The ManicaPost
Dr Tendai Zuze
CHRONIC kidney failure is the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine.
When chronic kidney failure reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
Signs and symptoms of chronic kidney disease develop over time. These may include:
Nausea
Vomiting
Loss of appetite
Fatigue and weakness
Sleep problems
Changes in how much you urinate
Decreased mental sharpness
Muscle twitches and cramps
welling of feet and ankles
Persistent itching
Chest pain, if fluid builds up around the lining of the heart
Shortness of breath, if fluid builds up in the lungs
High blood pressure (hypertension) that’s difficult to control
These signs and symptoms can also be caused by other illnesses and they may not appear until your kidneys have been irreversibly damaged.
Common diseases and conditions that cause chronic kidney failure include diabetes, high blood pressure, glomerulonephritis (inflammation of the kidney’s filters), polycystic kidney disease, prolonged obstruction of the urinary tract (for example from an enlarged prostate or kidney stones) and recurrent kidney infection.
You are more likely to get chronic kidney failure if you are diabetic, hypertensive, have heart disease, if you smoke, if you are obese, if you have a family history of kidney disease and kidney failure also becomes more likely as you get older.
Chronic kidney failure can affect almost every part of your body. Left unattended, it can cause the following:
Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs
A sudden rise in potassium levels in your blood, which could impair your heart’s ability to function and may be life-threatening
Heart and blood vessel (cardiovascular) disease
Weak bones and an increased risk of bone fractures
Anaemia
Decreased sex drive, erectile dysfunction or reduced fertility
Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
Decreased immune response, which makes you more vulnerable to infection
Pericarditis, an inflammation of the saclike membrane that envelops your heart
Pregnancy complications that carry risks for the mother and the developing foetus
Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival
To diagnose kidney failure, your doctor will not only rely on your personal and family history, but also on the following tests:
Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
Urine tests. Analysing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
Imaging tests. Your doctor may use ultrasound to assess your kidneys’ structure and size. Other imaging tests may be used in some cases.
Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. The biopsy sample is sent to a lab for testing to help determine what’s causing your kidney problem.
Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney failure has no cure. Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease.
Kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled.
If your kidneys can’t keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant.
Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do this.
Kidney transplant. A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors.
For some who choose not to have dialysis or a kidney transplant, a third option is to treat kidney failure with conservative measures.
However, once you have complete kidney failure, your life expectancy generally would be only a few months.
