ACUTE RENAL FAILURE

Acute kidney failure occurs when your kidneys are suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over a few hours or a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care. Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal or nearly normal kidney function.

CAUSE 1 : Impaired blood flow to the kidneys

Diseases and conditions that may slow blood flow to the kidneys and lead to kidney failure include:

  • Blood or fluid loss
  • Blood pressure medications
  • Heart attack
  • Heart disease
  • Infection
  • Liver failure
  • Use of aspirin, ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others) or related drugs
  • Severe allergic reaction (anaphylaxis)
  • Severe burns
  • Severe dehydration

CAUSE 2 : Damage to the kidneys

These diseases, conditions and agents may damage the kidneys and lead to acute kidney failure:

  • Blood clots in the veins and arteries in and around the kidneys
  • Cholesterol deposits that block blood flow in the kidneys
  • Glomerulonephritis- inflammation of the tiny filters in the kidneys (glomeruli)
  • Hemolytic uremic syndrome, a condition that results from premature destruction of red blood cells
  • Infection
  • Lupus, an immune system disorder causing glomerulonephritis
  • Medications, such as certain chemotherapy drugs, antibiotics, dyes used during imaging tests and zoledronic acid (Reclast, Zometa), used to treat osteoporosis and high blood calcium levels (hypercalcemia)
  • Multiple myeloma, a cancer of the plasma cells
  • Scleroderma, a group of rare diseases affecting the skin and connective tissues
  • Thrombotic thrombocytopenic purpura, a rare blood disorder
  • Toxins, such as alcohol, heavy metals and cocaine
  • Vasculitis, an inflammation of blood vessels

CAUSE 3 : Urine blockage in the kidneys

Diseases and conditions that block the passage of urine out of the body (urinary obstructions) and can lead to acute kidney failure include:

  • Bladder cancer
  • Blood clots in the urinary tract
  • Cervical cancer
  • Colon cancer
  • Enlarged prostate
  • Kidney stones
  • Nerve damage involving the nerves that control the bladder
  • Prostate cancer

Symptoms

Signs and symptoms of acute kidney failure may include:

  • Decreased urine output, although occasionally urine output remains normal
  • Fluid retention, causing swelling in your legs, ankles or feet
  • Drowsiness
  • Shortness of breath
  • Fatigue
  • Confusion
  • Nausea
  • Seizures or coma in severe cases
  • Chest pain or pressure
  • Sometimes acute kidney failure causes no signs or symptoms and is detected through lab tests done for another reason.

Complications

Potential complications of acute kidney failure include:
Fluid buildup:Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breaths.Chest pain:If the lining that covers your heart (pericardium) becomes inflamed, you may experience chest pain. Muscle weakness. When your body's fluids and electrolytes — your body's blood chemistry — are out of balance, muscle weakness can result. Elevated levels of potassium in your blood are particularly dangerous. Permanent kidney damage:Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive.Death:Acute kidney failure can lead to loss of kidney function and, ultimately, death. The risk of death is higher in people who had kidney problems before acute kidney failure.

Diagnosis

If your signs and symptoms suggest that you have acute kidney failure, your doctor may recommend certain tests and procedures to verify your diagnosis. These may include:

Urine output measurements : The amount of urine you excrete in a day may help your doctor determine the cause of your kidney failure.
Urine tests : Analyzing a sample of your urine, a procedure called urinalysis, may reveal abnormalities that suggest kidney failure.
Blood tests : A sample of your blood may reveal rapidly rising levels of urea and creatinine — two substances used to measure kidney function.

Imaging tests : Imaging tests such as ultrasound and computerized tomography may be used to help your doctor see your kidneys.

Removing a sample of kidney tissue for testing : In some situations, your doctor may recommend a kidney biopsy to remove a small sample of kidney tissue for lab testing. Your doctor inserts a needle through your skin and into your kidney to take the sample.

Treatment Options

Treatment for acute kidney failure typically requires a hospital stay. Most people with acute kidney failure are already hospitalized. The length of hospital stay depends on the reason for your acute kidney failure and how quickly your kidneys recover.
In some cases, you may be able to recover at home.

Treating the underlying cause of your kidney failure

Treatment for acute kidney failure involves identifying the illness or injury that originally damaged your kidneys. Your treatment options depend on what's causing your kidney failure.

Treating complications until your kidneys recover

Your doctor will also work to prevent complications and allow your kidneys time to heal. Treatments that help prevent complications include:

Treatments to balance the amount of fluids in your blood

If your acute kidney failure is caused by a lack of fluids in your blood, your doctor may recommend intravenous (IV) fluids. In other cases, acute kidney failure may cause you to have too much fluid, leading to swelling in your arms and legs. In these cases, your doctor may recommend medications (diuretics) to cause your body to expel extra fluids.

Medications to control blood potassium

If your kidneys aren't properly filtering potassium from your blood, your doctor may prescribe calcium, glucose or sodium polystyrene sulfonate (Kayexalate, Kionex) to prevent the accumulation of high levels of potassium in your blood. Too much potassium in the blood can cause dangerous irregular heartbeats (arrhythmias) and muscle weakness.

Medications to restore blood calcium levels

If the levels of calcium in your blood drop too low, your doctor may recommend an infusion of calcium.

Dialysis to remove toxins from your blood

If toxins build up in your blood, you may need temporary hemodialysis — often referred to simply as dialysis — to help remove toxins and excess fluids from your body while your kidneys heal. Dialysis may also help remove excess potassium from your body. During dialysis, a machine pumps blood out of your body through an artificial kidney (dialyzer) that filters out waste. The blood is then returned to your body.

Lifestyle - After Recovery

During your recovery from acute kidney failure, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Your doctor may refer you to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys.

Depending on your situation, your dietitian may recommend that you:

Choose lower potassium foods

Your dietitian may recommend that you choose lower potassium foods. High-potassium foods include bananas, oranges, potatoes, spinach and tomatoes. Examples of low-potassium foods include apples, cabbage, green beans, grapes and strawberries.

Avoid products with added salt

Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses.

Limit phosphorus

Phosphorus is a mineral found in foods, such as milk, cheese, dried beans, nuts and peanut butter. Too much phosphorus in your blood can weaken your bones and cause skin itchiness. Your dietitian can give you specific recommendations on phosphorus and how to limit it in your particular situation. As your kidneys recover, you may no longer need to eat a special diet, although healthy eating remains important.

Prevention

Acute kidney failure is often difficult to predict or prevent. But you may reduce your risk by taking care of your kidneys. Try to:

Pay attention to labels when taking over-the-counter (OTC) pain medications. Follow the instructions for OTC pain medications, such as aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others). Taking too much of these medications may increase your risk of acute kidney failure. This is especially true if you have pre-existing kidney disease, diabetes or high blood pressure.

Work with your doctor to manage kidney problems. If you have kidney disease or another condition that increases your risk of acute kidney failure, such as diabetes or high blood pressure, stay on track with treatment goals and follow your doctor's recommendations to manage your condition.

Make a healthy lifestyle a priority. Be active; eat a sensible, balanced diet; and drink alcohol only in moderation — if at all.

CHRONIC RENAL FAILURE

CHRONIC RENAL FAILURE

You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of your blood to make urine. They also keep the body's chemical balance, help control blood pressure, and make hormones.
CKD means that your kidneys are damaged and can't filter blood like they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health.
CKD is often a "progressive" disease, which means it can get worse over time. CKD may lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplant to maintain health.

You can take steps to keep your kidneys healthier longer:

  • Choose foods with less salt (sodium).
  • Keep your blood pressure at the level set by your health care provider.
  • Keep your blood glucose in the target range, if you have diabetes.

CKD and My Health

Chances are, you feel normal and were surprised to hear that you have CKD. It is called a "silent" disease, because many people don't have any symptoms until their kidneys are about to fail. The only way to know is to get your kidneys checked with blood and urine tests at periodic intervals.

1. A blood test checks your GFR, which tells how well your kidneys are filtering. GFR stands for glomerular filtration rate.
2. A urine test checks for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged. See picture below.

What causes CKD?

Diabetes and high blood pressure are the most common causes of CKD.Your provider will look at your health history and may do other tests. You need to know why you have CKD, so your treatment can address the cause of the CKD.

What medicines are used to treat CKD?

People with CKD often take medicines to lower blood pressure, control blood glucose, and lower blood cholesterol. Two types of blood pressure medicines—ACE inhibitors and ARBs—may slow CKD and delay kidney failure, even in people who don't have high blood pressure. Many people need to take two or more medicines for their blood pressure. They also may need to take a diuretic (water pill). The goal is to keep your blood pressure at the level set by your health care provider.

Do I need to change my medicines?

Some medicines are not safe for people with CKD. Other medicines need to be taken in smaller doses. Tell your provider about all the medicines you take, including over-the-counter medicines (those you get without a prescription), vitamins, and supplements.

Can CKD affect my health in other ways?

People with CKD often have high blood pressure. They can also develop anemia (low number of red blood cells), bone disease, malnutrition, and heart and blood vessel diseases.

What tests will help track my CKD?

The blood and urine tests used to check for CKD are also used to monitor CKD. You need to keep track of your test results to see how you're doing.

Track your blood pressure.

If you have diabetes, monitor your blood glucose and keep it in your target range. Like high blood pressure, high blood glucose can be harmful to your kidneys.

Will I have to go on dialysis?

Some people live with CKD for years without going on dialysis. Others progress quickly to kidney failure. You may delay dialysis if you follow your provider's advice on medicine, diet, and lifestyle changes.
If your kidneys fail, you will need dialysis or a kidney transplant to maintain health. Most people with kidney failure are treated with dialysis.

Will I be able to get a kidney transplant instead of going on dialysis?

Some people with kidney failure may be able to receive a kidney transplant. The donated kidney can come from someone you don't know who has recently died, or from a living person—a relative, spouse, or friend. A kidney transplant isn't for everyone. You may have a condition that makes the transplant surgery dangerous or not likely to succeed.

Lifestyle & Diet

People with CKD can and should continue to live their lives in a normal way: working, enjoying friends and family, and staying active. They also need to make some changes as explained here.

Do I need to change what I eat?

What you eat may help to slow down CKD and keep your body healthier. Some points to keep in mind:

  • Choose and prepare food with less salt.
  • Select the right kind and smaller amount of Protein.
  • Choose healthy diet options like Lean cut meat, skinless chicken, fish, fruits, vegetables and beans
  • Read the NUTRITION FACTS lable on any food package to understand how much Salt (Sodium) is added to it. The less, it is better.

Check what you drink

Water —

You don't need to drink more water unless you have kidney stones. Drink as much water as you normally do.

Soda and other drinks —

If you are told to limit phosphorus, choose light-colored soda (or pop), like lemon-lime, and homemade iced tea and lemonade. Dark-colored sodas, fruit punch, and some bottled and canned iced teas can have a lot of phosphorus.

Juice —

If you are told to limit potassium, drink apple, grape, or cranberry juice instead of orange juice.

Alcohol —

You may be able to drink small amounts of alcohol. Drinking too much can damage the liver, heart, and brain and cause serious health problems.

Is smoking cigarettes bad for my kidneys?

Cigarette smoking can make kidney damage worse. Take steps to quit smoking as soon as you can.

Tracking my Test Results

You are the most important person on your health care team. Know your test results and track them over time to see how your kidneys are doing. Bring this table to your health care visits and ask your provider to complete it.

GFR —

The GFR tells you how well your kidneys are filtering blood. You can't raise your GFR. The goal is to keep your GFR from going down to prevent or delay kidney failure. See the dial picture below.

  • A GFR of 60 or higher is in the normal range.
  • A GFR below 60 may mean kidney disease.
  • A GFR of 15 or lower may mean kidney failure.

Urine albumin —

Albumin is a protein in your blood that can pass into the urine when kidneys are damaged. You can't undo kidney damage, but you may be able to lower the amount of albumin in your urine with treatment. Lowering your urine albumin is good for your kidneys.

Blood pressure —

The most important thing you can do to slow down CKD is keep your blood pressure at the level set by your health care provider. This can delay or prevent kidney failure.

HbA1C —

HbA1C test is a lab test that shows your average blood glucose level over the last 3 months. Lowering your HbA1C can help you to stay healthy. (For people with diabetes only.)

We are among the List of approved Hospitals for Kidney Transplantation, and we strive to provide Kidney (Renal) failure patients, a better quality of life.