Kidney Disease: Causes, Symptoms & Treatment

Kidney disease is often underestimated. The kidneys of the human body perform a variety of vital functions. These include regulating water balance, blood pressure and acid-base balance.

What are kidney diseases?

Kidney diseases can be life-threatening. They occur when the kidneys malfunction, with the result that they no longer work properly. In severe cases, renal failure occurs. This means that the kidneys fail in their life-sustaining functions. This can happen in a chronic or acute way. It is not necessarily always both kidneys that are affected by hypofunction.

Causes

The causes of acute and chronic renal failure are many and very different. Acute renal failure manifests as a sudden lack of blood flow to the kidneys. The lack of blood flow can result from a sudden loss of blood, a drop in blood pressure or circulatory shock. In addition, possible poisoning or other damaging effects on the kidneys are also included. The tissue of the kidneys can also be damaged by taking medication or by fungi in the body, which can result in acute kidney failure. For example, those who continuously consume too little fluid and eat the wrong diet contribute to the formation of kidney stones, which, in addition to possible bladder stones or urinary stones, can be other causes of renal insufficiency. If the human organism is affected by a tumor, attention should always be paid to the function of the kidneys. This is because a tumor can cause immediate kidney failure. Inflammation of the kidneys often results from pre-existing diseases that weaken the human body in many ways. Diseases such as diabetes, hepatitis, cancer, autoimmune diseases, or heart inflammation can cause one or both kidneys to malfunction. However, kidney disease can also be hereditary. This is often the case with kidney cysts. Only when multiple cysts are present can the kidneys become dysfunctional. In this case, it is called a cystic kidney, which should be treated bypass.

Symptoms, complaints and signs

Basically, the first symptoms are manifested by a change in the urine. The change may be seen in the amount of urine or its color. In the first case, there may be either extremely decreased or a greatly increased amount of urine u.U. associated with a color turbidity or blood in the urine. Inflammatory reactions in the kidney activity may manifest themselves especially in secondary diseases. However, the main symptom of impaired work of kidneys is complete absence or limited urine production. As a result of the disruption of the functioning of the kidneys, metabolic products and toxins can no longer be eliminated from the human organism. At the beginning, this does not have to manifest itself directly and the affected person does not notice it at first. Chronic renal insufficiency in particular is initially overlooked because it initially progresses without symptoms. Only in the progressive course of the disease or in the progressive disturbance of renal activity can the following symptoms be expressed:

  • Water retention (edema) in the legs or lungs.
  • Pain in the bones
  • High blood pressure
  • Seizures
  • Shortness of breath / hyperventilation

There are non-specific symptoms that fit other clinical pictures. But they can also indicate a disorder of kidney function.

  • Weaknesses in concentration
  • Decreased performance
  • Fatigue
  • Increased headache
  • Nausea and vomiting
  • No feeling of hunger

Complications

In acute renal failure, complications can spread to the entire organ system of the human body. Complications may particularly affect the lungs, heart or brain.Lungs: Pulmonary edema can occur, which is also colloquially known as water lung. In this case, blood fluid leaks from the smallest vessels. This fluid flows into the intercellular space and into the alveoli of the human lungs. This prevents sufficient oxygen from being absorbed into the bloodstream. The affected person becomes short of breath, and may experience rattled breathing or frothy sputum. Heart: Heart failure may occur. If there is existing high blood pressure in the circulatory system of the body, arterial hypertension or high blood pressure in the pulmonary circulation may occur. This means that the blood pressure in the arterial vessels is chronically elevated. Heart failure can also occur as a result of overhydration in the case of renal dysfunction. The cardiac dysfunction can lead to reflux into the venous circulation, with the possible consequences of gastritis, the development of an ulcer, or blood loss into the interior of the digestive tract. Brain: in case of cerebral edema or water retention in the brain, neurological complications may occur. This may entail seizures or impaired attention.

When should you see a doctor?

The problem is that in the early stages of kidney dysfunction, no symptoms initially manifest themselves. The presence of nonspecific symptoms is often attributed to other causes. The possibility of kidney dysfunction is rarely if ever considered. But early warning signs can be seen in a urine examination. Many primary care physicians check the kidneys via a blood test when it is routine. During this examination, the creatinine level is checked. An affected person should in any case consult a doctor if the symptoms shown are already clearly evident. At least the leading symptom should not be ignored. Anyone who produces very little or excessive urine should see a doctor. In addition, the affected person himself usually knows from which various diseases he suffers and what effects they can have. If the person is aware of a disease, he or she will usually have already been informed about it by a doctor. This is particularly true with regard to the sequelae of an existing disease that could result in renal insufficiency.

Diagnosis

If renal dysfunction is suspected, it can be detected by a blood test. The blood test determines whether the kidneys are filtering urine properly. If insufficiency is present, the glomerular filtration rate value is also decreased. This rate indicates the total volume of primary urine. The total volume is formed by both kidneys together. The test also provides information on inflammation levels as well as information on creatinine levels. The disadvantage with just a blood test may be that damage to the kidneys is not indicated until at least fifty percent of the kidneys’ functional activity has long been lost. Therefore, it is useful to also have a microalbumin test done. This test focuses on the traces of protein in the urine that are present early in the course of the disease when renal activity is impaired. If the suspicion is solidified, it is advisable to see a kidney disease specialist. This is a nephrologist who can ultimately definitively determine the kidney disorder.

Treatment and therapy

The nephrologist will decide on the necessary treatment and therapy based on the type of kidney disease. Not every kidney disease sufferer will directly become a dialysis patient. In numerous cases, various medications are suitable for medical treatment. If inflammation in the kidneys is already severe, the specialist administers glucocorticoids or an immunosuppressant to the patient. These agents help to suppress inflammatory reactions in the human organism. In the case of acute kidney damage, treatment consists of a diet low in sodium chloride and protein. In combination with a balanced fluid intake and appropriate medication, symptomatic complaints are effectively alleviated in this way. If the patient suffering from renal insufficiency is already in an advanced stage of acute kidney failure, dialysis may become unavoidable. Dialysis involves artificial blood washing. In severe cases, a kidney transplant may become necessary.The therapy of chronic renal insufficiency mainly consists of administering medication, for example against high blood pressure. In addition, urinary tract infections are treated and blood sugar levels are properly adjusted. The therapy is aimed at preventing the progression of the kidney disease. The patient himself is urged to change his lifestyle.

Outlook and prognosis

Chronic kidney disease cannot be cured. People who have kidney disease are at increased risk of having a stroke or heart attack. Diabetics and older people are particularly at risk. The prognosis here depends on the course of the kidney disease, its underlying causes and underlying diseases. A prognosis can be achieved if the kidney weakness is detected early. The earlier the disease is detected, the more likely it is that treatment options will improve. Nevertheless, it should be emphasized that acute kidney weakness is often fatal. The actual cause of death is then due to the underlying disease present, such as shock in the presence of sepsis or myocardial infarction. The prognosis generally worsens if other organs are already damaged. A body suffering from kidney damage is particularly susceptible to pathogens. Accordingly, the most common cause of death is existing infections. However, kidney function can recover after acute renal impairment if fluid and blood losses and blood pressure have been successfully treated. In this case, it is possible that the kidneys can resume their work. In the severe case of a dialysis patient, recovery of kidney weakness is no longer possible. Dialysis remains a lifelong companion. The regular intake of already prescribed medication is necessary for an improvement of the course of the disease. The respective medical instructions must be strictly followed.

Prevention

Prevention can be created by a healthy lifestyle. This includes not only a healthy diet, but also sufficient fluid intake. At least two liters a day should be consumed by a person. This is because an adequate fluid intake is of great importance for the functioning of both the kidneys and the rest of the organs. In addition to an adequate fluid intake, salt or fat should only be consumed in moderation with food. The consumption of protein-rich foods should also be limited. If a person is already taking medication for another illness, care should be taken to ensure that it does not have a damaging effect on the kidneys. A physician can provide information on this and name possible alternatives.

Follow-up care

Follow-up care depends on the type and severity of kidney disease. Scheduled follow-up examinations following therapy that has been provisionally completed or terminated serve to detect complications or subsequent damage in good time and to treat them effectively, to adapt permanent therapy to the course of the disease and to help affected individuals maintain their quality of life. In the case of chronic kidney disease, after a kidney transplant or during dialysis treatment, close monitoring examinations are necessary. Follow-up measures include blood pressure checks, urine tests, creatine tests, checking kidney function values and ultrasound examinations. Medical rehabilitation sports may also be part of the follow-up treatment. In addition to regular follow-up examinations, patients also receive counseling for occupational or psychological problems, depending on the degree and stage of kidney disease. In certain cases, for example, psychotherapeutic care may be useful. The intervals at which follow-up care takes place are determined by the attending physician on the basis of the original findings. To carry out follow-up treatment, physicians conduct intensive counseling sessions with the patient to provide important information on how to pay attention to special details. In the case of an underlying disease or renal insufficiency, permanent follow-up is necessary. It is also important that patients with conditions such as diabetes receive additional support, for example in lifestyle changes to reduce the risk of cardiovascular problems. The doctor discusses all the details of follow-up treatment for kidney disease in detail with his patient.