Kidney
Failure
Kidney
failure facts.
§ Kidneys are the organs that help filter waste
products from the blood. They are also involved in regulating blood pressure, electrolyte balance, and red blood cell production in the body.
§ Symptoms of kidney failure are due to the
build-up of waste products in the body that may cause weakness, shortness of breath, lethargy, and confusion. Inability to remove potassium from the
bloodstream may lead toabnormal heart rhythms and sudden death. Initially kidney failure may
cause no symptoms.
§ There are numerous causes of kidney failure, and
treatment of the underlying disease may be the first step in correcting the
kidney abnormality.
§ Some causes of kidney failure are treatable and
the kidney function may return to normal. Unfortunately, kidney failure may be
progressive in other situations and may be irreversible.
§ The diagnosis of kidney failure usually is made
by blood tests measuring BUN, creatinine, and glomerular filtration rate (GFR).
§ Treatment of the underlying cause of kidney
failure may return kidney function to normal. Lifelong efforts to control blood
pressure anddiabetes may be the best way to prevent chronic kidney diseaseand its progression to kidney failure. As we age kidney function
gradually decreases over time.
What are the kidneys?
The kidneys play key roles in body
function, not only by filtering the blood and getting rid of waste products,
but also by balancing the electrolyte levels in the body, controlling blood
pressure, and stimulating the production of red blood cells.
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The kidneys are located in the
abdomen toward the back, normally one on each side of the spine. They get their
blood supply through the renal arteries directly from the aorta and send blood back to the heart via the
renal veins to the vena cava. (The term "renal" is derived from the
Latin name for kidney.)
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The kidneys have the ability to
monitor the amount of body fluid, the concentrations ofelectrolytes like sodium and potassium, and the acid-base
balance of the body. They filter waste products of body metabolism, like
urea from protein metabolism and uric acid from DNA breakdown. Two waste
products in the blood usually are measured; 1) blood urea nitrogen (BUN), and
2) creatinine (Cr)
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Renal causes of kidney failure
(damage directly to the kidney itself) include:
Sepsis: The body's immune system
is overwhelmed from infection and causes inflammation and shutdown of the
kidneys. This usually does not occur with simple urinary tract
infections.
Medications: Some medications are
toxic to the kidney including:
§ Antibiotics like aminoglycosides gentamicin (Garamycin), tobramycin
§ Iodine-containing medications such as those injected
for radiology dye studies
Rhabdomyolysis: This is a situation in which there is significant muscle breakdown
in the body, and the damaged muscle fibers clog the filtering system of the
kidneys. Massive muscle injury may occur because oftrauma, crush injuries, and burns. Some medications used to treat highcholesterol may causerhabdomyolysis.
Multiple myeloma
Acute glomerulonephritis or inflammation of the
glomeruli, the filtering system of the kidneys. Many diseases can cause this
inflammation including:
§ Goodpasture syndrome.
Hemolytic uremic syndrome: This condition results from abnormal destruction of red blood
cells. It most often occurs in children after certain infections, but also may
be caused by medications, pregnancy, or can occur for unknown reasons.
Post renal causes of kidney failure (post=after + renal= kidney) are due to factors
that affect outflow of the urine:
§ Obstruction of the bladder or the ureters can
cause back pressure because the kidneys continue to produce urine, but the
obstruction acts like a dam, and urine backs up into the kidneys. When the
pressure increases high enough, the kidneys are damaged and shut down.
§ Prostatic hypertrophy or prostate cancer may block the urethra and prevents the bladder
from emptying.
§ Tumors in the abdomen that surround and obstruct
the ureters.
§ Kidney stones. Usually, kidney stones affect only one kidney
and do not cause kidney failure. However, if there is only one kidney present,
a kidney stone may cause the remaining kidney to fail.
Chronic renal failure
§ chronic glomerulonephritis.Less common causes of
chronic renal failure include:
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§ Reflux nephropathy (damage caused by urine
backflow from the bladder into the ureters and kidney)
§ Nephrotic syndrome
§ Alport's disease
§ Interstitial nephritis
§ Kidney stones
§ Prostate disease
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Initially, kidney
failure may be not produce any symptoms (asymptomatic). As kidney function
decreases, the symptoms are related to the inability to regulate water and
electrolyte balances, clear waste products from the body, and promote red blood
cell production.
If unrecognized or untreated, the following
symptoms of kidney failure may develop into life-threatening circumstances.
§ Lethargy
§ Weakness
§ Shortness of breath
§ Generalized swelling (edema)
§ Generalized weakness due to anemia
§ Lethargy
§ Metabolic acidosis
§ Fatal heart rhythm disturbances (arrhythmias)
including ventricular tachycardia and ventricular fibrillation
§ Rising urea levels in the blood (uremia) may
lead to brainencephalopathy, pericarditis (inflammation of the heart lining), or low
calcium blood levels (hypocalcemia)
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