Kidney failure, renal dysfunction
English: renal failure
Under one Renal failure one understands the decrease in kidney function (see also: kidney). A distinction is made between the acute Renal failure from the chronic, whereby the former is characterized by a rapid, in principle reversible (rto be undone) Decrease in kidney function, the latter, however, is characterized by a gradual, irreversible (irreversible).
Read on under: Functions of the kidney
Kidney failure can manifest itself through many different symptoms. The main symptom is that decreased urea excretion.
This can lead to a Polyneuropathy (Disease of the peripheral nerves) with impaired sensation and abnormal sensations. Decreased appetite, Hiccups, Headache and vomiting are other symptoms. The build up of urea in the pericardium can cause a Pericarditis trigger. Also Heart failure and cardiac arrhythmias are possible symptoms.
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Because the urea no longer or hardly leaves the body, it accumulates in the organism. The too high urea value leads to Acidification of the blood, the urea is then excreted in the exhaled air. The exhaled air has a characteristic odor (foetor uraemicus), and it also occurs Hyperventilation (increased breathing). In severe cases of chronic kidney failure or in acute kidney failure it occurs Drowsiness and confusion or coma with Kussmaul breathing (deep, sighing breathing).
The kidneys produce erythropoietin (EPO), a Hormone that stimulates blood formation. With renal insufficiency it occurs as a result of the lack of EPO Anemia (Anemia) with paleness and tiredness. The kidneys are responsible for activating vitamin D: renal failure leads to Vitamin D deficiency and thus to a breakdown of the bone substance, Bone pain are the consequence.
Other symptoms of kidney failure affect the digestive tract (uremic gastritis or colitis, stomach ulcers), the blood system (decreased function of platelets and white blood cells) or the lungs.
$config[ads_text2] not foundRead more here: Symptoms of renal insufficiency
In chronic kidney failure, various skin diseases occur.Typical symptoms are calcification of the skin, yellowish discoloration and other pigmentation disorders.
In addition, the number of sebum and sweat glands in the skin is reduced, resulting in dry skin. The reduced excretion of urinary substances impairs the function of the blood platelets: patients with kidney failure often bruise more quickly than patients with healthy kidneys.
Another skin symptom of kidney failure is itching. On the one hand, it is favored by dry skin, and on the other hand, more mast cells are present in the skin in the case of kidney failure. These mast cells are actually involved in allergic reactions. They release the tissue hormone histamine, which gives the skin the feeling of "itching" via the free nerve endings.
The next article could also be of interest to you. Read more about this in our next article: Calcified Kidney - Causes, Diagnosis & Therapy
Acute renal failure occurs 1 to 5% the hospital patient on; more than 10% of patients in intensive care.
In Western Europe, the incidence of chronic renal failure is 10 per 100,000 per year.
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Acute kidney failure is often caused by circulatory disorders in the kidneys. Examples are circulatory shock from an accident or surgery, a blood clot in the kidney vessels, and certain medications. Long-term lack of oxygen can also lead to acute kidney failure. In addition, obstruction of the urine flow can damage the kidney. An enlarged prostate, urinary stones, inflammation and tumors can obstruct the urinary tract and impede the flow of urine. As a result, acute kidney failure can occur. Chronic kidney failure is caused by diabetes mellitus (diabetic nephropathy) in 35 percent of cases. In addition, high blood pressure is another common cause and at the same time a possible consequence of kidney failure. Various kidney infections, such as glomerulonephritis or interstitial nephritis, can also lead to the development of kidney weakness. Congenital malformations such as cyst kidneys can impair kidney function at an early stage and result in chronic kidney failure. There are also some drugs that can damage the kidneys. These include over-the-counter medicines like acetaminophen, ibuprofen, and diclofenac. These drugs can lead to chronic kidney failure, especially if they are used for a long time.
$config[ads_text2] not foundAcute renal insufficiency: Acute renal insufficiency is first diagnosed with the aid of the anamnesis and the clinical picture including the amount of urine excreted. In addition, blood (including the retention values creatinine and urea; Electrolytes) and urine (Urine status, urine sediment) examined. In addition to the diagnosis of "renal insufficiency", an imaging of the kidneys can be arranged, whereby ultrasound (Sonography, vascular doppler), MRI and CT. The last to be mentioned as a diagnostic means is a kidney biopsy, whereby kidney tissue is obtained for a microscopic examination with the help of a punch.
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Read more on the subject at: Urea increased
Chronic renal insufficiency: The diagnosis of "chronic renal insufficiency", like the acute form, is made on the basis of the anamnesis, the clinical picture, the laboratory (blood and urine, see "acute renal insufficiency") and imaging procedures.
Read more on the subject at: Kidney values
Acute kidney failure can have various causes. Depending on the cause, patients are either dehydrated (lack of water) or overloaded with fluids (edematous). The kidney values in the blood rise, the urine production decreases.
Acute renal insufficiency has a very good healing tendency with rapid, professional treatment, but can last up to 6 weeks. This is often followed by a recovery phase in which more urine is produced.
If the acute kidney failure is part of a multiple organ failure (i.e. several organs give up their function in a short time), the prognosis is much less favorable.
Find out more about: Troponin test
Chronic renal failure describes a gradually worsening, irreversible functional impairment of the kidneys. See also here: kidney values
Stages of renal failure
$config[ads_text1] not foundAn important reference value for kidney function in kidney failure is the glomerular filtration rate (GFR), which is 95 to 120 milliliters per minute in healthy people. The GFR indicates how much blood volume the kidneys can filter in a certain time unit. It is therefore a parameter for the function and filtration of the kidneys. With the increase in renal insufficiency, the GFR worsens.
For more information, we recommend our website to: Stages of renal failure
The division according to the so-called kidney values, whose concentration in the blood can be determined, is now explained here. The most important of these urinary substances are creatinine and urea, they must be excreted with the urine. When kidney function declines, kidney values rise, which is why they are used as a marker for kidney function.
Also read the article on the topic: Urinary poisoning
You might also be interested in: Stages of renal failure
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Acute renal failure: In the case of acute renal insufficiency, the underlying disease causing the disease is treated first.
In addition, symptomatic therapy of renal insufficiency can be carried out, which is a Balancing of the fluid and electrolyte balance of the patient. Specifically, this means the documentation of the recorded (Drinks, infusions) and the discharged liquid (urine, sweat, diarrhea, Vomit etc.) including daily weighing. In addition, to maintain urine production, special dehydrating agents (Loop diuretics) administered.
The last option for treating renal failure is what is known as a Renal replacement therapy on. In this process, the patient's blood is cleaned of excess water and urinary substances outside the body and then filtered back again (Hemodialysis, hemofiltration, combined methods).
Chronic renal failure: Preventing the progression of the disease and starting treatment early is important in the treatment of chronic kidney failure. At first, this can be tried conservatively: Treatment of the underlying disease, Stopping kidney-damaging drugs, Lowering blood pressure (increased values damage the kidneys), low in protein diet (to reduce kidney blood filtration), increased fluid intake, administration of loop diuretics (Dehydrating agent), Control of electrolytes, lowering of cardiovascular risk factors.
If the effect is insufficient, the chronic form of renal insufficiency as well as the acute one is treated with a kidney replacement procedure. If this therapy option fails, there is still the possibility of one Kidney transplant.
Acute renal failure: In intensive care patients with acute renal insufficiency, the mortality rate is (mortality ) at 60%. On the one hand, the underlying disease influences the mortality rate; on the other hand, acute kidney failure itself - regardless of the disease causing it - is a prognostically unfavorable factor, as it has a damaging effect on body and organ functions.
Chronic renal failure: The prognosis of the chronic form Dialysis therapy (Kidney replacement procedure) depends on the age of the patient. Overall, the 10-year survival rate is around 55%, but it decreases with increasing age. Became a Organ transplant completed, optimal blood pressure adjustment, treatment of high blood lipids (Hyperlipidemia) and protein loss in urine (Proteinuria), Normal weight and abstinence from nicotine are decisive. The origin of the new organ also plays a role, because with a corpse donation the kidney still functions in 70% of patients after 5 years, with a living donation, however, in up to 90%.
Basically, the earlier kidney failure is recognized and treated, the better the prognosis and life expectancy. In the case of chronic kidney weakness, cure is usually not possible and the lifespan can be shortened. In particular, the simultaneous occurrence of kidney failure and diabetes mellitus have a negative impact on life expectancy. Consequential damage such as diseases of the cardiovascular system can lead to serious complications. In the case of pronounced renal insufficiency, dialysis procedures and, in the best case, a donor kidney can lead to an improvement in the quality of life and an extension of the life span.
For more information on this topic, please also read: Life expectancy with renal insufficiency
Patients with renal insufficiency should Eat low in protein, low in phosphate and low in potassium, but high in calcium. In addition, a optimal adjustment of blood sugar levels in diabetic patients.
Read more about the topic here: Kidney failure diet, potato and egg diet
Renal failure denotes the loss of function of the Kidneys, being between acute and chronic Kidney failure is distinguished. Acute renal insufficiency develops faster than chronic and, in contrast to the chronic form, is in principle reversible (undo).
Renal insufficiency is diagnosed with the help of the anamnesis, the clinical picture, blood and urine tests (especially the retention values creatinine and urea, glomerular filtration rate) as well as imaging procedures (including Ultrasonic). The clinical picture usually includes changes in urine output, with both an increase (Polyuria) as well as a decrease (Oliguria, anuria) may occur.
In both forms of renal insufficiency, therapy is primarily focused on Treatment of the underlying disease leading to loss of function, there is also a conservative therapy with monitoring of the fluid balance and the administration of special dehydrating agents (Loop diuretics). In the case of inadequate success, a. In both acute and chronic renal insufficiency Kidney replacement procedure be initiated, with extracorporeal (= outside the body) devices the Task of filtering blood take over.
The last resort to treat chronic kidney failure is to transplant a new organ.