Diagnostic and treatment of Kidney failure
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Chronic or acute kidney disease is renal disease, when kidney gradually stops to function. It is also called chronic or acute renal failure. This disease can develop as a result of failure of secretory renal function. Primarily, kidneys are responsible for filtrating waste and eliminating excessive fluids that can be present in blood. In the course of this disease there is a progressive long-term accumulation of toxins in blood, which are normally eliminated from body by urine. Kidney disease can have chronic and acute forms. Chronic renal failure usually manifests itself after there was a progressive destruction of nephrons. Then, it results in impaired excretory function and a person feels symptoms of intoxication. This disease needs to be treated once diagnosed, because its prognosis is not very favorable. Findings shows that only in 2013 almost 100 000 people died from this disease, because there was no timely treatment. Nevertheless, this number has significantly decreased with respect to 1990, when almost 410 000 people died from kidney disease.
In most cases, acute or chronic renal failure is caused by some damage, which could appear as a result of acquired or congenital trauma or injury. It is also caused by type 1 or 2 diabetes, long history of hypertension, viral hepatitis B or C. If a person lives in country with high rate of malaria cases, kidney disease can develop as a result of having malaria. Also if a person suffers from an excessive amount of kidney stones or if there is urinary tract obstruction, it can also be a widespread cause of chronic or acute kidney disease. Some drugs and toxic substances contribute to development of this disease as well. Another renal failure cause is progressive liver disease. Food intoxication rarely contributes to the development of acute or chronic renal failure.
Symptoms depend on chronic or acute kidney disease stages. Early signs of disease are fatigue, frequent night urination, polyuria, which means an excretion of 3-5 liters of urine a day, and general dehydration. With renal failure progression almost all organs and systems become affected. General weakness increases. There can also be:
- Nausea
- Itching
- Muscle pain
- Signs of intoxication.
- Dryness
- Hoarseness
- Bitterness in mouth
- Increasing weight loss
- Pain
- Heaviness in pit of stomach
- Loose stools
- Pain in heart
- High blood pressure
Dysfunctional blood clotting, which can in the longer run result in nasal or gastrointestinal bleeding is another chronic or acute renal failure symptom.
In later stages people can have attacks of asthma and pulmonary edema. Complications can result in coma. Patients become more prone to infections, such as colds, pneumonia, which accelerates development of chronic renal failure.
- Diagnosis generally includes laboratory tests to check for decreased hemoglobin, signs of inflammation or tendency to bleeding.
- Biochemical analysis of blood can indicate increased levels of nitrogen metabolism, violation of electrolyte metabolism and reduced total protein in blood.
- Analysis of urine is necessary to determine amount of protein in urine. It can also show degree of kidney damage.
- Removing a sample of kidney tissue can also help with diagnosis as it determined stage of disease and assesses degree of damage done to kidneys. A doctor can also conduct an ultrasound examination of urinary system. Based on this information, he makes conclusion about disease prognosis and selects treatment.
- The most effective chronic kidney disease treatment is living-related kidney transplantation, as chances for recovery in this case are very high. In this type of transplantation relatives of a patient donate their kidney. According to Kidney Link.org, this transplantation is the safest because of antigen and gene compatibility. There are also decreased and living unrelated types of donors, who can donate their kidney. The basic requirement for donors is to have the same blood type and not have renal infections. For the rest of the life, person who underwent kidney transplantation is required to take special drugs, so that his body will not reject new kidney.
- Renal replacement, which is another treatment option, consists of hemodialysis and peritoneal dialysis.
- Hemodialysis is a method of extrahepatic blood purification, during which body toxins are eliminated and disorders of electrolyte balance are normalized. This is done by filtering the blood through semipermeable membrane of plasma. During hemodialysis a doctor surgically establishes a special catheter, through which harmful substances and excessive water are removed. This process lasts a few hours.
- Dialysis is used as a treatment in the preparation period of kidney transplantation.
After treatment begins the period of general therapeutic rehabilitation, when a person is returning to his normal lifestyle. One of the most important parts of this period is diet. Main components in diet with chronic or acute kidney disease are fats and carbohydrates. Fats need to be of vegetable origin and they must be eaten in amount sufficient to provide normal caloric intake. Source of carbohydrates should also have vegetable origin, except for beans, mushrooms and nuts. People should also avoid eating dried fruits, potatoes (fried and baked), chocolate, bananas, grapes and figs. They are also not recommended to drink milk and eat dairy products, as these products contain high level of protein. Coffee is also forbidden. It can be substituted by green tea.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
