Kidney(Renal) Failure

KIDNEY FAILURE is problem which is being encountered more frequently in the present day world. Further, many of the patients with kidney failure are daigonsed very late. The kidneys have said to be failed when they are damaged and do not perform their normal functions. kidney failure can be temporary i.e. reversible , or permanent i.e. irreversible. It is only when 50% of both kidneys put together are damaged that one can find out raised levels of creatnine and urea in the blood (The two chemicals which are generally used to estimate the level of waste products in the body.) As the kidney function deterioates further, the normal chemical, salt and fluid balance becomes increasingly abnormal.

(A) Acute Renal (kidney) Failure: Usually temporary kidney failure. This type of renal failure is sudden in onset, and commonly follows some other illness. Of patients having Acute renal failure 80-90% recover to normal renal, function within one to six weeks. During this perion they may require dialysis to remove the excess of waste products, salt and fluid which accumulate as the kidneys are not functioning. A patient may be advised to go Peritoneal dialysis or hemodailysis.

Some of the common causes of Acute Renal Failure :
Severe infection including malaria.
Hypotention (Very low blood pressure), which is commonly due to sudden loss of blood (bleeding) or fluids (vomiting, diarrhoea) from the body, heart problems or shock.
Toxic e.g. Drugs, poisons, etc.

(B)Chronic Renal (kidney) Failure: This type of renal failure is usually a slow process, which may occur over months or years. In relatively early stage of Chronic renal failure (kidney function reduced to about 35-50% of normal), overall kidney function is sufficient to maintain patient without complains. At this stage the functions of kidney are well maintained. The patient may have swelling of the face and legs and/or high blood pressure at this stage or later. At somewhat later stage in course of chronic renal failure (kidney function about 25-35% of normal), increased levels of urea and creatinine in blood are seen. High blood pressure, Anaemia and Nocturia (getting up frequently at night to pass urine) are commonly seen at this stage. Most patients hardly have any complaints at this stage, but the reserve of kidneys is reduced sufficiently so that any sudden stress like infection, dehydration or use of drug toxic to kidneys can reduce kidney function further and produce signs and symptoms of overt kidney failure.

(C)End Stage Renal (kidney) Failure: This is said to have occured when the total kidney function is less that 10% of normal. It is at this level of kidney function that some replacement (alternative) kidney function needs to be provided. The exact time when the renal replacement therapy should be started depends both on quality of life as well as kidney function as assessed by laboratory tests. Replacement therapy may have to be considered at an earlier stage if quality of life is affected significantly.

Some of the common causes of End Stage Renal Failure (ESRD) are:
Infections of the kidney and urinary tract, especially in childhood.
Diabetes or Hypertention.
Toxins, Drugs (Excessive use of pain killers, antibiotics, heavy metals which may be a constituent of "bhasmas"/ashes.)
Kidney Stones.
Hereditary or abnormalities of urinary tract (from birth).