Kidney Failure

 Kidney failure :

Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys are working at less than  15% of normal levels.  Kidney failure is classified as either acute kidney failure, which develops rapidly and can resolve; And chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include swelling of the feet, feeling tired, vomiting, loss of appetite, and dizziness.  Complications of acute and long-term failure include uremia, high blood potassium, and volume overload. Complications of chronic failure include heart disease, hypertension, and anemia. 

Causes of acute kidney failure include low blood pressure, urinary tract obstruction, certain medications, muscle rupture, and hemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, hypertension, nephrotic syndrome, and polycystic kidney disease. The diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine.  The diagnosis of chronic failure is based on the need for a glomerular filtration rate (GFR) of less than  15 or renal replacement therapy.  This stage is equivalent to chronic kidney disease. 

Treatment of acute failure depends on the underlying cause. Treatment for chronic failure may include hemodialysis, peritoneal dialysis, or a kidney transplant.  Hemodialysis uses machines to filter blood outside the body.  In peritoneal dialysis, specific fluid is placed in the abdominal cavity and then excreted, a procedure that is repeated several times per day.  Kidney transplant surgery involves placing a kidney from someone else and then taking immunosuppressive drugs to prevent it.  Other recommended measures for chronic illness include staying active and making specific dietary changes. 

Acute failure in the United States affects 1,000 people each year.  Old failures affect every 1,000 people, with new developments in every 1,000 people.  Acute failure is often reversible, while long-term failure is not. With proper treatment, many chronic diseases can continue to work. 

Sign and Symptoms:

Symptoms may vary from person to person. In the early stages, a person with kidney disease does not feel sick or has symptoms. When the kidneys fail to filter properly, blood and body wastes accumulate, a condition called azotemia. Very low levels of azotemia can produce mild, if any, symptoms. If the disease progresses, the symptoms appear easily (if there is a sufficient degree for failure symptoms). Kidney failure with painful symptoms is called uremia. 

Symptoms of kidney failure include:

High levels of urea in the blood, which can result in:

Vomiting or diarrhea (or both) can lead to dehydration

Nausea

Weight loss

Nocturnal urination (night)

More frequent urination, or more than normal volume, with yellow urine

Less frequent urination, or smaller than normal, with dark and colored urine

Blood in the urine

Pressure, or difficulty urinating

Abnormal amount of urine, usually in large quantities

A buildup of phosphate in the blood that sick kidneys cannot filter out:

Itching

Bone loss

Nonunion in broken bone

Muscle cramps (caused by low calcium levels that may be associated with hyperphosphatemia)

The formation of potassium in the blood can cause the diseased kidney to filter (called hyperkalemia):

Abnormal heart rhythm

Muscle paralysis 

Kidney failure can lead to excess fluid removal:

Swelling of the hands, feet, ankles, feet, or face

Breathing due to excess fluid in the lungs (can also cause anemia)

Polycystic kidney disease, which causes large, fluid-filled cysts in the kidneys and sometimes in the liver:

Pain in the back or side

A healthy kidney produces the hormone erythropoietin, which stimulates the bone marrow to make oxygen-carrying red blood cells. When the kidney fails, it produces less erythropoietin, resulting in reduced red blood cell production, replacing the old diseased red blood cells. As a result, the blood carries less hemoglobin, a condition called anemia. This can result in:

Feeling tired or weak

Memory problems

Difficulty concentrating

Dizziness

Low blood pressure

Proteins are usually too large to cross the kidneys. In any case, they can go away because their glomeruli are damaged. It does not cause symptoms until extensive kidney damage, followed by symptoms:

Foamy or bubbly urine

Swelling in the hands, feet, abdomen, and face

Other symptoms include:

Loss of appetite, which may include a bad taste in the mouth

Difficulty sleeping

The skin becomes dark

More protein in the blood

With high doses of penicillin, people with renal failure may experience seizures.

Diagnostic approach

Measurements for CKD

A condition of kidney failure

Chronic kidney failure is measured in five steps, calculated using the individual's GFR, or glomerular filtration rate. Stage 1 CKD is a mildly low renal function, with some obvious symptoms. Stage 2 and L need more supportive care from their medical providers to slow down and treat their renal dysfunction. A person with stage and kidney failure usually needs to be prepared for active treatment in order to survive. Stage C CKD is considered a serious illness and may require renal replacement therapy (dialysis) or some form of kidney transplant when possible.

Glomerular filtration rate

A typical GFR varies based on many factors, including gender, age, body size, and ethnic background. Renal professionals consider the glomerular filtration rate (GFR) to be the best overall index of kidney function. The National Kidney Foundation provides an easy-to-use GFR Calculator  for anyone who wants to know glomerular filtration rates. (A serum creatinine level, a simple blood test, calculator needs to be used.)

Use of the word uremia

Before the advent of modern medicine, kidney failure was often referred to as uremic toxicity. Uremia was used for blood infections with urea. This is due to the presence of excessive amount of urea in the blood. Beginning around 1847, this included low urine output, which was thought to be due to urine being mixed into the bloodstream rather than into the urethra.  The word uremia is now used to refer to diseases other than kidney failure. 

Treatment

Treatment of acute kidney injury depends on the cause. Treatment of chronic kidney failure may include renal replacement therapy: hemodialysis, peritoneal dialysis, or kidney transplantation. 

Diet

In non-diabetics and people with type 1 diabetes, a low-protein diet has an immune effect on the progression of chronic kidney disease. However, this effect does not apply to people with type 2 diabetes. [] 33] Whole foods, plant-based diets can help some people with kidney disease.  A high protein diet from either animal or plant sources appears to have a negative effect on kidney function at least in the short term. 

Slow progression

People who first receive recommendations from a nephrologist, which means they have a long time before they start dialysis, are admitted to a shorter initial hospital and the risk of death is reduced once dialysis is started.  Other ways to slow the progression of the disease include exposure to nephrotoxins such as NSAIDs and to reduce intracranial contrast.