Kidney Health What is Kidney Failure? Kidney failure occurs when your kidneys lose the ability to sufficiently filter waste from your blood. There are a number of reasons when the kidneys don’t work well. These are: diabetes, high blood pressure, infections and a group of diseases that affect the glomerulus. The kidneys also need an adequate supply of blood, so if there is something wrong with the blood vessels to the kidney, such as a narrowing, this will prevent the kidneys from working efficiently. The symptoms can differ based on how bad the kidney failure is, how quickly it is getting worse, and what is causing it. There are mainly 2 types of kidney failure: acute (sudden) and chronic (over time). Acute Renal failure (ARF) - ARF occurs when the kidneys suddenly stop filtering waste products from the blood. ARF is most likely to happen with: low blood flow (such as after complicated surgery or an accident) swelling of the kidney (such as a reaction to a drug or infection) sudden blockage (such as by a kidney stone) very high blood pressure inflammatory diseases (lupus, vasculitis,…) With ARF, the kidney often returns to normal or near normal after the cause is treated. Chronic Renal Failure – CRF - CRF builds slowly with very few symptoms in its early stages. A patient with CRF may not have any symptoms until kidney function declines to 20% or less. Possible symptoms include: a reduced amount of urine swelling of your legs, ankles, and feet from retention of fluids caused by the failure of the kidneys to eliminate water waste unexplained shortness of breath excessive drowsiness or fatigue persistent nausea confusion pain or pressure in your chest seizures coma CRF is permanent loss of kidney function. The most common causes are: high blood pressure chronic glomerulonephritis (kidney damage) high blood sugar (diabetes) polycystic kidney disease blocked urinary tract kidney infection There are several tests your doctor can use to diagnose kidney failure: Urine Analysis: Your doctor may take a urine sample to test for any abnormalities, including abnormal protein, presence of blood or sugar that spills into the urine. Urine Volume Measurements: Measuring urine output is one of the simplest tests to help diagnose kidney failure. For example, low urinary output may suggest that kidney disease is due to a urinary blockage, which multiple illnesses or injuries can cause. Blood Samples: Your doctor may order blood tests to measure substances that are filtered by your kidneys, such as blood urea nitrogen (BUN) and creatinine (Cr). A rapid rise in these levels may indicate acute kidney failure. Imaging: Tests like ultrasounds, MRIs, and CT scans provide images of the kidneys themselves as well as the urinary tract. This allows your doctor to look for blockages or abnormalities in your kidneys. Biopsy: Tissue samples are examined for abnormal deposits, scarring, or infectious organisms inflammatory disease. Your doctor will use a kidney biopsy to collect the tissue sample. Treatment for Adults: Chronic kidney disease is a progressive condition that has 5 stages. Understanding the stage of the condition, your nephrologist will work with you to slow the progression of disease and preserve the function of your kidney by medication, lifestyle and managing other conditions such as high blood pressure and diabetes, that affects kidney. End stage renal disease (ESRD), is stage 5 of chronic kidney disease. At this stage the health of your kidney has decline to the point where it can no longer perform its required functions on its own, patient requires either dialysis or a kidney transplant to survive. After the careful assessment of your kidney function through estimating the filter function of your kidney, your healthcare provider will determine the need for dialysis or kidney transplant. Dialysis: One of the only two treatment options available to ESRD or ESKD patients is dialysis. Dialysis treatment works to compensate for the loss of kidney functions with the use of machine that filters your blood from waste and excess fluid. There are two types of dialysis options available to patients: hemodialysis and peritoneal dialysis. Hemodialysis: it is the most common type of dialysis option available, where a machine called hemodialyzer is used. The blood from the patient is sent through the tube to the machine that filters it and return the cleaned blood in the body. For transferring of the blood, a surgical port is prepared in the body of the patient, usually in the arm, that connects the tube to the machine. Hemodialysis is usually performed in healthcare facility. The patient needs to get hemodialysis 3-5 times a week. Peritoneal dialysis: Another form of dialysis that uses abdomen lining (peritoneal membrane) to help filter blood, without transferring the blood through any machine. During Peritoneal dialysis, a cleansing solution is passed into the abdominal cavity where it absorbs excess fluids, waste and other toxins from blood and later this solution is drained from the cavity in to a bag via catheter and fresh fluid is replaced in the cavity. Peritoneal dialysis can be performed at home and may need to be performed daily to avoid buildup of waste in blood. At Mediclinic City Hospital we provide hemodialysis treatment options where our team of nephrologist and dialysis nurses work with the patients to provide them safe and effective dialysis treatment. Learn more about the dialysis service here. Kidney transplant A kidney transplant is preferred choice of treatment for kidney failure, compared with a lifetime on dialysis. Kidney transplant for ESRD patients is a surgical procedure where transplant surgeon replace the diseased kidney with healthy kidney from either live or deceased donor. For kidney transplantation surgery, patients are first evaluated to see if they are viable candidate. Once the kidney donation is applicable, the patient will go through certain tests to determine if the kidney donor kidney is a good match. After the transplant surgery, patient will be will required to take medication so that patient body does not reject donated kidney. Deceased donor kidney transplant A deceased donor is someone who has consented to donating his or her organs upon death during their life. In the event in which the deceased donor's wishes are unknown, the family members may consent to organ donation. If a compatible living donor isn't available for a kidney transplant, your name will be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. Living donor kidney transplant A living-related donor is a person who is a blood relative of the potential recipient. Relatives up to the 4th degree may be accepted for living donation. If a family member’s blood and tissue matches the patient and they clear the evaluation for being the donor, the patient can undergo the transplant surgery. The kidney transplant procedure is done on the same day for both recipient and donor. After the surgery the donor can live healthy life with one kidney. Receiving a kidney from a living donor is a good option for patient as it reduces their wait time and risk of body rejecting the donor kidney as well. Mediclinic City Hospital in an accredited institute that provides kidney transplant option to patient suffering from ESRD. The multidisciplinary team of nephrologist, urologists, transplant surgeons and nurses work with patients from initial consultation through to the procedure of donation or transplant, and ongoing treatment. To learn about kidney transplant procedure at Mediclinic City Hospital click here.