Renal Failure

Renal failure, also known as kidney failure, is the inability of the kidneys to filter waste products from the blood. The kidneys are among the body's most important organs and have many roles, including filtering blood, regulating blood pressure, and creating hormones. When they lose this ability, waste accumulates in dangerous amounts, and the body may develop a variety of health problems.

1.0What is Renal Failure?

Renal failure definition: It is the medical term for a condition where the kidneys are no longer able to effectively remove nitrogenous waste products and excess fluid from the body. This can be a gradual process or a sudden event.

The primary function of the kidneys is to filter waste from the blood, but they also:

• Maintain the body's fluid balance.
• Regulate blood pressure.
• Produce erythropoietin, a hormone that stimulates red blood cell production.
• Activate vitamin D to maintain healthy bones.

When the kidneys fail, these functions are compromised, leading to a buildup of waste products such as urea and creatinine.

2.0Types of Renal Failure

Renal failure is broadly classified into two main types:

1. Acute Renal Failure (ARF) / Acute Kidney Injury (AKI): This is a sudden and rapid decline in kidney function, often occurring over a few hours or days. It's usually a complication of other severe medical conditions like dehydration, blood loss, or obstruction of the urinary tract. ARF can often be reversed with prompt renal failure treatment.
2. Chronic Renal Failure (CRF) / Chronic Kidney Disease (CKD): This involves a gradual and progressive loss of kidney function over months or years. It's often caused by long-term diseases like diabetes and high blood pressure, which damage the tiny filtering units in the kidneys. Chronic renal failure is irreversible and usually progresses to end-stage renal disease (ESRD).

3.0Renal Failure Symptoms

The renal failure symptoms can vary depending on the type and stage of the disease. In the early stages of chronic renal failure, there may be no noticeable symptoms. As the condition progresses, a renal failure patient may experience:

• Fluid retention: Swelling in the legs, ankles, or feet (edema) due to the body's inability to excrete excess fluid.
• Reduced urine output: A significant decrease in the amount of urine produced.
• Fatigue and weakness: A feeling of tiredness due to the build-up of toxins and anaemia.
• Nausea and vomiting: These are common as waste products accumulate in the blood.
• Shortness of breath: Fluid build-up in the lungs can make breathing difficult.

4.0Renal Failure Diagnosis

The diagnosis of renal failure typically involves several tests to assess kidney function and identify the underlying cause.

• Blood tests: These measure levels of waste products such as urea and creatinine. A high level of these substances indicates poor kidney function.
• Urine tests: A urinalysis can detect protein or blood in the urine, both of which indicate kidney damage.
• Imaging studies: Ultrasound or CT scans can visualise the kidneys and detect abnormalities, blockages, or size changes.
• Kidney biopsy: In some cases, a small sample of kidney tissue is taken for microscopic examination to determine the exact cause of the damage.

5.0Causes of Renal Failure

The renal failure causes differ based on whether it is acute or chronic:

1. Causes of Acute Renal Failure:

• Severe dehydration or blood loss (shock)
• Infections that affect kidney function
• Obstruction in the urinary tract (stones, tumours)
• Reaction to certain medications or toxins

2. Causes of Chronic Renal Failure:

• Diabetes mellitus – long-term high blood sugar damages the nephrons
• Hypertension – persistent high blood pressure injures the kidney blood vessels
• Polycystic kidney disease – a genetic disorder causing cyst formation
• Glomerulonephritis – inflammation of glomeruli (filtering units)
• Chronic urinary tract obstruction

6.0Renal Failure Treatment

The renal failure treatment depends on whether the condition is acute or chronic.

• Acute Renal Failure: Treatment focuses on addressing the underlying cause. This may include restoring blood flow to the kidneys, treating infections, or removing urinary tract obstructions. In severe cases, temporary dialysis may be required.
• Chronic Renal Failure: The goal is to slow disease progression and manage symptoms.
• Medications: Drugs to control blood pressure, manage anaemia, and regulate electrolyte levels.
• Dietary changes: Limiting protein, sodium, and potassium intake to reduce the burden on the kidneys.
• Dialysis: When kidney function drops to a critical level, dialysis becomes necessary. This is a procedure that artificially filters the blood.
• Kidney transplant: For end-stage renal disease, a kidney transplant is the only definitive cure.