Chronic renal insufficiency or chronic kidney failure is characterized by decreased kidney function over a long period of time. In the final stages of the disease, the organ no longer works at all. However, if chronic renal failure is detected early, a worse course can be stopped and sometimes even reversed.
What is chronic renal failure?
Dialysis is a blood purification procedure used as part of renal replacement therapy for kidney failure. Chronic renal failure causes the kidney to stop working properly. Normally, this organ detoxifies the body and is responsible for regulating fluid balance. There are many potential triggers for kidney failure. For example, long-standing diabetes mellitus or constant high blood pressure can be the cause. Typical symptoms of chronic renal failure are overhydration, high blood pressure, edema, vomiting, anemia, nausea, and potency problems. If these symptoms exist and a disease is present at the same time that promotes kidney disease, chronic renal failure may be the correct diagnosis. A high creatinine value in the blood can confirm this suspicion. Diagnostic procedures include urine and blood analyses, which can be used to determine significant kidney values. Imaging techniques such as ultrasound, computed tomography, and X-ray contrast studies are also used when chronic renal insufficiency is suspected.
Causes
Chronic renal failure can have multiple triggers. Frequently, in the Western population, this condition is caused by poor behavior or an unhealthy lifestyle. In many cases, the reason is type II diabetes mellitus. However, the kidney tissue can also be damaged by frequently taken painkillers and thus cause kidney weakness. If high blood pressure is present, chronic renal insufficiency is negatively affected. This develops into complete kidney failure, which entails a complete loss of urine production. Other typical diseases as a cause of this condition are a chronic form of kidney inflammation, chronic kidney and renal pelvic inflammation, damage to the kidney due to high blood pressure, congenital malformation of the organ with many cysts, kidney damage caused by painkillers, and diseases of the blood vessels or connective tissue. Genetic factors can also play a role in determining the course of chronic renal failure.
Symptoms, complaints, and signs
Chronic renal failure affects the entire body and can cause a range of symptoms. In the early stages, there are usually no physical symptoms. The first signs may be increased urine output and an increased urge to urinate at night. The urine is very light in color and there is also strong thirst. A urine check may reveal increased excretion of protein (proteinuria). In many cases, water is deposited in the tissue, especially in the legs and eyelids. As the disease progresses, it is noticeable by rapid fatigability and a reduction in performance. Blood pressure may be elevated: Chronic kidney failure should be considered above all if it does not drop to normal despite taking blood pressure-lowering medication. If chronic kidney failure continues to progress, typical symptoms include nausea and vomiting, loss of appetite, itching all over the body, bone pain, muscle cramps and headaches. The amount of urine decreases, water retention in the lungs can cause shortness of breath. Patients often suffer from poor concentration and sensory disturbances, and occasionally clouding of consciousness is observed. Cardiac arrhythmias, cardiac insufficiency or pericarditis also occur, and the weakening of the immune system causes an increased susceptibility to infections. Urinary halitosis and yellowing of the skin indicate a late stage of the disease.
Diagnosis and course
Various diagnostic procedures are used to diagnose chronic renal failure. An initial indication may be elevated creatinine levels, which can be seen from a detailed blood count. If this is the case, further blood and urine analyses follow.They provide information about other kidney values such as blood urea, blood creatinine concentration and urine volume. Imaging techniques are also used. Ultrasound, computer tomography and X-ray contrast medium examinations can be used to diagnose renal insufficiency and monitor its progress. If the suspicion of the disease has been confirmed, the previous effects of the renal insufficiency are recorded with a physical examination. If chronic renal insufficiency is not treated, the disease will steadily worsen. Eventually, the kidney is no longer able to function and gives up its function completely. Dialysis or kidney transplantation becomes necessary at the end stage of chronic renal failure.
Complications
If left untreated, chronic renal failure can cause some complications. As a result of the progressive damage to the kidney, there is initially high blood pressure, triggered by the decrease in urine production and excretion and the resulting excess of salt and water. This can later lead to fluid retention in the arms and legs or the lungs. Edema in brings, among other things, pain, breathing difficulties and circulatory problems. In the final analysis, chronic renal failure develops into terminal renal failure; this leads to urine poisoning, gastrointestinal complaints, changes in consciousness, cardiac arrhythmias, pericarditis and finally to uremic coma. Nearly half of all patients die within ten years as a result of the kidney disease. The terminal study increases the risk of severe heart disease and stroke in particular. In addition, because the kidneys no longer produce potassium in chronic insufficiency, hyperkalemia can occur, resulting in muscle weakness, brief loss of consciousness and dizziness. Severely elevated potassium levels can also lead to cardiac arrest or stroke. Neurological disorders, bone metabolism disorders, and discomfort from malnutrition also often occur.
Treatment and therapy
The form of treatment chosen for chronic renal failure depends on the stage of the disease as well as its cause. In principle, two methods of therapy exist. Conservative therapy treats the underlying disease as well as the symptoms caused by the renal impairment. The medications used depend on the underlying disease. To prevent further progression of kidney weakness despite therapy of the underlying disease, some things must be considered. For example, the diet should be changed. A low-protein and low-potassium lifestyle is now called for. Salt should only be avoided as part of conservative therapy if the patient suffers from high blood pressure and edema. The symptoms that develop as a result of chronic renal insufficiency can be alleviated with medication. However, if the kidney weakness is already far advanced, no form of therapy can usually reverse the damage to kidney function. Dialysis or blood washing is now used, which accompanies the affected person for the rest of his or her life. The only alternative to continuous dialysis is kidney transplantation. The patient then receives a donor organ to treat his chronic renal failure.
Outlook and prognosis
The outlook for recovery from chronic renal failure is considered unfavorable. In most cases, patients with this disease do not experience a cure because of the damage to the organ tissues, and the disease is considered incurable by medical experts. Due to the poor prognosis and prospects of cure, the treatment of patients is focused on alleviating the existing symptoms. In addition, the progression of the disease should be delayed as long as possible and at the same time the patient’s quality of life should be optimized. The kidney tissue suffers irreparable damage in chronic kidney failure. A cure or improvement of the patient’s state of health is then only possible through a kidney transplant. Another complicating factor is that the disease progresses more rapidly in men and older people than in other affected individuals. If left untreated, chronic renal failure leads directly to the death of the patient. With treatment, life expectancy is considerably prolonged, but is significantly reduced in direct comparison to healthy people.If the cause of chronic renal failure is diabetes mellitus, the prognosis is worsened by another. In addition, many patients die prematurely due to various sequelae of renal failure. If, in addition to the kidneys, the vascular system also becomes diseased or heart disease sets in, the prospect of a cure decreases. In addition, the patient’s life expectancy is shortened.
Prevention
Chronic renal failure can be prevented by a healthy lifestyle. It is advisable to always protect the kidney. Therefore, bladder and kidney infections should be treated promptly and consistently. It is also advisable to avoid drugs that damage the kidneys or to stop taking them if kidney weakness has already begun. High blood pressure and diabetes mellitus should also be avoided or thoroughly treated.
Follow-up
Affected individuals have very few or no aftercare measures available to them in most cases of this disease. In this case, the disease also cannot be fully treated, so the patient’s life expectancy is also significantly reduced due to renal failure. In some cases, transplantation can be performed to provide permanent relief. In most cases, medications can be used to treat the renal failure. Affected persons should always ensure that the correct dosage is given and that the medication is taken regularly. Likewise, most sufferers are dependent on dialysis. The support of family and friends is also very important. Above all, psychological upsets or depression can be alleviated or avoided. In general, a healthy lifestyle with a balanced diet also has a positive effect on the course of the disease and can prevent further damage to the kidneys. Affected persons should pay attention to a low-salt and low-potassium diet. High blood pressure should also be avoided. Since chronic renal failure usually cannot be completely treated, regular examinations of the internal organs are very important in order to detect and treat further complications and damage at an early stage.
What you can do yourself
The options for self-help are limited in chronic renal failure. The main focus in everyday life is on a healthy lifestyle. Harmful substances, which are supplied to the body when consuming alcohol or nicotine, should be avoided as a matter of principle. These place an unnecessary burden on the organism. Measures that help to strengthen the immune system are helpful. These include a regular daily routine, sufficient rest, good sleep hygiene and a balanced diet. Vitamins and a diet rich in fiber support the immune system so that the organism is less susceptible to pathogens. During the disease, psychological stability and optimistic attitude to life are very helpful. The social environment should be structured in such a way that it gives the affected person support and security. Participation in social life should be adapted to current possibilities and should not be discontinued. Social withdrawal reduces the quality of life and promotes a depressive mood. Recreational or sporting activities can be oriented towards targeted stress-reducing activities or methods. This strengthens well-being and promotes a positive attitude toward life. Optimism and confidence help despite all adversity. Although the disease has many negative facets and the course of the disease is very difficult, an affirmation of life is beneficial in overcoming challenging situations and conditions.
