What Is Chronic Kidney Failure?
Your kidneys are responsible for filtering excess fluids and waste products from your blood. This waste is then eliminated in your urine. Chronic kidney failure refers to the loss of kidney function over months or years. In advanced stages, dangerous levels of wastes and fluids back up in your body. This condition is also called chronic kidney disease.
Symptoms of Chronic Kidney Failure
If you’re in the early stages of chronic kidney failure, you may or may not have symptoms. Many of the early signs of kidney failure can be confused with other illnesses and conditions. This makes diagnosis difficult.
Early symptoms include:
- nausea and vomiting
- loss of appetite
- chest pain
- uncontrollable high blood pressure
- unexpected weight loss
If the damage to your kidneys gets worse, you will eventually notice symptoms. However, this may not happen until a lot of damage is already done.
Later-stage symptoms include:
- difficulty staying alert
- cramps and twitches
- numbness in your limbs
- bad breath
- skin that’s darker or lighter than usual
- bone pain
- excessive thirst
- bleeding and bruising easily
- urinating much more or less than usual
- swollen feet and ankles
- absent menstrual periods
- shortness of breath
Chronic kidney disease can also lead to serious complications, including:
- high blood pressure
- fluid buildup in your lungs or other areas
- vitamin D deficiency, which can affect your bone health
- nerve damage that can lead to seizures
Causes of Chronic Kidney Failure
Diabetes and high blood pressure are the most common conditions that lead to chronic kidney failure.
Other causes include:
- damage to kidney function
- recurring kidney infections
- inflammation in your kidneys’ filtration system
- congenital kidney disease
- obstruction of your urinary tract
- autoimmune disorders
You’re at a higher risk of chronic kidney failure if you:
- are obese
- have diabetes
- have heart disease
- have high cholesterol
- have a family history of kidney disease
- are Native-American, African-American, or Asian-American
- are over the age of 65
Diagnosing Chronic Kidney Failure
If you have high blood pressure, diabetes, or another condition that puts you at higher risk of kidney failure, your doctor will likely monitor your kidney function. Be sure to have regular checkups and report any unusual symptoms.
At your appointment, your doctor will examine you thoroughly. Kidney failure may be causing fluids to back up in your lungs or heart. Your doctor will examine these organs by listening to them with a stethoscope. This can give your doctor important clinical information.
Blood and Urine Tests
If your doctor thinks you might have chronic kidney failure, they will order blood and urine tests.
Blood tests for kidney function measure the levels of electrolytes and waste in your blood. They measure waste products such as creatinine and blood urea. Creatinine is a byproduct of muscle metabolism. Blood urea is leftover when your body breaks down proteins. When your kidneys are working properly, they excrete both substances.
Urine tests will be performed to check for abnormalities. For example, protein is normally only present in trace amounts in your urine. An elevated protein level might indicate kidney problems months or even years before other symptoms appear. Your urine sediment and cells found in your urine will also be examined in a laboratory.
Imaging tests can provide structural details of your kidneys. These include an ultrasound, MRI scan, or CT scan.
If your doctor is still unsure about the cause of your symptoms, they may do a biopsy. This can be performed as a needle biopsy or an open biopsy.
A needle biopsy is the most common type of kidney biopsy. During this procedure, your doctor or technician will insert a special needle into your kidney. This is considered a minimally invasive procedure.
During an open biopsy, your doctor will use a surgical incision to expose your kidney. This procedure requires strict sterile techniques and general anesthesia.
After your doctor collects a sample of kidney tissue, they will send it to a lab for microscopic examination.
Testing Results and Follow-Up
The results of your examination will help your doctor make a diagnosis. It can also help them determine the cause of your kidney failure.
If you’re diagnosed with chronic kidney failure, you will need regular blood tests. These will be used to measure various substances in your body, such as calcium, potassium, cholesterol, sodium, magnesium, and phosphorous. You will also need to undergo ongoing kidney function tests for creatinine and urea levels.
Treatment of Chronic Kidney Failure
There is no cure for chronic kidney failure. However, there are measures you can take to slow its progression.
Kidney failure is linked to high blood pressure, so your doctor may put you on blood pressure medication. You might also need medications called statins to lower your cholesterol level.
Often people with chronic kidney failure experience anemia. Anemia occurs when your body doesn’t produce enough red blood cells. You may need a supplement to help increase your red blood cell production. Because your body needs iron to manufacture blood cells, your doctor might also prescribe iron pills or shots. In some cases, you may need a blood transfusion to improve your red blood cell health.
If your kidney problem is causing fluid retention, diuretics can help relieve your swelling. This medicine makes you urinate frequently.
Calcium and vitamin D supplements help to protect your bones. If you have chronic kidney disease, you will have lower-than-normal levels of Vitamin D, which is essential for calcium absorption. Taking Vitamin D will reduce your risk of bone fractures. Phosphate is elevated in kidney failure, and this can also reduce your body’s absorption of calcium. Your doctor may prescribe phosphate binders, a type of medicine to control your phosphate level.
Antihistamines can relieve the symptom of itchy skin.
Antiemetics can help with nausea.
Dietary changes might also be necessary. People with chronic kidney failure usually need to reduce their protein intake. As your body processes protein, it creates waste products. Your kidneys are responsible for filtering this waste. A lower-protein diet makes their job easier.
You might also need to monitor your levels of salt, potassium, and phosphate. Work with a dietitian to find out how much of these substances you should eat.
Get in the habit of reading labels. Even if you don’t add table salt to your food, many prepared foods, such as canned soup or fast food, are already high in sodium.
Learn which foods are high in potassium and which are low. Your kidneys are responsible for filtering excess potassium out of your body. When they’re not functioning well, they won’t be able to filter potassium properly. In people with chronic kidney failure, high levels of potassium (hyperkalemia) can be life threatening. It can lead to abnormal heart functioning or paralysis.
Your kidneys may not be able to process phosphate either. Phosphate can also diminish your body’s ability to absorb calcium. High-phosphate foods include fish, dairy products, eggs, and meat. You may need to eat less of these.
You may also need to limit your fluids, so your kidneys don’t have to work too hard.
People with chronic kidney failure often lose weight. Make sure you’re consuming enough calories from foods that your dietitian has approved and recommended.
You should also avoid smoking and keep up to date on your vaccinations, including your flu shots. Discuss supplements and over-the-counter medications with your doctor before taking them. If you see other doctors for different conditions, always inform them of your kidney situation.
If attempts to control your condition through diet and medication fail, you might face end-stage kidney disease. This occurs when your kidneys are operating at only 10 to 15 percent of their full capacity. At this stage, your kidneys can no longer eliminate waste as fast as you’re producing it.
There are two treatment options for end-state kidney disease: dialysis and kidney transplant. Doctors try to postpone these options as long as possible because both carry serious risks.
Dialysis is a system for filtering waste products and excess fluids out of your blood. There are several ways to do this. The two main types of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, your blood is filtered outside of your body, in a machine. In peritoneal dialysis, you fill your abdominal cavity with a special solution via a catheter. The solution absorbs excess fluid and waste before it’s drained from your body. Because dialysis usually needs to be done several times a week, it’s a big lifestyle change. Dialysis also carries a risk of infection.
Kidney transplant is more convenient than dialysis, if you can find an appropriate donor kidney. The donor needs to have the same blood type you. A kidney from a living sibling or other close relative is usually best. You could also get your kidney from a deceased donor. However, kidney transplants also carry a large risk of infection because you will need lifelong immunosuppression.
Long-Term Outlook for Chronic Kidney Failure
Some people with chronic kidney failure manage to live for many years. This can only be accomplished if you keep your kidneys from getting worse through lifestyle changes and medication. You will need to maintain a kidney-healthy regimen for the rest of your life.
If you reach end-stage kidney disease, you will need dialysis or a kidney transplant. Without such interventions, the disease is fatal.
The health of your kidneys affects your other organs and systems, too. Possible complications of kidney failure include heart and liver failure, damage to your nerves, stroke, fluid buildup in your lungs, infertility, erectile dysfunction, dementia, and bone fractures.
Children with kidney failure may not grow properly because their kidneys can’t activate vitamin D. Vitamin D is essential for bone growth.
Kidney failure also poses serious risks to pregnant women and their unborn babies. Pregnant women with kidney failure face a higher incidence of preeclampsia. Preeclampsia is a spike in blood pressure that can lead to brain or liver hemorrhage in pregnant women. This can potentially kill pregnant women and their unborn babies.
Preventing Chronic Kidney Failure
You can prevent kidney failure by making healthy lifestyle changes. Here are some general guidelines for healthy living:
- Women and men over 65 should limit themselves to no more than one alcoholic drink per day. Men who are younger than 65 should stop at two drinks.
- Maintain good control of your blood pressure.
- If you have diabetes, control your blood sugar.
- If you’re overweight, try to get down to a healthy weight. This usually means consuming fewer calories and being more active.
- Over-the-counter pain relievers can cause kidney damage. Follow the directions on the packages, only them take as needed, and discuss the use of pain relievers with your doctor if you have any kidney concerns.
- If you smoke cigarettes, quit today.