The so-called shrunken kidney, which in the final analysis is an advanced kidney scarring, can – if not treated – provide for a loss of kidney function. In the final stage, urinary toxicity occurs. Shrunken kidney is a disease that often goes unnoticed for a long time.
What is shrunken kidney?
If the kidney becomes smaller and smaller, it is called a shrunken kidney. The shrunken kidney weighs an average of 80 grams; in many cases, the weight can be significantly less. The size is about eight by four centimeters. Various reliable methods are available to detect the size and structure, although physicians rely exclusively on ultrasound. Sometimes – when a shrunken kidney has been diagnosed – other changes can also be detected; in many cases, the renal cortex also reduces in size.
Causes
A shrunken kidney can be caused by high blood pressure, circulatory problems, chronic inflammation (favored by bacteria), or by drugs or diabetes that damage the kidneys. If the patient suffers from extremely high blood pressure, the result is a shrunken kidney; the shrunken kidney also causes an increase in blood pressure, resulting in significant circulatory problems. In further consequence it comes to a constant attack of the kidney. For this reason, it is important to break this vicious circle – as soon as possible. On the other hand, the “unilateral shrinking kidney” occupies a special position. This is caused by vascular calcification, and sometimes bacteria, which can trigger chronic inflammation, also promote a unilateral shrinking kidney. This can also promote hypertension, so that the second kidney is also attacked.
Symptoms, complaints, and signs
The following symptoms are characteristic of a shrunken kidney: the patient complains of swollen legs (water retention), suffers from loss of appetite, is fatigued, complains of muscle cramps and visual disturbances, is afflicted by severe itching, and has recurrent fever as well as headaches. The first symptom that indicates a damaged kidney is the accumulation of fluid in the tissue. Thus, shrunken kidneys cause swelling of the eyelids, ankles or even lower legs. However, swelling caused by fluid retention does not immediately indicate the presence of a shrunken kidney; there are numerous other diseases that can also cause such symptoms. If the person concerned has to go to the toilet again and again, and the urge to urinate at night is particularly intense, advanced kidney damage can be assumed. However, if only very small amounts of urine are excreted, this can sometimes already be an indication that the kidney will soon lose its function.
Diagnosis and course of the disease
Medical professionals often detect the shrunken kidney during a routine examination. During this process, the medical professional notices altered values that can be detected by a urine examination. The physician discovers protein and blood in the urine; these are two substances that should not normally be present in urine. The protein makes the urine cloudy; the blood makes the urine dark yellow to red. This is followed by a physical examination. First, the physician taps the kidney area, where he can sometimes detect water that has already been stored. If the physician performs a blood test, he or she can detect high creatine levels (kidney value) – if a shrunken kidney is present. In order for the doctor to be sure that it is a shrunken kidney, an ultrasound examination is performed. Subsequently, tissue samples of the kidneys can also be taken; however, those measures are performed exclusively by a nephrology specialist.
Complications
Cirrhotic kidney disease almost always leads to renal failure. Initially, the disease causes hypertension and other cardiovascular problems such as ventricular fibrillation and arrhythmias. In extreme cases, this leads to a heart attack and thus often to the death of the patient. Kidney transplantation carries long-term health risks. As a result of the operation, chronic diseases of the cardiovascular system, diabetes mellitus and viral infections often occur. Transplantation also favors the development of tumors such as skin or kidney cancer.The kidney transplant itself can also become diseased – chronic allograft nephropathy occurs, which often leads to organ failure years later. Classic rejection reactions such as fever and pain are also not unlikely with a kidney transplant. Complications can also occur during dialysis. For example, infections of the surgically placed vascular access are possible, as are drops in blood pressure and the development of blood clots. In the event of a thrombosis, the procedure must be stopped and the access reopened – often resulting in further pain and stress for the patient. Increased protein and potassium intake can lead to life-threatening metabolic disorders in the course of blood washing. Increased phosphate can promote vascular damage such as atherosclerosis.
When should you see a doctor?
A shrunken kidney must always be treated by a physician. With this disease, self-healing cannot occur, so the affected person is always dependent on medical treatment. If the shrunken kidney is not treated, in the worst case it can lead to kidney insufficiency and thus to the death of the affected person. The earlier the shrunken kidney is detected, the better the further course of this complaint. A doctor should be consulted if the affected person suffers from swollen legs. The legs swell for no particular reason and the affected person also suffers from water retention. Likewise, severe and especially sudden visual complaints or severe headaches and fever may indicate the presence of the shrunken kidney. Most patients also suffer from a nocturnal urge to urinate and swollen eyelids. If these symptoms occur, a doctor should be consulted in any case. The shrinking kidney can be treated by an internist. Special complications do not occur.
Treatment and therapy
The medical doctor decides on therapy only after he has been able to find out the exact determination of the disease. If the physician has determined the shrunken kidney in the earlier stage, only the urine and blood values are checked at the beginning. However, if a bacterial infection is present, the patient must be treated with antibiotics. If the shrunken kidney results from a disorder of the immune system, special drugs are administered which subsequently suppress the immune system so that it cannot work “against itself”. Water retention – in the course of symptom treatment – is treated with dehydrating drugs. Subsequently, patients are also given antihypertensive drugs, since the shrunken kidney is responsible for high blood pressure. If the adrenal glands are already impaired, there is an acute risk of death, so that the patient has to undergo dialysis several times a week. In the end, if the patient is in the last stage of the disease, there is no cure. The last resort is a new kidney.
Prevention
Shrunken kidneys may very well be prevented, provided that the individual makes sure that he or she also consumes enough fluids. For this reason, it is important that the recommended amount (two liters of water a day) is actually consumed. Subsequently, people suffering from high blood pressure should take action against it, so that there is no further burden on the body (and no further burden on the kidneys).
Follow-up
Shrunken kidney usually results in complete loss of function of the organ. Follow-up care focuses on reviewing prescribed medications and readjusting them if necessary. In addition, the remaining kidney must be checked to ensure that it continues to function. In addition, the physician conducts a detailed interview with the patient to discuss the further course of action. In addition, it must be clarified whether a kidney transplant is an option. If both kidneys are damaged, measures must be taken to enable a transplant to be performed promptly. Chronic conditions such as neuropathy or congestive lung must also be controlled after follow-up. After complications such as renal insufficiency or renal hypertension, therapeutic measures are also part of the follow-up. The physical complaints sometimes cause psychological problems, such as anxiety disorders or moods, which need to be clarified. As part of the aftercare, the physician prepares a final report and sometimes also gives the patient general tips.Follow-up care of the shrunken kidney is provided by a specialist in internal medicine. Patients usually suffer from chronic diseases that require regular check-ups. Monthly or even weekly visits to the doctor are typical and must be maintained permanently.
This is what you can do yourself
With a shrunken kidney, permanent medical monitoring is necessary. Sufferers must be treated in a hospital because the organ is on the verge of complete loss of function. The self-help measures are limited to taking the medicines according to the doctor’s instructions and following the strict diet. Accompanying therapy should also be used in any case. Affected individuals are best advised to consult a self-help group in order to exchange information with other sufferers. In the event of complications such as renal insufficiency, immediate treatment is necessary. Sufferers must receive emergency medical care and then be observed in the hospital. In the case of high blood pressure, medication must be adjusted. Individuals suffering from cirrhotic kidney disease must carry their emergency medications so that immediate action can be taken in case of acute complications. If ventricular fibrillation develops, medical advice is also needed. In some cases, kidney function can be partially restored. The prerequisite for this is that the causes of the shrunken kidney are identified. It is best for patients to keep a diary in which they record all their symptoms and complaints. The physician can use this information to more quickly determine a trigger and initiate a suitable therapy. Accompanying this, various remedies from homeopathy, such as arnica and aloe vera, help against the pain.
