Causes of kidney failure are numerous and include circumstances such as myocardial infarction, glomerulonephritis or bladder cancer.
The symptomatological picture is very broad and reflects the functional incapacities of the kidneys.
If treatment of renal failure is immediate and appropriate to the cause, there is good hope of restoring renal function.
Brief review of the kidneys
The urinary system or excretory system is the set of organs and anatomical structures responsible for the elimination of urine.
The main organs of the urinary system are the kidneys.
Two in number, the kidneys reside in the abdominal cavity, on the sides of the last thoracic vertebrae and the first lumbar vertebrae; they are symmetrical and have a shape that is very reminiscent of that of a bean.
The most important functions of the kidneys are:
- Filter waste substances, harmful substances and foreign substances present in the blood and convert them into urine.
- Regulate the hydro-saline balance of the blood.
- Regulate the acid-base balance of the blood.
- Produce the glycoprotein erythropoietin.
The anatomy of the kidneys is quite complex: the image below shows the main anatomical elements of a generic human kidney.
In other words, the terms renal failure and acute renal failure refer to the same circumstance, which sees the kidneys have lost their functional capacity in a sudden and unexpected way.
If treated promptly and adequately, renal failure has reversible effects. Its presence, therefore, does not exclude a recovery of renal function.
KIDNEY INSUFFICIENCY: MEDICAL DEFINITION
By kidney failure, doctors mean a "generic inability of the kidneys to perform their functions properly.
ANOTHER KIND OF KIDNEY INSUFFICIENCY: THE CHRONIC FORM
The condition of renal insufficiency can also take shape gradually, as a result of a slowly evolving mechanism.
When the loss of renal function occurs in the aforementioned ways (slow and gradual evolution), doctors speak of chronic renal failure.
Unlike renal failure, chronic renal failure is a pathological state, the effects of which are irreversible and for which treatments only serve to slow down its inexorable worsening.
WHAT HAPPENS WHEN KIDNEYS WORK WRONG?
When the kidneys lose their abilities and malfunction, they skip several mechanisms, including:
- The mechanism of disposal of waste substances present in the blood. This involves the progressive accumulation of these substances and the consequent intoxication of the blood.
Two important parameters that describe the amount of waste substances accumulating in the blood are azotemia and creatininemia.
BUN is the concentration of non-protein nitrogen (or urea) in the blood; non-protein nitrogen is a waste product of protein metabolism.
Creatininemia, on the other hand, is the concentration of creatinine in the blood; creatinine is a waste product resulting from the creatine metabolism of the muscles.
Elevated blood urea and, likewise, elevated blood creatinine are indications of kidney failure. - The mechanism for regulating the hydro-saline balance of the blood. This results in the accumulation of fluids (edema) in various parts of the body, for example in the legs or ankles.
- The mechanism for regulating the acid-base balance of the blood. From this derives an "alteration of the blood levels of some electrolytes, such as phosphorus or potassium.
- The mechanism of erythropoietin production.
These conditions include:
- The formation of blood clots in the arterial or venous blood vessels of the kidneys;
- The formation of cholesterol deposits in the renal blood vessels;
- Glomerulonephritis;
- The so-called hemolytic-uremic syndrome;
- Infections affecting the kidneys;
- Systemic lupus erythematosus;
- The intake of certain drugs, including chemotherapy and antibiotics, or other substances, such as contrast fluids and zoledronic acid;
- Multiple myeloma;
- Scleroderma;
- Thrombotic thrombocytopenic purpura;
- Alcohol, cocaine or heavy metal intoxication;
- Vasculitis.
These conditions include:
- Bladder cancer
- The formation of blood clots in the urinary tract;
- Cancer of the uterine cervix in women;
- Colon cancer
- Benign prostatic hypertrophy in men;
- Kidney stones
- Prostate cancer in men;
- Damage to the nerve structures that control the bladder.
RISK FACTORS OF KIDNEY BLOCK
Those most at risk of kidney failure are: the elderly, diabetics, people with hypertension, heart patients, those with kidney disease, individuals with liver disease, people with high blood cholesterol levels and the carriers of the so-called peripheral arterial disease.
of renal block are collected in the table below, which, to the left of the reader, reports the clinical manifestations and, to the right of the reader, the specific causes of these manifestations. In this way the reader can realize why, in the presence of renal block, certain disorders and problems exist.
Nausea
Vomiting and diarrhea. They are often a cause of dehydration
Frequent urination and light colored urine, or, alternatively, reduced urination and dark urine
Difficulty urinating
Blood in the urine
High blood urea nitrogen (azotemia)
Muscle cramps and spasms
Accumulation of phosphorus in the blood (hyperphosphatemia)
Heart rhythm abnormalities
Muscle paralysis
Accumulation of potassium in the blood (hyperkalaemia)
Lower limb edema (water retention)
Dyspnea and chest pain following pleural and / or pericardial effusion
Accumulation of fluids in the tissues
Sense of fatigue and weakness
Drowsiness
Memory problems and confusion
Difficulty concentrating
Dizziness
Lack of production of erythropoietin and resulting anemia
Hypertension
Loss of appetite
Convulsions
Persistent hiccups
Easy bruising, due to a marked tendency to bleed
Failure to implement other renal mechanisms
WHEN TO SEE THE DOCTOR?
The presence of the manifestations indicated above must induce an individual to immediately contact their own doctor and to consult with the latter on what to do.
Kidney failure is a medical condition that requires adequate and prompt treatment. Otherwise, the patient's life is in grave danger.
COMPLICATIONS
Kidney failure itself is a complication of other conditions or diseases.
Having said this, its further worsening may correspond to: an aggravation of the edema present; an aggravation of hyperkalaemia with the appearance of severe cardiac arrhythmias, the need to undergo dialysis and, finally, death, especially in the absence of adequate or timely treatment.
In all those circumstances in which doubts remain about the triggering causes, the use of a kidney biopsy is essential.
OBJECTIVE EXAMINATION AND HISTORY
Physical examination and medical history are two diagnostic assessments that provide useful information about the patient's symptoms and signs.
Furthermore, they allow the doctor to understand the state of health of the person under examination and to deduce the most probable causes of the symptoms in progress.
BLOOD ANALYSIS
The blood tests allow to measure the blood concentrations of urea - that is the azotemia - and of creatinine - that is the creatininemia.
BUN and creatinine are two parameters that allow for a meaningful assessment of an individual's kidney function.
URINE ANALYSIS
Urinalysis provides information on the causes and characteristics of kidney failure present in an individual.
IMAGE DIAGNOSTICS
Among the possible diagnostic imaging tests useful for a correct diagnosis of renal failure, the following deserve a mention: ultrasound - which allows an evaluation of the anatomy and size of the kidneys - and abdominal CT - which provides three-dimensional images of the kidneys rich in details.
KIDNEY BIOPSY
Kidney biopsy is a minimally invasive diagnostic test, which consists of the collection of a sample of cells from a kidney (kidney cells) and its subsequent analysis in the laboratory.
The execution of the kidney biopsy involves local anesthesia and the use of a long needle to aspirate the sample of kidney cells.
Kidney biopsy is the safest test for tracing factors.
DIALYSIS
Briefly, dialysis is a treatment that artificially reproduces certain functions of the kidney, clearing the blood of excess waste products and water.
Figure: dialysis.
LIFESTYLE AND HOME REMEDIES
Generally, every patient with renal failure receives precise and accurate indications from their doctor on what type of diet to adopt.
For patients with renal failure, adhering to the letter to the diet planned by the doctor is a fundamental cornerstone of the therapeutic process.
The most common dietary recommendations include:
- Avoid too salty foods;
- Prefer low-potassium foods;
- Limit the ingestion of foods rich in proteins;
- Limit foods that are high in phosphorus.
