Chronic renal failure

From ArticleWorld

Chronic renal failure is the progressive loss of kidney function due to several underlying conditions. The kidney can deteriorate in function over several months and years. Often it has no symptoms initially and is evidenced only by an abnormally high level of creatinine in a blood test. When chronic renal failure becomes nearly total, it becomes what is known as end-stage renal disease.

Causes

There are several common causes of chronic kidney failure. Diabetics can develop diabetic nephropathy (damage to the glomeruli of the kidneys) as a cause of failure. Diabetics also can have large artery disease with gradual blockage of the renal arteries supplying the kidneys. High blood pressure can damage the blood flow to the delicate capillaries and glomeruli that filter the kidneys.

Infections from HIV are also known to damage the kidneys over time. Chronic backup of urine causes reflux nephropathy that permanently affects the kidneys. Chronic blockage from kidney stones or prostate enlargement adversely affects kidney function if not treated.

A large number of genetic or acquired kidney diseases lead to chronic renal failure. Diseases like lupus nephritis, IgA nephritis, polycystic kidney disease, toxic states and other rare genetic disorders can lead to permanent loss of kidney function.

Diagnosis

Anytime the kidneys fail on a chronic basis, the blood pressure can be elevated, products of metabolism, such as urea, can accumulate and fluid can build up due to lack of the kidneys to filter properly. The afflicted person can become anemic because the kidney puts out less erythropoietin, the hormone affecting red blood cell production. Eventually, potassium levels and phosphate levels in the body rise, sometimes to dangerous levels. A highly elevated potassium can result in dangerous heart arrhythmias and death.

Doctors can use ultrasound to determine if the kidneys are too big or too small. Small kidneys are often found in chronic renal failure. Doctors also follow the patient’s creatinine levels. If renal insufficiency is chronic, the creatinine gradually rises over time. If it is acute, the creatinine rises dramatically.

Treatment

Certainly, if there are reversible causes of chronic renal failure, the treatment is aimed at correcting the underlying cause. Doctors need to control the patient’s blood pressure if elevated. Many patients with irreversible renal failure undergo long-term dialysis or kidney transplant.