RENAL FAILURE, CHRONIC

(Kidney Failure, Chronic)

 Basic information

description

Chronic renal failure is a gradual failure (over months to years) of the kidneys to function. Kidneys have several important functions. They produce certain hormones and help rid the body of waste products. When kidneys fail, the waste products build up and cause symptoms that vary in severity. Kidney failure can affect all ages (often the elderly).

FREQUENT SIGNS & SYMPTOMS

• None or few symptoms until 60% to 75% of the kidney function fails. The symptoms listed may then occur.
• Listlessness, mental confusion, and drowsiness.
• Mild shortness of breath. Swelling of feet and ankles.
• Sudden weight change or nausea and vomiting.
• Itching, dry skin, and easy bruising.
• Headaches.
• Frequent hiccups.
• Changes in urine flow.
• Muscle cramps, twitches, or pain. Bone or joint pain.
• Numbness or tingling in hands or feet.
• Anemia with paleness and fatigue.
• Unusual bleeding.
• High blood pressure.

causes

Many conditions (in the kidney, or in other areas of the body) can cause the kidneys to slowly lose their ability to function normally.

risk increases with

• High blood pressure.
• Diabetes or gout.
• Disorders that cause kidney inflammation such as systemic lupus erythematosus.
• Glomerulonephritis (kidney inflammation).
• Polycystic kidney disease; other hereditary disorders.
• Chronic kidney stones and infections.
• Use of certain drugs that are toxic to the kidneys.
• Blood vessel diseases and various cancers.
• Previous kidney surgery.
• HIV, sickle cell disease, and amyloidosis.
• Heroin abuse.

PREVENTIVE MEASURES

None specific. Avoid risk factors where possible or get medical care for diseases that can lead to kidney failure.

expected outcomes

Kidney failure is a condition that worsens gradually. Treatment can help slow the progress. Kidney dialysis or kidney transplant will eventually be needed.

possible complications

• Kidney failure can affect almost any body function.
• End stage renal disease (ESRD).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include blood and urine tests that measure kidney function and fluid and electrolytes. Ultrasound, x-ray, heart studies, and other tests may be done to diagnose underlying disorder or complications.
• Treatment is aimed at slowing the progress of the disease, treating the underlying disorder, treating complications, and replacing kidney function.
• Treatment steps may include hospital care, drugs, diet changes, dialysis, and kidney transplant.
• Hospital care may be needed for severe symptoms.
• Dialysis to filter and remove waste products from the blood may be needed for advanced kidney failure. Hemodialysis uses a machine. Peritoneal dialysis uses the body's abdominal lining as a filter.
• A kidney transplant may be recommended.
• To learn more: National Kidney Foundation, 30 E. 33rd St., New York, NY 10016; (800) 622-9010; website: www.kidney.org.

medications

• Your health care provider may prescribe:
  • Diuretics to reduce fluid build-up in the body.
  • Drugs to lower high blood pressure, treat anemia, treat an underlying disorder, prevent bone loss, treat symptoms (such as itchy skin), or treat complications.
  • Changes in drugs you now take that may be toxic to the kidneys.

activity

Reduce activity as needed. Get adequate sleep.

diet

Limits on protein, salt, and fluids are usually needed. A dietitian can be helpful in providing instructions.

 notify our office if

• You or a family member has symptoms of chronic renal failure.
• Chest pain, fainting, difficulty breathing, severe vomiting, bleeding, weakness, or a change in alertness occur.

Special Notes: