Chronic Renal Failure

Chronic renal failure is defined as glomerular filtration rate (GFR) below 30 ml/min. Symptoms of uremia often occur when the GFR is less than 15 ml/minute.

Causes—

  • Autoimmune disorders( systemic lupus erythematosus and scleroderma)
  • Chronic glomerulonephritis
  • Diabetes
  • Hypertension
  • Injury or trauma
  • kidney stones
  • Polycystic kidney disease
  • Reflux nephropathy
  • Toxic chemicals

Symptoms And Signs–

  •  Restless leg syndrome
  • Abnormally dark or light skin
  • Amenorrhea
  •  Bleeding
  •  Blood in the stool
  • Bone pain
  • Breath odor
  •  Confusion
  • Drowsiness
  • Easy bruising
  • Edema
  • Excessive thirst
  • Fatigue                       
  • Frequent hiccups
  • Headaches

  • Insomnia
  • Loss of appetite
  • Low level of sexual interest and impotence
  •  Malaise
  • Muscle twitching or cramps
  • Nausea
  • Numbness in the hands, feet, or other areas
  •  Obstructive sleep apnea
  • Pruritus and dry skin
  • Unintentional weight loss
  • Vomiting, typically in the morning

Investigations—-

  • BUN
  • S. Creatinine
  • GFR
  • CT scan-abdomen
  • MRI-Abdomen
  • USG-Abdomen
  • Renal scan

Treatment—

  • Ayurvedic Medications
  • Dialysis

Dialysis cleanses the body of waste products in the body by use of filter systems. Dialysis is life saving. Without it, patients whose kidneys no longer function would die relatively quickly due to electrolyte abnormalities and the buildup of toxins in the blood stream.

There are two types of dialysis;

  • Hemodialysis
  • Peritoneal dialysis

Hemodialysis

Hemodialysis uses a machine filter called a dialyzer or artificial kidney to remove excess water and salt, to balance the other electrolytes in the body, and to remove waste products of metabolism. Blood is removed from the body and flows through tubing into the machine, where it passes next to a filter membrane. A specialized chemical solution (dialysate) flows on the other side of the membrane. The dialysate is formulated to draw impurities from the blood through the filter membrane. Blood and dialysate never touch in the artificial kidney machine.

For this type of dialysis, access to the blood vessels needs to be surgically created so that large amounts of blood can flow into the machine and back to the body. Surgeons can build a fistula, a connection between a large artery and vein in the body, usually in the arm, that causes a large amount of blood flow into the vein. This makes the vein larger and its walls thicker so that it can tolerate repeated needle sticks to attach tubing from the body to the machine. Since it takes many weeks for a fistula to mature enough to be used, significant planning is required if hemodialysis is to be considered as an option.

If the kidney failure happens acutely and there is no time to build a fistula, special catheters may be inserted into the larger blood vessels of the arm, leg, or chest. These catheters may be left in place for up to three weeks. In some diseases, the need for dialysis will be temporary, but if the expectation is that dialysis will continue for a prolonged period of time, these catheters act as a bridge until a fistula can be planned, placed, and matured.

Dialysis treatments normally occur three times a week and last a few hours at a time. Most commonly, patients travel to an outpatient center to have dialysis, but home dialysis therapy is becoming an option for some

Peritoneal dialysis

Peritoneal dialysis uses the lining of the abdominal cavity as the dialysis filter to rid the body of waste and to balance electrolyte levels. A catheter is placed in the abdominal cavity through the abdominal wall by a surgeon and is expected to remain there for the long-term. The dialysis solution is then dripped in through the catheter and left in the abdominal cavity for a few hours and then is drained out. In that time, waste products leech from the blood normally flowing through the lining of the abdomen (peritoneum).

Kidney transplantation

This is required for an irreversible kidney damage. Sometimes, family members have compatible tissue types and, if they are willing, may donate a kidney. Otherwise, the patient will be placed on the organ transplant list.

Complications—-

  • Anemia
  • Bleeding from the stomach or intestines
  • Bone, joint, and muscle pain
  • Changes in blood sugar
  • Congestive heart failure
  • Coronary artery disease
  • Dementia
  • Fractures
  • High phosphorous, potassium levels
  • Hyperparathyroidism
  • Hypertension
  • Infections
  • Infertility
  • Liver damage or failure
  • Malnutrition
  • Miscarriages
  • Pericarditis
  • Peripheral neuropathy
  • Pleural effusion
  • Seizures
  • Stroke

Prevention–

               Treating the underlying disease/cause.

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