Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys are functioning at less than 15% of normal. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; or chronic kidney failure, which develops slowly. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, high blood potassium, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anemia.
Causes of acute kidney failure include low blood pressure, blockage of the urinary tract, certain medications, muscle breakdown, and haemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, high blood pressure, nephritic syndrome, and polycystic kidney disease. Diagnosis of acute failure is often based on a combination of factors such as decrease urine production or increased serum creatinine.
Treatment of acute failure depends on the underlying cause. Treatment of chronic failure may include haemodialysis, peritoneal dialysis, or a kidney transplant. Haemodialysis uses a machine to filter the blood outside the body. In peritoneal dialysis specific fluid is placed into the abdominal cavity and then drained, with this process being repeated multiple times per day. Kidney transplantation involves surgically placing a kidney from someone else and then taking immunosuppressant medication to prevent rejection. Other recommended measures from chronic disease include staying active and specific dietary changes.
Signs and symptoms:
- Vomiting or diarrhea (or both) may lead to dehydration
- Weight loss
- Nocturnal urination (nocturia)
- More frequent urination, or in greater amounts than usual, with pale urine
- Less frequent urination, or in smaller amounts than usual, with dark coloured urine
- Blood in the urine
Diet: In non-diabetics and people with type 1 diabetes, a low protein diet is found to have a preventative effect on progression of chronic kidney disease. However, this effect does not apply to people with type 2 diabetes. A whole food, plant-based diet may help some people with kidney disease. A high protein diet from either animal or plant sources appear to have negative effects on kidney function at least in the short term.
Slowing progression: People who received earlier referrals to a nephrology specialist, meaning a longer time before they had to start dialysis, had a shorter initial hospitalization and reduced risk of death after the start of dialysis. Other methods of reducing disease progression include minimizing exposure to nephrotoxins such as NSAIDs and intravenous contrast.
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Clinical Nephrology and Research: Open Access