Kidney failure refers to loss of kidney function. Acute renal failure refers to sudden and temporary loss of kidney function. Chronic renal failure refers to slow and progressive loss of kidney function over several years, often resulting in permanent kidney failure. People with end-stage renal disease (ESRD) need dialysis or transplantation to replace the work of the kidneys. Otherwise the body retains extra fluid and harmful wastes build up.
Most kidney diseases attack the nephrons, causing them to lose their filtering capacity. Damage to the nephrons may happen quickly, often as the result of injury or poisoning. But most kidney diseases destroy the nephrons slowly and silently. Only after years or even decades will the damage become apparent. Most kidney diseases attack both kidneys simultaneously.
The two most common causes of kidney disease are diabetes and high blood pressure. Chronic infection of the kidneys and obstructing kidney stones can also cause kidney failure.
People in the early stages of kidney disease usually do not feel sick at all.
If your kidney disease gets worse, you may need to urinate more often or less often. You may feel tired or itchy. You may lose your appetite or experience nausea and vomiting. Your hands or feet may swell or feel numb. You may get drowsy or have trouble concentrating. Your skin may darken. You may have muscle cramps.
A combination of blood pressure measurement, urine protein level, serum creatinine level and creatinine clearance are some important tests.
Ultrasound of the kidneys and kidney biopsy may be necessary.
Complete and irreversible kidney failure is sometimes called end-stage renal disease, or ESRD. If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia. Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly. Untreated uremia may lead to seizures or coma and will ultimately result in death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplantation.
The two major forms of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, your blood is sent through a filter that removes waste products. The clean blood is returned to your body. Hemodialysis is usually performed at a dialysis center three times per week for 3 to 4 hours.
In peritoneal dialysis, a fluid is put into your abdomen. This fluid captures the waste products from your blood. After a few hours, the fluid containing your body’s wastes is drained away. Then, a fresh bag of fluid is dripped into the abdomen. Patients can perform peritoneal dialysis themselves. Patients using continuous ambulatory peritoneal dialysis (CAPD) change fluid four times a day. Another form of peritoneal dialysis, called continuous cycling peritoneal dialysis (CCPD), can be performed at night with a machine that drains and refills the abdomen automatically.
A donated kidney may come from an anonymous donor who has recently died or from a living person, usually a relative. The kidney that you receive must be a good match for your body. The more the new kidney is like you, the less likely your immune system is to reject it. Your immune system protects you from disease by attacking anything that is not recognized as a normal part of your body. So your immune system will attack a kidney that appears too “foreign.” You will take special drugs to help trick your immune system so it does not reject the transplanted kidney.
