Synonyms
renal failure, renal dysfunction
Symptoms
Renal insufficiency can manifest itself through many different symptoms. The main symptom is the reduced excretion of urea. This can lead to polyneuropathy (a disease of the peripheral nerves) with sensory disturbances and paresthesia.
Reduced appetite, hiccups, headaches and vomiting are further symptoms. The deposition of urea in the pericardium can cause pericarditis. Heart failure and arrhythmia are also possible symptoms.
Because the urea no longer or hardly ever leaves the body, it accumulates in the organism. If the urea level is too high, the blood becomes overly acidic and the urea is then excreted via the exhaled air. The exhaled air has a characteristic odor (foetor uraemicus), and hyperventilation (increased breathing) also occurs.
In severe cases of chronic renal insufficiency or acute renal failure, drowsiness and confusion or coma with kissing mouth breathing (deep, sighing breathing) occurs. The kidneys produce erythropoietin (EPO), a hormone that stimulates blood formation. In renal insufficiency, the lack of EPO leads to anemia with paleness and fatigue.
The kidneys are responsible for the activation of vitamin D: renal insufficiency leads to vitamin D deficiency and thus to a reduction in bone substance, bone pain is the result. Other symptoms of renal insufficiency affect the digestive tract (uremic gastritis or colitis, stomach ulcers), the blood system (reduced function of platelets and white blood cells) or the lungs. Chronic renal insufficiency leads to various skin diseases.
Typical symptoms are calcification of the skin, yellowish discoloration and other pigmentation disorders. In addition, the number of sebaceous and sweat glands in the skin is reduced, resulting in dry skin. The reduced excretion of urinary substances impairs the function of the blood platelets: patients with renal insufficiency therefore often get bruises more quickly than patients with healthy kidneys.
Another skin symptom of renal failure is itching. On the one hand, it is favored by dry skin, and on the other hand, there are more mast cells in the skin of patients with renal insufficiency. These mast cells are actually involved in allergic reactions.
They secrete the tissue hormone histamine, which gives the feeling of “itching” via the free nerve endings of the skin. The next article could also be of interest to you. Acute renal failure occurs in 1 to 5% of hospital patients; in patients under intensive care in more than 10%.
In Western Europe, the incidence of chronic renal failure is 10 per 100,000 per year. Acute renal failure is often caused by circulatory disorders of the kidney. Examples are a circulatory shock in an accident or surgery, a blood clot in the renal vessels and certain medications.
A prolonged lack of oxygen can also lead to acute kidney failure. In addition, obstruction of urine flow can damage the kidney. An enlarged prostate, urinary stones, inflammation and tumors can obstruct the urinary tract and obstruct the flow of urine.
This can result in acute kidney failure. Thirty-five percent of chronic kidney failure is caused by diabetes mellitus (diabetic nephropathy). In addition, high blood pressure is another common cause and a possible consequence of renal failure.
Various kidney inflammations, such as glomerulonephritis or interstitial nephritis can also lead to the development of kidney weakness. Congenital malformations such as cystic kidneys can restrict kidney function early on and lead to chronic renal failure. There are also some drugs that can damage the kidney.
These include over-the-counter drugs such as paracetamol, ibuprofen and diclofenac. These drugs can lead to chronic renal insufficiency, especially when used over a longer period of time. Acute renal insufficiency: Acute renal insufficiency is first diagnosed by means of the patient’s medical history and clinical picture, including the amount of urine excreted.
In addition, blood (including the retention values of creatinine and urea; electrolytes) and urine (urine status, urine sediment) are examined.In addition to the diagnosis “renal insufficiency”, an imaging of the kidneys can be arranged, whereby ultrasound (sonography, vascular Doppler), MRT and CT are possible. Finally, a kidney biopsy can be performed as a diagnostic tool, whereby kidney tissue is obtained for microscopic examination using a punch. Chronic renal insufficiency: Like the acute form, the diagnosis of “chronic renal insufficiency” is made on the basis of the patient’s medical history, the clinical picture, the laboratory (blood and urine, see “acute renal insufficiency “) and imaging procedures.
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