Kidney failure (renal failure)

A Kidney weakness or Renal failure (also Kidney failure) a distinction is made between an acute and a chronic form. The acute renal failure can occur suddenly and within a few hours. The cause is usually a disturbed kidney bleeding. However, if the kidney weakness occurs more frequently or persists over a longer period of time, one of chronic renal failure be spoken.

What is kidney failure (renal failure)?

For a longer one Kidney failure (renal failure) these two bean-shaped organs in the back of the pelvis are chronically inflamed. If the kidneys are weak, this inflammation leads to progressive destruction of the kidney tissue, so that the blood can no longer be completely purified. If the symptoms of kidney weakness remain undetected, acute kidney failure with coma can occur, which is life-threatening.

Depending on the degree of kidney weakness, this is divided into 5 stages. Chronic kidney failure can also go unnoticed for a long time until it leads to acute kidney failure. The tissue of the kidneys is then so destroyed that only about 10% actually function for detoxification. Due to the lack of detoxification of the body, all other organs are affected if the kidneys are weak, and the elimination of water and purification of the blood must then be carried out through regular dialysis or a transplant.

causes

Kidney weakness or. Renal failure occurs in 40% of all cases as a result of diabetes mellitus. In 25% of patients, this condition develops due to unknown factors. There are also hereditary factors that favor the formation of cysts in the kidney, which also leads to inflammation of the kidney corpuscles. Furthermore, high blood pressure and the use of drugs that damage the kidneys in other chronic diseases can lead to permanent damage and renal insufficiency.

A genetic disposition also seems to play a role in the development of this chronic form of kidney failure. There are congenital malformations of the urethra in which the urine is partially flushed back into the kidney and there can also lead to inflammation and chronic kidney weakness. That being said, obesity and smoking are factors that further promote kidney weakness.

Kidney weakness can start out harmlessly with more frequent bladder problems or fatigue and infections. Those who discover and treat the symptoms at an early stage protect themselves from the progressive destruction caused by kidney weakness and the life-threatening acute kidney failure as well as the consequential damage.

Symptoms, ailments & signs

Kidney weakness can initially go completely unnoticed. The chronic form in particular does not show any typical characteristics at the beginning. Later on, patients usually suffer increasingly from difficult-to-control blood pressure. In doing so, they often exceed the limit values ​​of 140/90 mmHg for no apparent reason.

Changes in the color and consistency of the urine are common. This is lighter. An increased proportion of proteins leads to a clearly visible foam formation when urinating. Sometimes small additions of blood make the skin darker and more cloudy. As a rule, however, the proportion is not in the visually perceptible range (microhematuria).

Due to the restricted performance, the body stores water in the form of edema. Those affected also notice a difficult to understand weight gain, loss of appetite and general malaise. As a result, there are fluctuations in the electrolyte and acid-base balance. In addition to a reduced efficiency of the immune system, the deficiency of the hormone erythropoietin (EPO) reduces the number of red blood cells.

As a result, anemia develops, which is accompanied by a general feeling of weakness, pale skin and difficulty concentrating. In the long term, blood pressure problems and the lack of purification of the blood provoke organic malfunctions throughout the body.

Visual disturbances, nausea, diffuse pain in bones and severe itching are caused by uremic syndrome. Permanent changes in the cardiovascular system also put a strain on physical wellbeing. Extreme contamination can lead to drowsiness, convulsions and even loss of consciousness or even a coma.

Course of disease

In acute Kidney weakness it is important to consult the doctor as early as possible. Symptoms of the disease in the case of kidney weakness are similar to symptoms of a cold or the flu and are therefore often difficult to interpret. Fatigue, weakness, a high temperature, or a high fever with pain in the kidney area or around the bladder are signs that you have kidney disease. If a cystitis first shows up with frequent urination, every general practitioner can immediately see through a urine sample under the microscope whether there are acute pathogens for a flu-like infection. These pathogens are fought with special antibiotics. If the symptoms do not go away within three days and the symptoms get worse, a urologist should be consulted or the clinic should be visited.

The condition of the skin, which is extremely pale, and the breathing and heart rate as well as the blood filling of the neck veins give the doctor indications of kidney weakness. The number of white blood cells, the C-reactive protein, liver values ​​and fat values ​​are further indications for the diagnosis for the doctor. Doctors also speak of prerenal and postrenal kidney failure when the kidneys are weak. In prerenal cases, the doctor can prevent further complications such as cardiac arrhythmias, infections and pulmonary edema; In the case of postrenal failure of the kidney, damage due to urine congestion in the kidney cavities must be determined. Then a kidney puncture is necessary, whereby tissue is also removed for histological diagnosis.

Complications

If left untreated, renal failure progresses until the kidneys fail completely. The more kidney tissue is destroyed, the slower the kidneys can process the ingested fluid. In the end stage of renal insufficiency, the harmful substances that should be excreted by the kidneys accumulate in the blood, so that only dialysis can help. Here, the blood is regularly withdrawn from the body, cleaned of harmful substances and fed back into it - a lengthy and exhausting procedure.

Since blood pressure is also regulated by the hormones of the kidneys, the angiotensin-aldosterone-renin system, further complications can arise here. Doctors speak of renal, i.e. high pressure triggered by the kidneys.

The list of other complications of kidney failure is long: an increased tendency to fracture bones, water retention in the legs and in the tissue, odor of urine on the skin, pale yellowish skin color, cardiac arrhythmias, water in the lungs, cramps triggered by the brain, poor elimination of drugs, Salt deficiency, potassium deficiency, vomiting and diarrhea. Every single complication should be taken seriously and discussed with the doctor.

When should you go to the doctor?

A weak kidney is often only recognized when the kidney tissue is already severely damaged. It is therefore all the more important to clarify typical symptoms early on. For example, tiredness, edema in the legs and signs of anemia should be examined by the family doctor. The doctor can determine whether the symptoms indicate kidney weakness and, if necessary, initiate treatment immediately. People who suffer from kidney failure should consult their family doctor regularly. If you suspect that the symptoms are getting worse, it is advisable to see a doctor. Above all, sudden cramp-like pain or swelling in the kidney area must be clarified, as there is a risk of kidney infarction. If it comes to a kidney attack, the emergency doctor must be called.

The affected person must receive medical care immediately. Kidney weakness is treated by your family doctor or a specialist in kidney diseases. Further contact persons are the internist and the gastroenterologist, always depending on the symptoms and the cause of the kidney weakness. Advanced kidney disease requires hospital treatment. Since a cure is only possible through an organ transplant, appropriate preparatory measures must be taken. It is also necessary to change your diet, for which a visit to the nutritionist is recommended. In the case of chronic diseases, therapeutic help is also useful.

Treatment & Therapy

As soon as a Kidney failure (renal failure) If the blood is no longer adequately filtered, excreted substances such as creatinine and urea in the blood increase. This will be determined by a blood test. The higher the proportion of these substances in the blood, the weaker the function of the kidneys. If the urea level has risen to over 450 milligrams per liter of blood, there is a malfunction. Above all, the increase in protein in the urine is a sure indicator of kidney weakness.

The family doctor will use this value to make an initial diagnosis using the rapid test. Using the GFR, the globular filtration rate, the family doctor can also immediately determine how acute the disease is. Increased urine sediment is always an indicator of a disorder. Then, above all, the amount of creatinine should be measured. Unfortunately, this value only shows an increase when the kidney function has already decreased by more than 50%. Unfortunately, kidney weakness is often diagnosed too late.

Treatment must then be initiated immediately so that the patient does not fall into acute kidney failure with a coma. The so-called creatinine clearance is more suitable for diagnosis. This determines how quickly the kidneys filter the creatinine out of the blood. Acute insufficiency is only spoken of when kidney function drops by 60%. With a kidney weakness of over 80%, the person concerned must be treated with dialysis in order to carry out the severely disturbed blood purification by machine. Dialysis always takes several hours. Depending on the severity, dialysis patients have to go to a dialysis department of the clinic every 2-4 weeks in order to be connected to a dialysis machine for a few hours. That is a considerable reduction in the quality of life.

In order to prevent kidney weakness, doctors recommend herbal medicines such as herbal teas and tablets made from medicinal herbs to strengthen the urogenital tract in the event of recurrent bladder infections. A hardening through Kneipp cures is also recommended.

Outlook & forecast

The earlier chronic kidney weakness is diagnosed and treated, the more favorable the prognosis. However, damage to the kidney tissue that has already occurred cannot be reversed. Chronic renal failure takes a gradual course, with men and elderly and physically weakened patients likely to progress more rapidly than in otherwise physically healthy patients and women.

High blood pressure and blood pressure values ​​have a negative influence on the course of the disease. Smoking, alcohol consumption, obesity and other risk factors also have a negative effect on the prognosis. Chronic kidney weakness usually shortens the life expectancy of patients. People with chronic diseases such as diabetes mellitus or high blood pressure are particularly at risk.

In general, poor physical condition has a negative impact on the prognosis. Acute kidney failure leads to kidney failure and, as a result, in half of the cases to death of the patient. The cause of death are usually concomitant diseases such as blood poisoning or heart attacks. The life expectancy is accordingly greatly reduced.

Only in a few patients does kidney function recover to the greatest possible extent, provided the cause of the acute kidney failure is eliminated quickly. The prognosis for chronic and acute kidney failure is made by a specialist in internal medicine with regard to the symptoms and the constitution of the patient.

Aftercare

Many patients resign themselves to the finding of renal failure and feel powerless. In a necessary support network for aftercare, consisting of relatives, loved ones and the medical dialysis staff, help and support have a high priority. During follow-up care, patients should be prepared to live with the necessary control and renunciation.

The attending doctor and nephrologist will answer the patient's questions and fears about the future that are related to the disease and answer them individually. Thus, psychotherapeutic support is extremely important in order to better process psychosocial stress, repressed feelings and depressive moods. The reduced quality of life caused by kidney failure is improved and stabilized by follow-up care.

This also improves the situation in the family environment. A zest for life and a confidence for the future combined with the necessary self-confidence are returning. During follow-up, however, the ongoing medical dependency and limitation to control kidney function that is associated with drug treatment remains. Only a stable, familiar and social environment can help bear these burdens on the patient during aftercare and protect him from social withdrawal.

You can do that yourself

Loss of appetite and nausea as a result of kidney weakness often lead to malnutrition, which leads to the breakdown of muscle mass and an impairment of many body functions. Sick people should therefore attach great importance to a balanced diet, but protein, sodium, potassium and phosphate may only be consumed in moderation. A diet rich in carbohydrates is ideal, salt should be used sparingly.

In order to ensure a sufficient supply of essential amino acids, a combination of animal and vegetable protein sources such as milk and wheat or legumes and eggs is recommended. Milk, hard and soft cheese may be consumed sparingly, but those who are ill should do without processed cheese, canned fish, heavily salted sausages and meats and finished products. Potassium is found in abundance in fruit and vegetable juices, nuts, bananas, dried fruits and mushrooms, so these foods should only rarely be on the menu.

In the case of renal insufficiency that requires dialysis, it is not necessary to restrict the protein intake, as the blood wash removes all urinary substances. The amount of fluid required per day depends on the severity of the kidney weakness and is determined by the attending physician. Patients requiring dialysis, in particular, must strictly adhere to a restriction on the amount they drink: ice cubes and lemon pieces are suitable for quenching thirst in between, and rinsing the mouth and chewing sugar-free chewing gum can relieve a feeling of thirst.