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Chronic Renal Failure

Definition

Chronic renal failure is an deficiency in kidney function. Kidneys clean waste from the blood, which passes out of the body in urine.

Anatomy of the Kidney
Glomerulonephritis
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Causes

Chronic renal failure is often caused by diseases such as:

  • High blood pressure
  • Diabetes
  • Vascular diseases
  • Kidney diseases
  • Obstructive diseases, such as kidney stones
  • Polycystic kidney disease
  • Acute tubular necrosis
  • Glomerular disease
  • Renal tubular disorders
  • Toxin/drug-induced kidney disease
  • Severe infection
  • Autoimmune diseases

Risk Factors

The following factors increase your chance of developing chronic renal failure. If you have any of these risk factors, tell your doctor:

Symptoms

Symptoms include:

  • Tiredness
  • Weakness
  • Not sleeping well
  • Less desire to eat than usual
  • Nausea
  • Itching
  • Shortness of breath
  • Altered taste
  • Altered mental state

Diagnosis

Your doctors will ask about your symptoms and medical history. A physical exam will be done.

Your bodily fluids and tissues may be tested. This can be done with:

  • Blood tests
  • Biopsy

Images may be taken of your kidneys. This can be done with ultrasound .

Patients who are already at high risk for kidney disease should be tested more frequently so any damage can be diagnosed early. Patients with kidney disease will be referred to a specialist called a nephrologist, who is dedicated to managing kidney diseases.

Treatment

Although chronic kidney disease cannot be cured, it is possible to slow the damage to the kidney in most patients. Your doctor may recommend any of the following:

  • Controlling protein in the urine by restricting the amount of protein in the diet or medication
  • Taking ACE inhibitors or angiotensin II receptor antagonists to slow the progression to chronic renal failure
  • Reducing the use of and the dosages of drugs that may be toxic to the kidneys
  • Managing the complications of chronic renal disease such as fluid overload, high blood phosphate or potassium levels, low blood level of calcium, and anemia
  • Lowering high blood pressure
  • Controlling blood sugar and lipid levels
  • Staying hydrated
  • Controlling salt in the diet
  • Participating in an exercise training program to keep you physically fit and reduce the chance of depression
  • Quitting smoking
  • Undergoing dialysis , a medical process that cleans the blood
  • Having a kidney transplant
  • Counseling for you and your family about dialysis and/or transplant options

Prevention

To help reduce your chance of chronic kidney failure, take the following steps:

  • Get a physical exam every year that includes a urine test to monitor your kidney's health.
  • Do not smoke. Stop smoking if you are a smoker.
  • Maintain a healthy weight.
  • Drink water and other fluids to stay hydrated.
  • People who have diabetes, previously known kidney disease, high blood pressure, or are over the age of 60 should be screened regularly for kidney disease.
  • People with a family history of kidney disease should also be screened regularly.

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://www.familydoctor.org

  • National Kidney Foundation

    http://www.kidney.org

  • Health Canada

    http://www.hc-sc.gc.ca

  • The Kidney Foundation of Canada

    http://www.kidney.ca

  • Chronic renal failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 12, 2013.

  • Pendse S, Singh AK. Complications of chronic kidney disease: anemia, mineral metabolism, and cardiovascular disease. Med Clin N Am. 2005; 89:549-561.

  • Snyder S and Pendergraph B. Detection and evaluation of chronic kidney disease. Am Fam Physician. 2005; 72:1739-1746. Available at: http://www.aafp.org/afp/20051101/1723.html. Accessed July 12, 2013.

  • Zandi-Nejod K, Brenner BM. Strategies to retard the progression of chronic renal disease. Med Clin N Am. 2005; 89:489-509.

  • 8/26/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Heiwe S, Jacobson SH. Exercise training in adults with CKD: A systematic review and meta-analysis. Am J Kidney Dis. 2014;64(3):383-393.