Renal Failure

Renal failure is characterized by the inability for the kidneys to function properly. Renal failure is a major risk factor for developing renal cell carcinoma. There are two main types of renal failure – acute renal failure and chronic renal failure. Chronic renal failure develops slowly and gives few symptoms at its initial development. Chronic renal failure can be a complication of great number of kidney diseases, not just renal cell carcinoma. Due to its stealthy development chronic renal failure can result in end-stage renal failure. At this stage, the kidneys have lost all ability to function on their own; dialysis (an external machine used to regulate waste excretion) is required until a transplant kidney is found. Acute renal failure is the rapid loss of kidney function. Symptoms for acute renal failure are more obvious and therefore easier to catch before causing long-term damage. For this reason, acute renal failure may be treatable. Occasionally, acute renal failure can be found along with chronic renal failure; this is known as acute on chronic renal failure.

Renal failure can develop for a variety of reasons. Decreased blood flow due to low blood pressure is a major cause. Low blood pressure can be caused by trauma, surgery, serious illness, septic shock, hemorrhage, severe burns or dehydration. Acute tubular necrosis (ATN) is another cause of both acute and chronic renal failures. Tubular cells in the ureters are constantly replacing themselves; ATN is a disease characterized by the inability to form these new tubular cells. Infections that directed injury the kidneys, urinary tract obstructions and autoimmune kidney diseases may also lead to renal failure, as well as disorders that cause clotting within the thin blood vessels of the kidneys. These disorders include: idiopathic thrombocytopenic thrombotic purpura (ITTP), reactions to transfusions, malignant hypertension, scleroderma, hemolytic (a uremic syndrome) and disorders of childbirth, such as bleeding placenta.

Renal failure is characterized by a number of signs and symptoms. These symptoms include:

  • Oliguria – decrease in amount of urine
  • Anuria – cessation of urine
  • Excessive nocturnal urination
  • Swelling of the ankles, legs and feet
  • Generalized swelling and fluid retention
  • Decreased sensation, especially in the hands and feet
  • Decreased appetite
  • Metallic taste in the mouth
  • Persistent hiccups
  • Changes in metal status – agitations, drowsiness, lethargy, delirium, confusion, coma, mood swings, concentration trouble, hallucinations
  • Slow or sluggish movements
  • Hand tremors
  • Nausea or vomiting
  • Ease of bruising
  • Prolonged bleeding
  • Nosebleeds
  • Bloody stools
  • Flank pain
  • Fatigue
  • Breath odor
  • High blood pressure

When it is suspected that a generalized swelling is the result of fluid retention a doctor will listen to the heart and lungs. The built-up fluid may cause a heart murmur or crackling in the lungs, which can be heard through a stethoscope. Doctors can perform a blood test to check for normal hormone and chemical levels. A blockage causing renal failure can also be detected by performing an ultrasound, abdominal x-ray, CT scan, or MRI.

Acute and chronic renal failure can be treated in a variety of ways. The ultimate goal in treatment is to restore kidney function to normal and prevent fluids and wastes from building up while the kidneys heal. Modifying one’s diet can help to amend renal failure. Eating foods that are high in carbohydrates and low in protein, salt and potassium can help to reduce the build up of toxins. Taking antibiotics to fight infections or diuretics to expel fluid may also help to fight off extraneous diseases associated with renal failure. Dialysis is an option for treating kidney failure, but it is not required with every case. Symptoms of renal failure that call for dialysis are: mental state changes, rising potassium levels, urination cessation, pericarditis development (inflammation of sac-like lining of the heart), excessive fluid build-up or the inability to eliminate nitrogen waste.

The prognosis for acute renal failure is generally optimistic, yet the disease can be fatal if not properly treated. Often times, the kidneys will begin working again within several weeks to a month after the underlying cause(s) has been treated. When the kidneys do not begin functioning properly, chronic renal failure or end-stage renal failure may develop resulting in renal cell carcinoma and possibly even death. The risk of fatality increases with age, presence of infection, loss of blood in the intestinal track and following trauma or major surgery. Untended renal failure can cause long-term complications, such as hypertension and damage to the heart or lungs. Therefore, it is extremely important to discuss any abnormal signs or symptoms with a medical professional.

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