Wednesday 30 December 2015

Renal causes of kidney failure



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:
§  Nonsteroidal anti-inflammatory drugs(NSAIDs) like ibuprofen (Advil, Motrin, and others), and naproxen (Aleve, Naprosyn)
§  Antibiotics like aminoglycosides gentamicin (Garamycin), tobramycin
§  lithium (Eskalith, Lithobid)
§  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 
develops over months and years. The most common causes of chronic renal failure are related to:
§  poorly controlled diabetes,
§  poorly controlled high blood pressure, and
§  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
§  Fatigue
§  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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