Kidney failure is total or partial loss of function of the kidneys. It can occur acutely or chronically. The main function of the kidney is to “clarify” the blood of end products of metabolism and regulate the volume of body fluids. It involves an alteration in the internal environment, mainly with fluid retention and minerals, and an accumulation of waste products (urea, creatinine, uric acid …). Nitrogenous products derived primarily from protein metabolism. We will refer to the diet of chronic renal failure and acute kidney failure is handled primarily in the hospital.
Chronic renal failure is manifested by the so-called uremic syndrome manifested at all levels in the body.
Causes
There are many possible causes of kidney damage, such as:
- Acute tubular necrosis (ATN)
- Autoimmune kidney disease, such as acute nephritic syndrome, interstitial nephritis.
- Decreased blood flow due to very low blood pressure, which may result from burns, dehydration, bleeding, injury, septic shock, severe illness, surgery.
- Disorders that cause clotting within the blood vessels of the kidney, such as hemolytic uremic syndrome, idiopathic thrombocytopenic purpura (ITP), malignant hypertension, transfusion reaction, scleroderma.
- Infections that directly injury the kidney such as acute pyelonephritis, septicemia,
- Complications of pregnancy, such as placental abruption, placenta previa,
- Obstruction of the urinary tract
Symptoms
They result from a slow accumulation of wastes in the blood and the progressive failure of the regulatory functions of the kidneys.
The excess fluid accumulates in the body because of kidney failure does not produce enough urine. This can lead to a condition known as edema. This excess fluid causes symptoms such as swelling around the eyes, hands, ankles and feet. If this continues to accumulate excess fluid, fluid overload occurs. Liquids can also accumulate in the lungs, causing pulmonary edema.
If you have fluid overload, also increase your blood pressure because their blood contains more water than normal, which increases pressure on blood vessels.
When the kidneys are damaged will slow the production of the hormone erythropoietin, which means that the body will not have enough red blood cells. This causes anemia, a common complication of kidney failure. If you do not have enough red blood cells to carry oxygen to our body, weaken us, we feel cold, we feel tired and breathless.
Since the symptoms of kidney failure appear gradually over a very long time, it’s easy to overlook, or might think they are normal responses to stress and daily life activities, delaying the diagnosis and treatment and increasing damage to the kidneys.
If you experience any symptoms of kidney failure are listed below, discuss with your doctor:
• A metallic taste or other strange taste in your mouth
• Fatigue
• Feeling cold
• Headaches
• High blood pressure
• Insomnia
• Itching and dry skin
• Loss of appetite or nausea
• Pain in the lumbar region in the kidney area
• Poor concentration, confusion, forgetfulness
• Poor sexual drive
• Legs without rest or cramped
• Shortness of breath
• Swelling in hands, feet or face, especially around the eyes (up)
• Changes in urine as foamy urine or bloody urine more or less normal, or a change in frequency of urination.
Diagnosis
The best guide to make this differentiation is a good medical history, previous analytical studies help to assess the degree of renal failure at the time and if the patient had prior kidney or not, so if there are no haematological, biochemical or urine sediment, we assume that this is an IRA.
If no previous analysis, ask for the presence of hypotension or hypertension, renal colic or changes in the appearance of urine or rhythm of diuresis. Polyuria and nocturia clear urine with anemia, spontaneous bruising unjustified, muscle cramps, itching, decreased libido, and menstrual abnormalities indicate the existence of an IRC. Family history may be helpful Eat Stop Eat and plain abdominal radiographs to objectify the size of the kidney silhouettes allow an IRA suspect if this increased renal size (longitudinal axis 3.7 times the height of the second lumbar vertebra) or a chronic situation renal dysfunction if the size is decreased kidney or kidneys are asymmetrical.
Second, it should rule out an obstructive cause is usually easy to diagnose and should be suspected in patients with previous urologic pathology and clinical prostate cancer. Abdominal palpation, and rectal examination for lumps and abdominal and pelvic evaluation of prostate size and shape should not be forgotten. The figure shows a simple RX enlarged kidney. However, the easiest, most reliable and devoid of risk is the abdominal ultrasound.
The next step is to identify and critical if acute deterioration of renal function or prerenal in origin parenchymal and in this case is also necessary to rule out the presence of NTA ischemic or toxic or otherwise intrinsic parenchymal disease not NTA-related disease (large and small vessels, gromerolupatías, hemolytic uremic syndrome or thrombotic thrombocytopenic purpura, malignant hypertension, acute tubular interstitial, etc.).. The latter possibility can not be studied in detail here, limiting ourselves in what follows the study of prerenal acute renal failure and acute tubular necrosis as well as the differential diagnosis between the two.
Prerenal acute renal failure should be suspected in cases of true volume depletion (bleeding, gastrointestinal losses, excessive urinary or skin, etc..) Or, where applicable, effective circulating volume decreased (liver failure, treatment with NSAIDs inhibitors or angiotensin-converting enzyme-ACE inhibitor-etc.).
Patients with true volume depletion, often have “thirst” (if conscious), orthostatic hypotension (low blood pressure greater than 10 mmHg diasistólica adopting the standing position), symptomatic (dizziness, orthostatic hypotension), tachycardia, decreased venous pressure jugular, cold skin, dry mucous membranes, and lack of sweating, but you must know that you can lose up to 2% of extracellular fluid volume without symptoms.
In all cases, the analytical data available prior, diuresis, weight, medication use neurotoxic contrast agents, chemotherapy, etc.. is useful to achieve an accurate diagnosis.
The sooner you are diagnosed and begin treatment, the more likely you are to feel better and slow the progression of renal disease. When you lose kidney function, it may not recover. Symptoms may worsen without medical treatment. All you can do, under the care of your doctor, to delay the loss of renal function is worth
Treatment
When you receive the right treatment for chronic renal failure, especially during the first stage of renal failure may slow or even stop the course of kidney damage. During the early stages of renal failure is important to make regular visits to your doctor and follow his instructions. The careful management of blood pressure and health surveillance using the test results are essential to prolong your kidney function as much as possible.
Most people can improve their health by taking simple steps such as quitting smoking, eating healthily and exercising regularly. Once you have been diagnosed with kidney failure will be sent a medical team that specializes in the care of kidney patients. Nephrologists (kidney specialists), renal nurses and other medical staff will watch you closely. They should have regular appointments at the renal unit. She underwent blood and urine tests to determine the function of your kidneys.
Studies have shown that raising glutathione levels by precursors is of great benefit to patients.
Prevention
It was always said that “better safe than sorry.” The trends in modern medicine are intended to act on the healthy individual to avoid the appearance of the disease. However, when we speak of renal failure, this rule can be relative. Many times, before the onset of symptoms of kidney failure, the disease is already established that the case base. In these cases, the measures will be aimed at delaying the onset of renal failure.
We can, in a generic way, take a series of preventive measures acting on the various causes of renal failure.
1. Hereditary Diseases: We need to carry out a genetic and a good family planning counseling as the only prevention that can be applied is to prevent offspring.
2. Inflammatory diseases of the kidney. Effective treatment of infectious processes that can produce glomerulonephritis (bacterial endocarditis, strep throat).
3. Diabetes. Adhere to the prescribed treatment. Avoid the appearance of sudden drop in blood sugar (hypoglycemia). Make a specific diet, established by the physician. Keep your glutathione levels high.
4. Blood Pressure. Avoid or reduce alcohol intake. Reduce salt intake. Control your weight. If you are hypertensive, do not abandon medication ever indicated. Comply with the prescribed dosage and regimen. Take your blood pressure regularly. Maintain high levels of glutathione.
5. Urinary tract infections. In urinary tract infections often go unnoticed by the absence of specific symptoms. Among females appear more frequently in children, adolescents coinciding with the onset of menstruation and sexual intercourse and pregnancy. In case of pregnancy there are a number of mechanisms that affect the proper functioning of urination, so it is important that your obstetrician about establishing a control. In males the frequency increases with the presentation of prostate problems. Avoid alcohol, cigarettes and other substances that can poison the blood (especially snuff, as it accelerates the process of failure) and no anti-inflammatory painkillers or over.
On the other hand, we take many natural herbal teas with diuretic effect, ie that increase the excretion of urine. For example, parsley, nettle, dandelion and celery, although the latter in moderation, especially during pregnancy or when presenting the inflamed bladder. Raising glutathione levels also prevents kidney problems and infections.
In many cases it is possible to timely detect and treat kidney failure. Is achieved with education campaigns and health extension workers, and through regular checkups. Also important is the control and monitoring of certain processes, such as diabetes, high blood pressure, pregnancy, etc., As well as medication and dietary patterns are determined by medical specialists.
