|
Overview |
| |
| When both
kidneys stop working normally, the condition is called kidney
failure |
This failure
may be sudden ( )
or gradual and progressive ( ). |
| Chronic kidney
failure may also lead to permanent loss of kidney function (end- |
| stage kidney
failure) which is life threatening if not treated. |
| |
|
Acute kidney
failure |
| The kidneys will
stop working properly if their blood supply is suddenly reduced |
| This can happen
after serious bleeding, serious infection or a heart attack when |
| there is a large
drop in blood pressure. |
Kidney failure
may also result from diseases such as
 , |
 or
toxic chemicals and drugs. |
| |
|
Chronic kidney
failure |
 failure
is the gradual and progressive loss of function in both kidneys. |
| This causes
problems due to a build up of waste substances in the body. The |
| kidney function
may be reduced by as much as 60 percent before this build up
|
| of waste begins.
By this time the kidneys may be irreversibly damaged. |
 or a transplant
is very likely to be necessary in the future. |
| |
|
End-stage renal
disease (ESRD) |
| This occurs when
85 to 90 percent of kidney function has been lost.
or |
| a transplant is
necessary at this stage. End-stage kidney failure is terminal if |
| left untreated. |
| |
Stages of Chronic Kidney
Disease
|
Stages
|
Description
|
GFR(ml/min/1.73m2)
|
|
1
|
Normal or increase in GFR |
Greater than 90 |
|
2
|
Mild decrease in GFR |
60-89 |
|
3
|
Moderate decrease in GFR |
30-59 |
|
4
|
Severe decrease in GFR |
15-29 |
|
5
|
Kidney Failure |
Less than 15 or dialysis |
|
|
|
Symptoms |
| When you have
healthy kidneys, they remove waste materials and excess fluids |
| from the blood.
When the kidney is not functioning properly, the symptoms may |
| differ according
to the cause. |
| |
|
Symptoms of
acute kidney failure |
| The symptoms of
kidney failure may
appear rapidly, sometimes |
| over a period of
hours, they may include: |
| • Greatly
reduced urine volume |
| • Drowsiness and
headaches |
| • Vomiting |
| • Back pain |
| |
|
Symptoms of
chronic kidney failure |
| These symptoms
may develop gradually over weeks or even months: |
• You may
experience some water retention ( )
mainly around your |
| ankles, hands or
eyes. |
• There may be
blood in your urine ( )
|
| • You may find
it difficult or painful to urinate, and need to urinate more |
| frequently than
usual, particularly at night |
• You may also
suffer from high blood pressure ( ) |
| • Other symptoms
might include headache, nausea & vomiting, feeling |
| cold, fatigue,
restless legs, skin irritation and cramps. |
| |
|
Diagnosis |
| If you are
suspected of having
kidney failure
your doctor will |
| arrange a number
of tests. |
| |
|
Blood and urine
tests |
| |
|
Scans |
| You may also
have a scan to determine the size of your kidneys; abnormally |
| small kidneys
are often a sign of
kidney failure. |
| |
|
Kidney biopsy |
Sometimes a
kidney
 is performed. This
is a minor procedure in |
| which a small
piece of kidney tissue is removed and examined to diagnose |
any disease. It
is usually performed under local
 . Kidney tissue
is |
| removed using a
specially designed biopsy needle. |
| |
|
Diseases in adults |
| There are many
diseases that can affect the kidneys, some of which are |
| explained in
this section. In adults and children, the causes are generally
very |
| different, as
children usually have a higher level of inherited syndromes that
lead |
| to kidney
disease. |
| |
| The most common
causes of kidney disease in adults are: |
•
|
•
– high blood pressure |
•
 – a
painless inflammation of the kidneys |
| |
| Other clinical
causes include scarring from kidney infections in childhood and |
| obstructions to
the urine flow. Drug abuse (e.g. heroin addiction) can cause |
| kidney disease,
unfortunately so can the prolonged use of painkillers for long- |
| term diseases
such as rheumatoid arthritis. |
| |
| There are many
treatments for the conditions that can cause kidney disease, but |
| if these
conditions are not controlled, the resulting kidney failure is
irreversible. |
| |
| To find out more
information on each kidney disease click on the links below: |
|
|
|
|
|
|
 |
| |
|
Diabetes |
is a condition in which the amount of
 in the blood is |
| too high because
the body is unable to process it properly. This high level |
| of glucose
causes damage to small blood vessels throughout the body –
|
| including those
within the kidney. |
| |
| There are two
different types of diabetes, one called type 1 diabetes, which
is |
caused by the
destruction of
 -producing cells in
the pancreas, and is |
| controlled by
the drug insulin, the other called type 2 diabetes, caused by
not |
| enough insulin
being released by the pancreas or resistance to the action of |
| insulin on
muscle, liver and body fat. This type diabetes is usually
controlled by a |
| range of
anti-diabetic pills. |
| |
| One sign of
kidney disease is when the need for either of these diabetes |
| medications
drops. |
| The following
symptoms may also be an indication of kidney disease in people |
| with diabetes: |
| • High blood
pressure |
| • Leg swelling,
leg cramps |
| • An increased
need to urinate, especially at night |
| • Morning
sickness, nausea and vomiting |
• Weakness,
pallor and
|
| • Itching
|
| |
Blood tests may
show a rise in
 and
 , whereas urine
tests |
| may show high
levels of protein. |
| |
|
Hypertension
(High Blood Pressure) |
| In
, the force of
blood on the blood vessels is greater than normal |
| and this causes
damage, particularly to the small blood vessels such as the |
in the kidney. High blood pressure can be caused by kidney
failure |
| s well as be the
cause of kidney failure. |
| |
| There are,
however, many effective drugs to treat high blood pressure. In |
| addition,
healthy lifestyle changes, such as losing weight and regular
exercise |
| often help to
control - and may even help to prevent - high blood pressure. |
| |
|
Glomerulonephritis |
| This is a
painless inflammation of the
in the kidney,
which can |
| lead to high
blood pressure and the progressive loss of kidney function.
|
| In many cases,
the cause of
is not
known. It is thought that |
| some cases may
be inherited and others may be triggered by an infection. |
In children, the
disease is often triggered by
 infections, |
| and the
prognosis (the forecast of recovery) is good. |
| In adults, the
disease is marked by nausea, joint pain, high levels of protein
in the |
| urine and
breathing complications; all symptoms are more severe than in |
| children. |
| |
|
Polycystic
kidney disease |
|
is a disease which runs in families, it is due to a |
problem in
kidney development and leads to enlarged kidneys full of
 . |
| |
| The onset of the
disease is normally seen in the sufferer's late 40s to 50s and, |
| due to it's
genetic causes, is passed down the generations. |
| It does not
always lead to kidney failure. |
| |
| If diagnosed
with polycystic kidney disease, you may wish to consider genetic |
| counselling for
your family. This may help your children understand the possible |
| implications for
themselves and their families. |
| |
|
Disease in children |
| The causes of
kidney disease in children are usually connected to a variety of |
| inherited
conditions, of the heart or bones for example. |
| |
| The most common
conditions known to cause kidney failure in children are: |
| |
|
a. Congenital
obstructive uropathy |
When the
 system does
not develop properly, a blockage in |
the flow of
urine from the kidney to the
 can occur. This means
that |
| urine is backed
up into the kidney, and causes kidney damage. |
| |
| This condition
can be spotted early on in pregnancy through anti-natal
|
 tests. |
| |
|
b. Aplastic/hypoplastic/dysplastic
kidneys |
| These are all
different types of improper or incomplete development of the |
| kidneys prior to
birth. As a result, the kidneys may not be able to filter waste |
| materials from
the blood. |
| |
|
c. Reflux
nephropathy |
| The backward
flow of urine into the kidney causes damage to the internal |
| structures
within the kidney. |
