taken with a needle and sent to the pathologist for further analysis.

Treatment is determined by what is causing your kidneys to not function normally. Treating the cause is key, leading to reduced complications and slowing progression of kidney disease. For example, getting better blood pressure control, improved sugar control and diabetes, and reducing weight are often key interventions. However, existing damage is not usually reversible. In some conditions, treatment can reverse the cause of the disease. So seeking medical review is really important. Individual complications vary, but treatment might include high blood pressure medication, diuretics to reduce fluid and swelling, supplements to relieve anemia, statins to lower cholesterol, or medications to protect your bones and prevent blood vessel calcification. A lower-protein diet may also be recommended. It reduces the amount of waste your kidneys need to filter from your blood. These can not only slow the damage of kidney disease, but make you feel better as well. When the damage has progressed to the point that 85 to 90 percent of your kidney function is gone, and they no longer work well enough to keep you alive, it's called end-stage kidney failure. But there are still options. There's dialysis, which uses a machine to filter the toxins and remove water from your body as your kidneys are no longer able to do this. Where possible, the preferred therapy is a kidney transplant. While an organ transplant can sound daunting, it's actually often the better alternative, and the closest thing to a cure, if you qualify for a kidney transplant.

If you have kidney disease, there are lifestyle choices. Namely quit smoking. Consuming alcohol in moderation. If you're overweight or obese, then try to lose weight. Staying active and getting exercise can help not only with your weight, but fatigue and stress. If your condition allows, keep up with your routine, whether that's working, hobbies, social activities, or other things you enjoy. It can be helpful to talk to someone you trust, a friend or relative who's good at listening. Or your doctor could also refer you to a therapist or social worker. It can also be helpful to find a support group and connect with people going through the same thing. Learning you have chronic kidney disease and learning how to live with it can be a challenge. But there are lots of ways to help you to be more comfortable for longer before more drastic measures are needed. And even then, there is plenty of hope. If you'd like to learn even more about chronic kidney disease, watch our other related videos or visit mayoclinic.org. We wish you well.

Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body.

In the early stages of chronic kidney disease, you might have few signs or symptoms. You might not realize that you have kidney disease until the condition is advanced.

Treatment for chronic kidney disease focuses on slowing the progression of kidney damage, usually by controlling the cause. But, even controlling the cause might not keep kidney damage from progressing. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

How kidneys work

One of the important jobs of the kidneys is to clean the blood. As blood moves through the body, it picks up extra fluid, chemicals and waste. The kidneys separate this material from the blood. It's carried out of the body in urine. If the kidneys are unable to do this and the condition is untreated, serious health problems result, with eventual loss of life.

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Symptoms

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Loss of kidney function can cause a buildup of fluid or body waste or electrolyte problems. Depending on how severe it is, loss of kidney function can cause:

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Urinating more or less
  • Decreased mental sharpness
  • Muscle cramps
  • Swelling of feet and ankles
  • Dry, itchy skin
  • High blood pressure (hypertension) that's difficult to control
  • Shortness of breath, if fluid builds up in the lungs
  • Chest pain, if fluid builds up around the lining of the heart

Signs and symptoms of kidney disease are often nonspecific. This means they can also be caused by other illnesses. Because your kidneys are able to make up for lost function, you might not develop signs and symptoms until irreversible damage has occurred.

When to see a doctor

Make an appointment with your doctor if you have signs or symptoms of kidney disease. Early detection might help prevent kidney disease from progressing to kidney failure.

If you have a medical condition that increases your risk of kidney disease, your doctor may monitor your blood pressure and kidney function with urine and blood tests during office visits. Ask your doctor whether these tests are necessary for you.

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Causes

Healthy kidney vs. diseased kidney

A typical kidney has about 1 million filtering units. Each unit, called a glomerulus, connects to a tubule, which collects urine. Conditions such as high blood pressure and diabetes take a toll on kidney function by damaging these filtering units and collecting tubules and causing scarring.

Polycystic kidney

A healthy kidney (left) eliminates waste from the blood and maintains the body's chemical balance. With polycystic kidney disease (right), fluid-filled sacs called cysts develop in the kidneys. The kidneys grow larger and gradually lose the ability to function as they should.

Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years.

Diseases and conditions that cause chronic kidney disease include:

  • Type 1 or type 2 diabetes
  • High blood pressure
  • Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney's filtering units (glomeruli)
  • Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's tubules and surrounding structures
  • Polycystic kidney disease or other inherited kidney diseases
  • Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
  • Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys
  • Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

Risk factors

Factors that can increase your risk of chronic kidney disease include:

  • Diabetes
  • High blood pressure
  • Heart (cardiovascular) disease
  • Smoking
  • Obesity
  • Being Black, Native American or Asian American
  • Family history of kidney disease
  • Abnormal kidney structure
  • Older age
  • Frequent use of medications that can damage the kidneys

Complications

Chronic kidney disease can affect almost every part of your body. Potential complications include:

  • Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
  • A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's function and can be life-threatening
  • Anemia
  • Heart disease
  • Weak bones and an increased risk of bone fractures
  • Decreased sex drive, erectile dysfunction or reduced fertility
  • Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
  • Decreased immune response, which makes you more vulnerable to infection
  • Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
  • Pregnancy complications that carry risks for the mother and the developing fetus
  • Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

Prevention

To reduce your risk of developing kidney disease:

  • Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), follow the instructions on the package. Taking too many pain relievers for a long time could lead to kidney damage.
  • Maintain a healthy weight. If you're at a healthy weight, maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss.
  • Don't smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you're a smoker, talk to your doctor about strategies for quitting. Support groups, counseling and medications can all help you to stop.
  • Manage your medical conditions with your doctor's help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.

By Mayo Clinic Staff

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Chronic kidney disease - Diagnosis and treatment

Diagnosis

Kidney disease FAQs

Nephrologist Andrew Bentall, M.D., answers the most frequently asked questions about kidney disease.

Living with diabetes is difficult, thinking about what you eat. But controlling the sugar levels are really important for helping kidney function and specifically slowing down any damage to the kidneys. Newer drugs that have come out in the last couple years can help with this, as well as working with your primary care physician or endocrinologist with your current therapies to get better sugar control.

We really want to help your health and so losing weight can be a key component to reducing your risk of progressing with kidney disease. Reducing calorie intake, which is either smaller portions, less snacking in between meals, and then thinking about burning calories with increasing your exercise, are great steps forward in starting that journey towards weight loss.

We look to get blood pressure less than 130 systolic, that's the top number. And less than 80 diastolic, that's the bottom number, on blood pressure readings. There are a number of different drugs that we can use to do this. And this will help both with your cardiovascular health, but slowing down any kidney disease progression over time as well.

There are two different types of dialysis: hemodialysis, which is done through cleaning the blood through a machine, which you attend a dialysis center three times a week for about four hours each time. It can be done at home in certain circumstances. Or peritoneal dialysis, where fluid gets put into your tummy, takes out the toxins and is drained. And that can be done either during the day or overnight on a machine. The benefits and risks of these are individualized, as some people are able to do the treatment at home or need to go to a treatment center for this. It also depends on your location and how close the nearest dialysis centers are.

The kidney transplant works in the same way as your own kidneys do, with the blood coming through the transplant, filtering it and the urine coming out. The kidney transplant is protected by the anti-rejection medication, so your body doesn't attack it. And we leave your own kidneys in because they eventually shrivel down and don't function anymore. You don't want more surgery than you need.

For a kidney transplant at the moment, taking anti-rejection drugs is an everyday, lifelong occurrence. These can come with side effects. But current research is looking to try and minimize or come off anti-rejection drugs with specific research protocols at the moment.

We really want to partner with you to get the best outcomes for you, so that chronic kidney disease doesn't affect you as much as it can. Controlling your blood pressure and therefore monitoring that at home, taking your medications regularly, and letting us know about side effects is a really important part in partnering and helping you to have a good quality of life living with chronic kidney disease.

Kidney biopsy

During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound.

As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits and whether you have family members who have kidney disease.

Next, your doctor performs a physical exam, checking for signs of problems with your heart or blood vessels, and conducts a neurological exam.

For kidney disease diagnosis, you might also need certain tests and procedures to determine how severe your kidney disease is (stage). Tests might include:

  • Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
  • Urine tests. Analyzing a sample of your urine can reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
  • Imaging tests. Your doctor might use ultrasound to assess your kidneys' structure and size. Other imaging tests might be used in some cases.
  • Removing a sample of kidney tissue for testing. Your doctor might recommend a kidney biopsy, which involves removing a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem.

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  • Ultrasound
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Treatment

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Kidney transplant

During kidney transplant surgery, the donor kidney is placed in your lower abdomen. Blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen, just above one of your legs. The new kidney's urine tube (ureter) is connected to your bladder. Unless they are causing complications, your own kidneys are left in place.

Depending on the cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure.

Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you might need treatment for end-stage kidney disease.

Treating the cause

Your doctor will work to slow or control the cause of your kidney disease. Treatment options vary depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as diabetes mellitus or high blood pressure, has been controlled.

Treating complications

Kidney disease complications can be controlled to make you more comfortable. Treatments might include:

  • High blood pressure medications. People with kidney disease can have worsening high blood pressure. Your doctor might recommend medications to lower your blood pressure — commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers — and to preserve kidney function.

    High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you might need frequent blood tests to monitor your condition. Your doctor may also recommend a water pill (diuretic) and a low-salt diet.

  • Medications to relieve swelling. People with chronic kidney disease often retain fluids. This can lead to swelling in the legs as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.
  • Medications to treat anemia. Supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron, help produce more red blood cells. This might relieve fatigue and weakness associated with anemia.
  • Medications to lower cholesterol levels. Your doctor might recommend medications called statins to lower your cholesterol. People with chronic kidney disease often have high levels of bad cholesterol, which can increase the risk of heart disease.
  • Medications to protect your bones. Calcium and vitamin D supplements can help prevent weak bones and lower your risk of fracture. You might also take medication known as a phosphate binder to lower the amount of phosphate in your blood and protect your blood vessels from damage by calcium deposits (calcification).
  • A lower protein diet to minimize waste products in your blood. As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys must do, your doctor might recommend eating less protein. A registered dietitian can suggest ways to lower your protein intake while still eating a healthy diet.

Your doctor might recommend regular follow-up testing to see whether your kidney disease remains stable or progresses.

Treatment for end-stage kidney disease

If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant.

  • Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do this. In hemodialysis, a machine filters waste and excess fluids from your blood.

    In peritoneal dialysis, a thin tube inserted into your abdomen fills your abdominal cavity with a dialysis solution that absorbs waste and excess fluids. After a time, the dialysis solution drains from your body, carrying the waste with it.

  • Kidney transplant. A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors.

    After a transplant, you'll need to take medications for the rest of your life to keep your body from rejecting the new organ. You don't need to be on dialysis to have a kidney transplant.

For some who choose not to have dialysis or a kidney transplant, a third option is to treat your kidney failure with conservative measures. Conservative measures likely will include symptom management, advance care planning and care to keep you comfortable (palliative care).

Kidney Disease: How kidneys work, Hemodialysis, and Peritoneal dialysis

More Information

  • Chronic kidney disease care at Mayo Clinic
  • Deceased-donor kidney transplant
  • Hemodialysis
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  • Nondirected living-donor transplant
  • Peritoneal dialysis
  • Preemptive kidney transplant
  • Kidney disease FAQs

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Lifestyle and home remedies

As part of your treatment for chronic kidney disease, your doctor might recommend a special diet to help support your kidneys and limit the work they must do. Ask your doctor for a referral to a registered dietitian who can analyze your diet and suggest ways to make your diet easier on your kidneys.

Depending on your situation, kidney function and overall health, dietary recommendations might include the following:

  • Avoid products with added salt. Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses.
  • Choose lower potassium foods. High-potassium foods include bananas, oranges, potatoes, spinach and tomatoes. Examples of low-potassium foods include apples, cabbage, carrots, green beans, grapes and strawberries. Be aware that many salt substitutes contain potassium, so you generally should avoid them if you have kidney failure.
  • Limit the amount of protein you eat. Your registered dietitian will estimate how many grams of protein you need each day and make recommendations based on that amount. High-protein foods include lean meats, eggs, milk, cheese and beans. Low-protein foods include vegetables, fruits, breads and cereals.

More Information

  • Chronic kidney disease care at Mayo Clinic
  • Renal diet for vegetarians
  • Effectively managing chronic kidney disease

Coping and support

Receiving a diagnosis of chronic kidney disease can be worrisome. To help you cope with your feelings, consider:

  • Connecting with other people who have kidney disease. They can understand what you're feeling and offer unique support. Ask your doctor about support groups in your area. Or contact organizations such as the American Association of Kidney Patients, the National Kidney Foundation or the American Kidney Fund for groups in your area.
  • Maintaining your normal routine, when possible. Try to keep doing the activities you enjoy and continue working, if your condition allows. This can help you cope with feelings of sadness or loss that you might have.
  • Being active most days of the week. With your doctor's advice, aim for at least 30 minutes of physical activity most days of the week. This can help you cope with fatigue and stress.
  • Talking with someone you trust. You might have a friend or family member who is a good listener. Or you may find it helpful to talk with a faith leader or someone else you trust. Ask your doctor for a referral to a social worker or counselor.

Preparing for your appointment

You'll likely start by seeing your primary care doctor. If lab tests reveal that you have kidney damage, you might be referred to a doctor who specializes in kidney problems (nephrologist).

What you can do

To get ready for your appointment, ask if there's anything you need to do ahead of time, such as limit your diet. Then make a list of:

  • Your symptoms, including any that seem unrelated to your kidneys or urinary function, and when they began
  • All your medications, vitamins or other supplements you take, including doses
  • Other medical conditions you have and relatives with kidney disease
  • Questions to ask about your condition

Take a family member or friend along, if possible, to help you remember the information you receive. Or use a recorder during your visit.

For chronic kidney disease, some basic questions to ask include:

  • What's the level of damage to my kidneys?
  • Is my kidney function worsening?
  • Do I need more tests?
  • What's causing my condition?
  • Can the damage to my kidneys be reversed?
  • What are my treatment options?
  • What are the potential side effects of each treatment?
  • I have these other health conditions. How can I best manage them together?
  • Do I need to eat a special diet?
  • Can you refer me to a dietitian who can help me plan my meals?
  • Are there brochures or other printed material I can have? What websites do you recommend?
  • How often do I need to have my kidney function tested?

Don't hesitate to ask other questions as they occur to you.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • How long have you had symptoms?
  • Have you been diagnosed or treated for high blood pressure?
  • Have you noticed changes in your urinary habits?

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Diseases and treatment

Renal insufficiency

Renal insufficiency is an acute or chronic disease in which the excretory and filtration functions of the kidneys are impaired. The result is a malfunction of the whole organism against the background of poisoning by decay products that enter the bloodstream. More recently, it was believed that kidney failure develops due to glomerulonephritis, but recently the opinion of doctors has changed. Now the main causes are diabetes and hypertension - these diseases contribute to the destruction of small blood vessels in the kidneys.

Acute renal failure develops for the following reasons:

  • genetic predisposition;
  • living in regions with poor ecology;
  • unbalanced diet;
  • forced long-term use of certain drugs;
  • infectious diseases;
  • the presence of parasites in the body;
  • chronic pathologies of the cardiovascular, endocrine and urinary systems;
  • metabolic disorder.

More often renal failure develops in men and over the age of 60 years. Also, acute renal failure can rapidly develop against the background of an organ injury and a large loss of blood, poisoning with poisons, obstruction of the ureters, acute / complicated pyelonephritis.

Women may develop kidney failure during pregnancy.

Symptoms and signs of kidney failure

Acute kidney failure is in almost every case a complication of another internal disease. Therefore, the first symptoms and signs of it may be unexpressed, but if they are identified on time, and doctors begin treatment, then the process of destruction of kidney tissues can be stopped and their functionality can be fully restored. The first sign is a decrease in the amount of urine excreted: no more than 600 ml per day. If you ignore this symptom, then dehydration quickly develops, an infection joins. With proper treatment, it will be possible to restore the functionality of the kidneys within 6-12 months. If renal failure occurs without treatment, then it is transformed into a chronic form of the course.

Chronic renal failure is manifested by the following symptoms and signs :

  • apathy, weakness, fatigue;
  • intense and constant thirst;
  • an unpleasant taste in the mouth is a pronounced sign of poisoning the body with toxins;
  • memory problems;
  • sleep disorders;
  • constant feeling of nausea.

These symptoms appear as chronic renal failure progresses, and the first signs are always frequent urination at night and a decrease in total urine output.

If there is no treatment, then the person's condition is complicated by neurological disorders - kidney failure provokes the appearance of involuntary muscle twitches, profuse vomiting, regardless of food intake, and a decrease in the reaction rate.

Symptoms in a man and signs in a woman are almost the same, but there may be differences:

  • women experience pain and burning during urination;
  • in men, libido is reduced;
  • chronic renal failure in women leads to gynecological inflammatory diseases;
  • chronic renal failure in men can cause prostatitis.

Diagnosis of renal failure

The diagnosis of "renal failure" is made on the basis of the results of laboratory, instrumental studies:

  • urinalysis - the cause of the disease is determined;
  • clinical blood test - the level of leukocytes is assessed;
  • biochemical blood test - the most informative study, the level of urea and creatinine is determined;
  • ultrasound examination of the kidneys - there is a decrease in size if renal failure occurs in a chronic form;
  • computed or magnetic resonance imaging of the abdominal cavity and small pelvis.

If the diagnosis is difficult, then a kidney biopsy is prescribed - a fragment of the organ is sent for histological examination under a microscope. Kidney failure in this case will be diagnosed on a specific basis: the replacement of healthy tissues with scar tissue.

Additional diagnostics are for men - ultrasound and manual examination of the prostate, for women - ultrasound of the reproductive system and manual examination on the gynecological chair.

Treatment of renal failure

If the diagnosis has confirmed that the patient has acute renal failure, then he is immediately admitted to the inpatient department of a medical institution. It will be necessary to treat immediately both the underlying disease and renal failure. It is mandatory to prescribe drug therapy to stabilize the patient's condition and normalize kidney function:

  • saline solutions - administered by drip, necessary to restore the overall water-salt balance;
  • diuretics - renal insufficiency is characterized by urinary retention, which must be eliminated;
  • means for improving blood circulation in the pelvic organs;
  • erythropoietin preparations;
  • vitamin D.

If renal failure occurs in a chronic form and there is a long-term violation of the filtration function of the kidneys, then the patient is prescribed a hemodialysis procedure - hardware blood purification. Manipulation is performed regularly, eliminates toxins from the body. If chronic renal failure is severe, hemodialysis does not give positive results, then the patient is shown kidney transplantation. After the operation, therapy is carried out that increases immunity and prevents rejection of the transplanted organ by the body.

Regardless of whether acute or chronic renal failure is diagnosed, general measures are indicated for patients:

  • fluid restriction - will help stabilize the water-salt balance and normalize urination;
  • refusal to use certain drugs - the action is agreed with narrow specialists if the patient is prescribed medication for life;
  • menu correction - diet implies strict control over the intake of salt, nuts, dairy products, liver, meat.

Treatment is prescribed at the Research Institute of Urology and Interventional Radiology named after. ON THE. Lopatkin on an individual basis, after receiving the results of analyzes and instrumental examinations. In men, the treatment of the inflammatory process in the prostate gland can be carried out in parallel. If kidney failure is diagnosed in a woman during pregnancy, then the treatment will be aimed at stabilizing the water-salt balance and cleansing the body of toxins.

Possible complications

If renal insufficiency proceeds without treatment, its symptoms and signs are ignored, then serious complications may develop:

  • arrhythmia and pericarditis;
  • anemia and heart failure;
  • encephalopathy and peptic ulcer of the stomach, duodenum;
  • vascular atherosclerosis with subsequent development of a heart attack, stroke.

In a man, renal insufficiency is complicated by lack of sexual desire, prostatitis and impotence. In a woman during pregnancy, kidney failure can lead to congenital malformations of the fetus and miscarriage.

Without treatment, chronic renal failure is fatal for the patient because uremic coma and cardiovascular complications develop.

Kidney failure is a serious impairment of kidney function that, if left untreated, leads to complications and death. Symptoms and signs are not expressed only at the initial stage of development. Diagnosis consists in a laboratory study of blood and urine tests, ultrasound of the pelvic organs and the abdominal cavity. If acute renal failure is being treated, then the chances of recovery and full restoration of kidney function are high. Chronic renal failure is introduced into the stage of long-term remission, and if the patient follows the doctor's recommendations / prescriptions, his life will remain active.

Branches and departments that treat kidney failure

Research Institute of Urology and Interventional Radiology. ON THE. Lopatkin - a branch of the Federal State Budgetary Institution "NMITs Radiology" of the Ministry of Health of Russia.

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Kidney failure - causes, symptoms, stages, diagnosis, diet, treatment0003


Renal failure is an acute or chronic disease in which the filtration, excretory and other functions of the kidneys are disturbed with the development of numerous failures in the functioning of the whole organism. In this case, poisoning occurs with its own toxic metabolic products that have entered the blood - uremia. Pathology, especially with rapid development, can threaten the life of the patient and requires prompt treatment.

The global prevalence of chronic kidney disease averages 13.4%. In Russia, renal failure occurs in 36% of people over 60 years of age and in 16% of working-age citizens.

Reasons

The chronic form of the disease most often develops as a complication of other pathologies. Previously, glomerulonephritis was thought to be the main cause of renal failure. Currently, the leading place is occupied by hypertension and diabetes mellitus, leading to damage to the small vessels that feed the kidneys, and persistent circulatory disorders in them.

Acute renal failure (ARF) in more than half of cases is associated with trauma or surgery on the pelvic organs. It also develops with improper use of medications, disruption of the heart, bleeding and shock, generalized allergic reaction, dehydration, cirrhosis, poisoning, autoimmune and infectious diseases, oncology, transfusion of incompatible blood.

The following factors predispose to impaired functioning of the kidneys:

  • poor ecology;
  • nutritional features;
  • male;
  • over 60 years of age;
  • overweight;
  • bad habits - smoking, alcohol abuse;
  • genetic predisposition;
  • taking certain medications;
  • infectious and parasitic lesions;
  • chronic diseases of the cardiovascular (including high blood pressure), urinary and endocrine systems;
  • violation of fat metabolism, dyslipidemia, hypercholesterolemia, metabolic syndrome.

Symptoms of kidney failure

The kidneys not only cleanse the blood of toxins and remove them from the body, but also regulate the water-salt balance, control the level of blood pressure, vascular tone, hemoglobin concentration, and help maintain the health of the musculoskeletal system and heart. Given such a variety of organ functions, renal failure is manifested by numerous symptoms, the severity of which depends on the stage and form of the disease.

In acute kidney injury at the initial stage, there are only manifestations of the underlying disease. This is followed by the most severe, oliguric stage, lasting up to 3 weeks, with a decrease in daily urine volume of less than 500 ml. The first sign of the disease is a sharp decrease or cessation of urination.

The condition is often reversible (if the underlying disease or condition leading to ARF is reversible) and, with proper treatment, progresses to polyuric renal failure with recovery of urine volume. In this case, the patient's well-being is normalized, but dehydration of the body may develop and an infection may join. The full recovery stage lasts from six months to a year. With severe violations, the condition becomes chronic.

Chronic renal failure (CRF) develops slowly, over several months or even years, and leads to permanent changes in the organ. At the initial stage, there are usually no specific symptoms, but sometimes a person may notice a decrease in the amount of urine excreted. Or the only manifestation of the pathology may be nocturia - frequent nighttime urination.

As the disease progresses and uremia sets in, other symptoms appear:

  • apathy, general weakness;
  • thirst;
  • bad taste in the mouth;
  • sleep disorder;
  • memory impairment;
  • nausea.

In the absence of effective treatment, neurological disorders join - involuntary muscle twitches, a decrease in the speed of reactions, as well as profuse vomiting, diarrhea, shortness of breath, irritation of the skin and mucous membranes.

Complications

The disease is complicated by the appearance of arterial hypertension, anemia, pericarditis, arrhythmia and heart failure, osteoporosis, gout, encephalopathy, peptic ulcer of the stomach and duodenum, atherosclerosis of the vessels with the development of heart attack and stroke, restless legs syndrome.

In children, kidney failure leads to delayed bone growth.

The development of renal failure in women during pregnancy is associated with miscarriage or the formation of congenital malformations in it.

Without treatment, chronic renal failure can result in the death of the patient from cardiovascular complications or uremic coma.

Diagnostics

During the initial examination, the doctor collects an anamnesis of the disease, specifying complaints and the duration of symptoms. Next, an examination of the skin, palpation and tapping with the fingers of the lumbar region are carried out.

The diagnosis of renal insufficiency is made on the basis of the following laboratory and instrumental studies:

  • Urinalysis. The method allows you to determine the cause of the disease. An admixture of blood, the presence of red blood cells in the biomaterial indicate urolithiasis, glomerulonephritis, infection, neoplasm or injury. White blood cells indicate an infectious or autoimmune process. Urine density may also decrease, protein and waxy cylinders may be present in it.
  • Clinical blood test. An increase in leukocytes and ESR indicates an infectious process, and a decrease in the number of erythrocytes and hemoglobin in the blood indicates concomitant renal failure anemia.
  • Biochemical blood test. An increase in serum urea and creatinine is the main sign of renal failure. These substances are formed during the breakdown of proteins and can be excreted from the body exclusively with urine. A progressive increase in creatinine concentration is the main diagnostic criterion for the severity of the disease. Diabetes mellitus is one of the most common causes of chronic renal failure, however, even without endocrine diseases, with kidney dysfunction, there is a tendency to a moderate increase in blood glucose. A significant increase in potassium levels accompanies a pronounced impairment of kidney function, and a high concentration of uric acid is characteristic of gout and can lead to the development of urolithiasis. Also in blood tests for renal failure, albumin, calcium are often reduced, triglycerides, alkaline phosphatase, phosphorus and cholesterol are increased.
  • Kidney biopsy. In difficult diagnostic cases, a small part of the kidney tissue can be taken, which is subjected to subsequent examination through a microscope. The method allows to detect characteristic histological signs of CRF - replacement of kidney glomeruli with scar tissue.
  • Ultrasound examination of the pelvic organs. An important place in the diagnosis of renal failure is occupied by ultrasound of the kidneys. With chronic renal failure, their decrease (wrinkling) is noted along with the thinning of the outer layer. The method is also used to detect neoplasms, stones or cysts.
  • Computed and magnetic resonance imaging of the abdominal cavity. A more accurate way to visualize tumors, cysts and stones even smaller than 5 mm.

Treatment of kidney failure

Diagnosis and treatment of the pathology that caused renal failure, as well as the elimination of risk factors, are mandatory.

An important role in the treatment of the disease is played by general measures aimed at maintaining the function of the affected organ:

  1. Fluid restriction.
  2. Refusal to take certain medications.
  3. Supply correction. A diet for kidney failure involves limiting foods and drinks with a high content of sodium, phosphorus, and potassium. These are table salt, dairy products, liver, legumes, nuts. The amount of protein consumed is also strictly dosed.

Conservative treatment of renal failure is prescribed by the doctor based on the results of the tests. To restore the water-salt balance, special solutions are administered intravenously through a dropper. With fluid retention, diuretics may be used. Therapy is also carried out with agents that improve blood circulation in the pelvic organs, erythropoietin preparations, vitamin D.

In case of a severe or prolonged impairment of the filtration function of the kidneys, the patient is indicated for hardware-assisted blood purification - hemodialysis.


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