Kidney failure involves:
Loss of Kidney Function: The kidneys lose their ability to filter waste products from the blood, maintain electrolyte balance, and regulate fluid levels.
Acute or Chronic Damage: Can result from acute injury (acute kidney injury, AKI) or chronic conditions (chronic kidney disease, CKD) such as diabetes, hypertension, or glomerulonephritis.
Uremia: Accumulation of waste products in the blood (uremia) leading to systemic toxicity and multi-organ dysfunction.
Complications: Can lead to electrolyte imbalances, fluid overload, anemia, cardiovascular disease, and death.
Clinical Evaluation
Symptoms: Assessment of symptoms such as fatigue, swelling (edema), shortness of breath, decreased urine output, and confusion.
Physical Examination: Examination findings may include edema, hypertension, signs of fluid overload, and pallor due to anemia.
Diagnostic Tests: Blood tests to measure serum creatinine, blood urea nitrogen (BUN), and electrolyte levels. Urinalysis to check for proteinuria or hematuria. Imaging studies (ultrasound, CT scan) to assess kidney size and structure. Kidney biopsy in some cases to determine the underlying cause.
Fatigue and weakness.
Swelling in the legs, ankles, and feet due to fluid retention (edema).
Shortness of breath and difficulty breathing due to fluid buildup in the lungs (pulmonary edema).
Decreased urine output or, in severe cases, no urine output.
Nausea, vomiting, and loss of appetite.
Confusion, difficulty concentrating, and altered mental status.
Persistent itching and dry skin.
Treatment aims to manage symptoms, prevent complications, and address the underlying cause:
Dialysis: Hemodialysis or peritoneal dialysis to filter waste products and excess fluid from the blood.
Medications: Medications to manage blood pressure, control blood sugar levels, reduce fluid retention, and treat anemia.
Dietary Modifications: Low-sodium, low-potassium, and low-phosphorus diet to reduce the workload on the kidneys and manage electrolyte levels.
Fluid Management: Monitoring and limiting fluid intake to prevent fluid overload.