Renal Insufficiency

Renal insufficiency, sometimes called renal failure or kidney failure, occurs when the kidneys lose their ability to filter waste products from the blood and cannot regulate the body’s balance of salt and water. Urine production slows and waste products and water accumulate in the body. Renal insufficiency can eventually affect the functions of the heart and the brain, posing a dangerous and potentially life-threatening situation.

Renal failure can be of three types-acute, chronic, and end stage.

(1) Acute renal failure

Acute renal failure occurs when illness, infection, or injury damages the kidneys. This can be caused by shock, major surgery, severe burns, massive hemorrhage, or a heart attack.

Symptoms of Acute Renal Failure:

• decreased urine output
• pale skin
• swelling
• high blood pressure
• nausea and vomiting

These symptoms are in addition to those of the underlying illness or medical problem and can lead to complications if left untreated.

Your doctor will consider your symptoms and take your medical history. He or she will order a urinalysis and possibly more sophisticated urine tests, along with other procedures, such as a chest X-ray and an ultrasound examination of the kidneys. Treatment will be based on the diagnosis.

Treatment

Treatment includes close monitoring and will start with measures to correct the underlying cause of acute renal failure. Specific treatment may include:

• intravenous fluids
• medications
• dialysis (if necessary)
• modification of protein in the diet
• restriction of sodium and phosphate in the diet

(2) Chronic Renal Failure

Chronic renal failure is a condition in which kidney function decreases over a period of years. It is caused by illnesses that progressively damage the kidneys, such as diabetes, hypertension, and nephritis (inflammation or infection of the kidneys).

Symptoms of Chronic Renal Failure

Symptoms of chronic renal failure develop slowly and sometimes do not appear until the kidney function is almost completely lost. Symptoms can include:

• headache
• fatigue
• difficulty concentrating
• weakness
• vomiting

Your doctor will take your medical history and consider your symptoms. If you have chronic medical conditions that increase the risk of kidney damage, such as diabetes or high blood pressure, your doctor will monitor these conditions and look for symptoms of chronic renal failure. To confirm the diagnosis, the doctor will usually order lab tests of blood and urine.

Occasionally it is necessary to perform a renal biopsy to definitively diagnose the cause of the kidney failure.

In adults with acute renal failure, prognosis is guarded. Patients with chronic renal failure generally have a progressive decrease in kidney function, leading to end-stage renal disease (ESRD).

(3) End-stage renal failure (ESRD)

In this type of renal failure, kidney function deteriorates to the point where it cannot sustain life. This often follows chronic renal failure, but it can also follow acute renal failure.

Symptoms of ESRD:

• headache
• fatigue
• difficulty concentrating
• weakness
• vomiting, diarrhea
• chest pain, bone pain

Doctors make the diagnosis of ESRD when a patient with chronic renal failure develops symptoms of ESRD, as well as consistently high levels of certain blood chemicals that indicate the kidneys have been severely and permanently damaged. Hemodialysis, peritoneal dialysis, and kidney transplant are the three forms of renal replacement therapy for ESRD.

Renal insufficiency is a serious condition, but with proper treatment, medications and diet, many people can continue to live a long and healthy life.