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What causes kidney failure?
Kidney failure may occur from an acute situation that injures the kidneys or from chronic diseases that gradually cause the kidneys to stop functioning, regulating blood pressure, electrolyte balance, and red blood cell production in the body.
Symptoms of kidney failure are due to the build-up of waste products and excess fluid in the body that may cause weakness, shortness of breath, lethargy, swelling, and confusion. Inability to remove potassium from the bloodstream may lead to abnormal heart rhythms and sudden death. Initially kidney failure may cause no symptoms.
There are numerous causes of kidney failure, and treatment of the underlying disease may be the first step in correcting the kidney abnormality.
Some causes of kidney failure are treatable and the kidney function may return to normal. Unfortunately, kidney failure may be progressive in other situations and may be irreversible.
The diagnosis of kidney failure usually is made by blood tests measuring BUN, creatinine, and glomerular filtration rate (GFR).
Treatment of the underlying cause of kidney failure may return kidney function to normal. Lifelong efforts to control blood pressure and diabetes may be the best way to prevent chronic kidney disease and its progression to kidney failure. As we age, kidney function gradually decreases over time.
If the kidneys fail completely, the only treatment options available may be dialysis or transplant.
What Is Kidney Disease? What Are the Symptoms?
Kidney disease refers to conditions and problems with the kidneys and their function. Signs and symptoms of kidney disease may vary depending upon the type; however, common non-specific symptoms of chronic kidney
The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing the electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells.
The kidneys are located in the abdomen toward the back, normally one on each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava. (The term “renal” is derived from the Latin name for kidney.)
What do the kidneys do?
When blood flows to the kidney, sensors within specialized kidney cells regulate how much water to excrete as urine, along with what concentration of electrolytes. For example, if a person is dehydrated from exercise or from an illness, the kidneys will hold onto as much water as possible and the urine becomes very concentrated. When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear. This system is controlled by renin, a hormone produced in the kidney that is part of the fluid and blood pressure regulation systems of the body.
Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more red blood cells.
Urine that is made by each kidney flows through the ureter, a tube that connects the kidney to the bladder. Urine is stored within the bladder, and when urination occurs, the bladder empties urine through a tube called the urethra.
Battery with 10% usage left signifying that it’s possible to lose as much as 90% of kidney function without experiencing any symptoms or problems.
In acute renal failure, kidney function is lost rapidly and can occur from a variety of insults to the body. Since most people have two kidneys, both kidneys must be damaged for complete kidney failure to occur. Fortunately, if only one kidney fails or is diseased it can be removed, and the remaining kidney may continue to have normal kidney (renal) function. If a both patient’s kidneys are injured or diseased, a donor kidney(s) may transplanted.
Hemolytic uremic syndrome: This condition results from abnormal destruction of red blood cells. It most often occurs in children after certain infections, but also may be caused by medications, pregnancy, or can occur for unknown reasons.
Postrenal kidney failure causes
Post renal causes of kidney failure (post=after + renal= kidney) are due to factors that affect outflow of the urine:
Obstruction of the bladder or the ureters can cause back-pressure because the kidneys continue to produce urine, but the obstruction acts like a dam, and urine backs up into the kidneys. When the pressure increases high enough, the kidneys are damaged and shut down.
Prostatic hypertrophy or prostate cancer may block the urethra and prevents the bladder from emptying.
Tumors in the abdomen that surround and obstruct the ureters.
Kidney stones. Usually, kidney stones affect only one kidney and do not cause kidney failure. However, if there is only one kidney present, a kidney stone may cause the remaining kidney to fail.
What causes chronic kidney failure?
Initially, kidney failure may be not produce any symptoms (asymptomatic). As kidney function decreases, the symptoms are related to the inability to regulate water and electrolyte balances, clear waste products from the body, and promote red blood cell production.
If unrecognized or untreated, the following symptoms of kidney failure may develop into life-threatening circumstances.
Prevention is always the goal with kidney failure. Chronic diseases such as hypertension (high blood pressure) and diabetes are devastating because of the damage that they can do to kidneys and other organs. Lifelong diligence is important in keeping blood sugar and blood pressure within normal limits. Specific treatments depend upon the underlying diseases.
Once kidney failure is present, the goal is to prevent further deterioration of renal function. If ignored, the kidneys will progress to complete failure, but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved.
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Diet is an important consideration for those with impaired kidney function. Consultation with a dietician may be helpful to understand what foods may or may not be appropriate.
In this state of impaired kidney function, the kidneys cannot easily remove excess water, salt, or potassium from the blood, so foods high in potassium salt substitutes may need to be consumed in limited quantities. Examples of potassium rich foods include:
Phosphorus is a forgotten chemical that is associated with calcium metabolism and may be elevated in the body in kidney failure. Too much phosphorus can leech calcium from the bones and cause osteoporosis and fractures. Examples of foods and beverages high in phosphorus include:
Different classes of medications may be used to help control some of the issues associated with kidney failure including:
Phosphorus-lowering medications, for example, calcium carbonate (Caltrate), calcitriol (Rocaltrol), and sevelamer (Renagel)
Red blood cell production stimulation, for example, erythropoietin, darbepoetin (Aranesp)
Once the kidneys fail completely, the treatment options are limited to dialysis or kidney replacement by transplantation.
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A female nurse looking after two patients undergoing renal dialysis.
Dialysis and Hemodialysis
Dialysis cleanses the body of waste products in the body by use of filter systems. There are two types of dialysis, 1) hemodialysis, and 2) peritoneal dialysis.
Hemodialysis uses a machine filter called a dialyzer or artificial kidney to remove excess water and salt, to balance the other electrolytes in the body, and to remove waste products of metabolism. Blood is removed from the body and flows through tubing into the machine, where it passes next to a filter membrane. A specialized chemical solution (dialysate) flows on the other side of the membrane. The dialysate is formulated to draw impurities from the blood through the filter membrane. Blood and dialysate never touch in the artificial kidney machine.
For this type of dialysis, access to the blood vessels needs to be surgically created so that large amounts of blood can flow into the machine and back to the body. Surgeons can build a fistula, a connection between a large artery and vein in the body, usually in the arm, that allows a large amount of blood flow into the vein. This makes the vein swell or dilate, and its walls become thicker so that it can tolerate repeated needle sticks to attach tubing from the body to the machine. Since it takes many weeks or months for a fistula to mature enough to be used, significant planning is required if hemodialysis is to be considered as an option.
If the kidney failure happens acutely and there is no time to build a fistula, special catheters may be inserted into the larger blood vessels of the arm, leg, or chest. These catheters may be left in place for weeks. In some diseases, the need for dialysis will be temporary, but if the expectation is that dialysis will continue for a prolonged period of time, these catheters act as a bridge until a fistula can be planned, placed, and matured.
Dialysis treatments normally occur three times a week and last a few hours at a time. Most commonly, patients travel to an outpatient center to have dialysis, but home dialysis therapy is becoming an option for some.
Outpatient dialysis is available on some cruise ships. They are equipped with dialysis machines with trained health care professionals ready to care for those with kidney failure while traveling.
Peritoneal dialysis uses the lining of the abdominal cavity as the dialysis filter to rid the body of waste and to balance electrolyte levels. A catheter is placed in the abdominal cavity through the abdominal wall by a surgeon, and it is expected to remain in place for the long-term. The dialysis solution is then dripped in through the catheter and left in the abdominal cavity for a few hours after which itÃ‚ is drained out. During that time, waste products leech from the blood flowing through the lining of the abdomen (peritoneum), and attach themselves to the fluid that has been instilled by the catheters. Often, patients instill the dialysate fluid before bedtime, and drain it in the morning.
There are benefits and complications for each type of dialysis. Not every patient can choose which type he or she would prefer. The treatment decision depends on the patient’s illness and their past medical history along with other issues. Usually, the nephrologist (kidney specialist) will have a long discussion with the patient and family to decide what will be the best option available.
Dialysis is life saving. Without it, patients whose kidneys no longer function would die relatively quickly due to electrolyte abnormalities and the buildup of toxins in the blood stream. Patients may live many years with dialysis but other underlying and associated illnesses often are the cause of death.
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If kidney failure occurs and is non-reversible, kidney transplantation is an alternative option to dialysis. If the patient is an appropriate candidate, the healthcare professional and nephrologist will contact an organ transplant center to arrange evaluation to see whether the patient is suitable for this treatment. If so, the search for a donor begins. Sometimes, family members have compatible tissue types and, if they are willing, may donate a kidney. Otherwise, the patient will be placed on the organ transplant list that is maintained by the United Network of Organ Sharing.
Not all hospitals are capable of performing kidney transplants. The patient may have to travel to undergo their operation. The most successful programs are those that do many transplants every year.
While kidney transplants have become more routine, they still carry some risk. The patient will need to take anti-rejection medications that reduce the ability of the immune system to fight infection. The body can try to reject the kidney or the transplanted kidney may fail to work. As with any operation, there is a risk of bleeding and infection.
Kidney transplants may provide better quality of life than dialysis. After one year, 95% of transplanted kidneys are still functioning and after five years, the number is 80%. It seems that the longer a patient is on dialysis, the shorter the life of the transplanted kidney.
The outlook for kidney failure depends upon the underlying condition that caused it. Kidney function may return to normal, especially if it is due to an acute obstruction and that obstruction is relieved. Other causes of decreased kidney function leading to kidney failure are due to underlying disease and occur slowly over time.
Prevention is the best chance to maintain kidney function, and controlling high blood pressure and diabetes over a lifetime can decrease the potential for progressive kidney damage. Chronic kidney failure may be managed byÃ‚ to help monitor electrolyte and waste product levels in the bloodstream. Major abnormalities can be life threatening, and treatment options may be limited to dialysis or transplant.
Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
Chronic kidney disease care at Mayo Clinic
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms of kidney disease.
If you have a medical condition that increases your risk of kidney disease, your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regular office visits. Ask your doctor whether these tests are necessary for you.
Chronic kidney disease can affect almost every part of your body. Potential complications may include:
Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart’s ability to function and may be life-threatening
Heart and blood vessel (cardiovascular) disease
Weak bones and an increased risk of bone fractures
Decreased sex drive, erectile dysfunction or reduced fertility
Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival
Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), follow the instructions on the package. Taking too many pain relievers could lead to kidney damage and generally should be avoided if you have kidney disease. Ask your doctor whether these drugs are safe for you.
Maintain a healthy weight. If you’re at a healthy weight, work to maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss. Often this involves increasing daily physical activity and reducing calories.
Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting smoking. Support groups, counseling and medications can all help you to stop.
Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of
Your kidneys are a pair of organs located toward your lower back. One kidney is on each side of your spine. They filter your blood and remove toxins from your body. Your kidneys send toxins to your bladder. Your body later removes toxins during urination.
Kidney failure occurs when your kidneys lose the ability to filter waste from your blood sufficiently. Many factors can interfere with your kidney health and function, such as:
Your body becomes overloaded with toxins if your kidneys can’t do their regular job. This can lead to kidney failure and even be life-threatening if it’s left untreated.
What are the symptoms of kidney failure?
Many different symptoms can occur during kidney failure. Usually someone with kidney failure will have a few syptoms of the disease, though sometimes none are present. Possible symptoms include:
When your body can’t eliminate urine, toxins build up and overload the kidneys. Some cancers can block the urine passageways. These include prostate (most common type in men), colon, cervical, and bladder cancers.
Insufficient blood flow to the kidneys can cause acute prerenal kidney failure. The kidneys can’t filter toxins from the blood without enough blood flow. This type of kidney failure can usually be cured once you and your doctor determine the cause of the decreased blood flow.
Acute intrinsic kidney failure
Acute intrinsic kidney failure can be caused by direct trauma to the kidneys, such as physical impact or an accident. Causes also include toxin overload and ischemia, which is a lack of oxygen to the kidneys. The following may cause ischemia:
When there isn’t enough blood flowing to the kidneys for an extended period of time, the kidneys begin to shrink and lose the ability to function.
Chronic intrinsic kidney failure
This happens when there is long-term damage to the kidneys due to intrinsic kidney disease. Intrinsic kidney disease is caused by a direct trauma to the kidneys, such as severe bleeding or a lack of oxygen.
Chronic post-renal kidney failure
A long-term blockage of the urinary tract prevents urination. This causes pressure and eventual kidney damage.
How is kidney failure diagnosed?
There are several tests your doctor can use to diagnose kidney failure. These include:
Your doctor may take a urine sample to test for any abnormalities, including abnormal protein or sugar that spills into the urine. Your doctor may also perform a urinary sediment examination. This measures the amount of red and white blood cells, looks for high levels of bacteria, and searches for high numbers of cellular casts.
Urine volume measurements
Measuring urine output is one of the simplest tests to help diagnose kidney failure. For example, low urinary output may suggest that kidney disease is due to a urinary blockage, which can be caused by multiple illnesses or injuries.
Your doctor may order blood tests to measure substances that are filtered by your kidneys, such as blood urea nitrogen (BUN) and creatinine (Cr). A rapid rise in these levels may indicate acute kidney failure.
Tests such as ultrasounds, MRIs, and CT scans provide images of the kidneys themselves, along with the urinary tract. This allows your doctor to look for blockages or abnormalities in your kidneys.
Kidney tissue sample
Tissue samples are examined for abnormal deposits, scarring, or infectious organisms. Your doctor will use a kidney biopsy to collect the tissue sample. A biopsy is a simple procedure that’s usually performed while you’re awake. You’ll have a local anesthetic to eliminate any discomfort. The sample is collected with a biopsy needle inserted through your skin and down into the kidney. X-ray or ultrasound equipment is used to locate the kidneys and assist the doctor in guiding the needle.
Treatment for kidney failure
There are several treatments for kidney failure. The type of treatment you need will depend on the reason for your kidney failure. Your doctor can help you determine the best treatment option, which may include:
Dialysis filters and purifies the blood using a machine. The machine performs the function of the kidneys. Depending on the type of dialysis, you may be connected to a large machine or a portable catheter bag. You may need to follow a low-potassium, low-salt diet along with dialysis.
Another treatment option is a kidney transplant. There’s usually a long wait to receive a donor kidney that’s compatible with your body, though if you have a living donor the process may go more quickly.
The advantages of a transplant are that the new kidney can work perfectly, and dialysis is no longer required. The disadvantage is that you must take immunosuppressive drugs after the surgery. These drugs have their own side effects, some of which are serious. Also, transplant surgery is not always successful.
Preventing kidney failure
There are steps you can take to reduce your risk of kidney failure.
Follow directions when taking over-the-counter medications. Taking doses that are too high (even of common drugs such as aspirin) can create high toxin levels in a short amount of time. This can overload your kidneys.
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In end-stage kidney disease, also known as end-stage renal disease (ESRD), the kidneys are functioning below 10 percent of their normal function.
What are common tests are available to diagnose kidney diseases?
What is the treatment for kidney pain?
A woman presses into her back due to kidney pain.
Kidney pain definition and facts
The function and purpose of the kidneys are to remove excess fluid and waste products from the body.
The kidneys are organs that are located in the upper abdominal area against the back muscles on both the left and right side of the body.
Kidney pain and back pain can be difficult to distinguish, but kidney pain is usually deeper and higher in the and back located under the ribs while the muscle pain with common back injury tends to be lower in the back.
Causes of kidney pain are mainly urinary tract infections and kidney stones. However, there are many other causes of kidney pain, including penetrating and blunt trauma that can result in a “lacerated kidney.”
If a woman is pregnant and has kidney pain, she should contact her doctor.
Causes of kidney pain are diagnosed with the patient’s history, physical examination, and lab tests, including blood, pregnancy, and urine tests. A CT scan or MRI of the abdomen and pelvis may be ordered.
Treatment for the cause of kidney pain depends upon the underlying cause, but in general, ibuprofen (Motrin), ketorolac (Toradol), and/or acetaminophen (Tylenol) are used for pain. Antibiotics are usually required if the underlying cause is bacterial infection.
Some people can pass a kidney stone spontaneously that resolves kidney pain; however, other people may need surgery.
Kidney pain can be prevented by avoiding those situations that are the underlying causes of kidney infection and/or damage.
The prognosis for someone with kidney pain depends upon the cause, and the majority of patients can have a good outcome when treated quickly and appropriately.
Kidney Stone Symptoms
Kidney stones form within the kidney or urinary tract. Kidney stones that do not produce symptoms are called “silent” stones. When symptoms do occur, they usually come on suddenly and include excruciating cramping pain in the low back and/or abdomen, side, or groin. Changing body positions does not relive the pain.
The kidneys are two organs whose major functions are to remove waste products and excess fluid from the body and to produce hormones that regulate blood pressure, red blood cell production, acid regulation and to 1 cm x 7 cm x 3 cm) that are located against the back muscles in the upper abdominal area. They sit opposite each other on both the left and right side of the body; the right kidney, however, sits a little lower than the left to accommodate the size of the liver.
Your kidneys are located in the back of your abdomen, just under your ribcage, on each side of your spine. Pain in your sides or middle to upper back could be coming from your kidneys. However, having pain in your back or sides does not necessarily mean there is something wrong with your kidneys. It is possible to have pain on only one side if only one kidney has a problem, or both sides if both kidneys are affected
If the pain you feel is coming from your kidneys, it could be a sign of a kidney problem. Some problems that can cause kidney pain include:
The treatment for kidney pain depends on what is causing it. Your health care provider might want you to have a urine test to check for signs of an infection. You may also need to have imaging tests, such as an ultrasound or CT scan, to help figure out what is causing your pain. When your health care provider knows what is causing your pain, he or she can prescribe the right treatment for you.
American Kidney Fund has partnered with Amino to help you choose your care with confidence. Amino makes it easy to find a doctor, estimate costs, and book an appointment.
Search by your condition, and you’ll be matched with a doctor who has the most experience treating people with that specific condition. Amino powers their results by an unbiased database that covers health experiences from more than 200 million people.
There are over 800 health topics, procedures, or conditions to search from, and doctors can’t pay to be included or excluded from your list of matches. Some relevant kidney conditions include: acute kidney failure, chronic kidney disease, kidney cancer, kidney cyst, kidney failure, kidney infection, kidney stones, kidney transplant, Because your kidneys are located toward your back and underneath your ribcage, it may be hard to tell if pain you may be experiencing in that area is coming from your back or your kidney.
The symptoms you’re having can help you figure out which is the source of the pain. The location, type, and severity of the pain are some of the things that will be different depending on whether the pain is from a problem in your kidneys or your back.
How to identify kidney pain
Kidney pain is most often caused by a kidney infection or a stone in the tubes coming out of your kidney. If the pain is coming from your kidney, it will have these features:
Where the pain is located
Kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides.
Type of pain
Kidney pain is usually sharp if you have a kidney stone and a dull ache if you have an infection. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment.
Kidney pain is classified according to how bad it is severe or mild. A kidney stone usually causes severe pain, and the pain from an infection is usually mild.
Things that make it better or worse
Typically, nothing makes the pain better until the problem is corrected, such as by passing the stone. Unlike back pain, it usually won’t change with movement.
Muscle pain feels like a dull ache. If a nerve has been injured or irritated, the pain is a sharp burning sensation that may travel down your buttock to your lower leg or even your foot.
Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks,
numbness or weakness in one or both of your legs (if the pain is due to a nerve issue)
If you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away.
When to see a doctor
Once youÃ¢’ve determined whether your pain is coming from your back or your kidneys, consider seeing your doctor for evaluation and treatment. You should always be seen if you think you have a kidney infection or kidney stone.
You might be able to treat acute back pain that is mild without seeing your doctor, but if it doesn’t get better, is more than mild pain, or spreads, you should see your doctor.
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