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Chronic kidney failure
Symptoms of Chronic Kidney Failure
The clinical symptoms of chronic renal failure mainly include symptoms related to disturbances in electrolyte and acid-base balance, as well as symptoms of metabolic disorders of proteins, carbohydrates, fats, and vitamins. There are also manifestations in various organ systems, including the cardiovascular system, respiratory system, gastrointestinal tract, hematologic system, neuromuscular system, endocrine system, and bone lesions. Metabolic acidosis is common; patients may also exhibit water and sodium retention or hypovolemia and hyponatremia. Potassium metabolism disorders are often characterized by hyperkalemia, while disturbances in phosphorus and calcium metabolism are mainly manifested as hyperphosphatemia and calcium deficiency. Patients may also show cardiovascular manifestations, primarily hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms in patients may include loss of appetite, nausea, and vomiting. Additionally, renal anemia and a tendency to bleed are common, and skeletal changes are quite frequent, leading to malnutrition of bones, osteomalacia, and osteoporosis.
What medicine is used for chronic renal failure?
The treatment of chronic renal failure primarily requires identifying the cause and treating it accordingly. Chronic renal failure refers to the state in which various diseases damage the kidneys, leading to the destruction of kidney tissue and resulting in the kidneys' inability to adequately excrete metabolic waste, causing an accumulation of such wastes in the body. There are no medications that can directly affect the kidneys, regenerate kidney tissue, and restore kidney function. Currently, medicine cannot achieve this, and there are no specific drugs for the treatment. Therefore, the treatment of chronic renal failure focuses on treating the primary disease to slow the progression of renal failure. For example, chronic renal failure caused by diabetes necessitates the use of insulin to control blood sugar, while patients with hypertension need to use antihypertensive drugs.
What should I do about edema from chronic renal failure?
Chronic renal failure often leads to edema, which is a common symptom associated with the decreased ability of the kidneys to excrete water, resulting in significant water retention in the body. There are two treatment options for this disease. First, medication can be used, typically diuretics such as loop diuretics. After administration, the patient's urine output increases, which can help reduce edema. Second, for patients who do not respond well to medication, and in cases where edema leads to heart failure or pulmonary edema, dialysis treatment may be considered. Through dialysis ultrafiltration and dehydration, edema can also be alleviated.
Chronic Renal Failure Clinical Manifestations
Patients with chronic renal failure may exhibit fatigue, which is mainly due to anemia. Patients with stage three or higher chronic renal failure generally have anemia, which can lead to symptoms such as fatigue, palpitations, and pallor. Additionally, patients may experience nausea and vomiting, which are primarily caused by an increase in toxins. Furthermore, patients may also exhibit symptoms such as edema and shortness of breath, as individuals with chronic renal failure typically experience reduced urine output. A higher intake than output over time can lead to an increased circulating blood volume, resulting in heart failure.
Does chronic renal failure require dialysis?
Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.
Can chronic renal failure be cured?
Chronic kidney failure is irreversible and incurable, with no possibility of kidney function recovery. There are many causes of chronic kidney failure, commonly including diabetic nephropathy, hypertensive nephropathy, chronic nephritis, polycystic kidney disease, etc. These causes affect the kidneys over the long term, resulting in extensive damage to kidney tissues. Since kidney tissues cannot regenerate, chronic kidney failure is incurable and irreversible. Patients with chronic kidney failure still require treatment to control the underlying causes leading to the condition, aiming to slow down the progression of the disease as much as possible, prolong the patient’s life, and ensure the quality of life. This is the primary goal of treatment.
What is best to eat for chronic renal failure?
Patients with chronic renal failure are advised to adopt a low-salt, low-fat, and high-quality protein diet. For those not undergoing dialysis, protein intake should be strictly controlled to 0.6 to 0.8 grams per kilogram of body weight per day. Additionally, patients with stage 3 CKD or above often experience electrolyte disorders, such as hyperkalemia, which can lead to cardiac arrest and arrhythmias. Therefore, it is important to avoid foods high in potassium, such as bananas, oranges, dates, kiwis, and tomatoes. Due to the strict protein intake, hypoproteinemia may occur, and these patients are also prone to hyperphosphatemia. It is recommended to choose foods with a low phosphorus to protein ratio, generally those with a ratio below fifteen. After starting dialysis, the same principles apply, but protein intake can be slightly increased, as some protein is lost during both hemodialysis and peritoneal dialysis. The protein intake can be adjusted to 1.0 to 1.2 grams per kilogram of body weight per day, while still controlling phosphorus and potassium intake.
Symptoms of chronic renal failure
The clinical symptoms of chronic renal failure vary at different stages. In the compensatory and early decompensatory stages of chronic renal failure, patients may experience no symptoms or only mild discomforts such as fatigue, back pain, and increased nocturia, while a few may suffer from reduced appetite, metabolic acidosis, and mild anemia. The main clinical symptoms include disorders of water, electrolyte, and acid-base balance, presenting metabolic acidosis, sodium retention or hypovolemia, or hyponatremia, along with hyperkalemia. Moreover, there are significant manifestations of excess phosphorus and calcium deficiency. Patients may also experience disruptions in the metabolism of proteins, carbohydrates, fats, and vitamins. Cardiovascular symptoms mainly include hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms can manifest as loss of appetite, nausea, and vomiting. Hematological manifestations may include renal anemia and a tendency to bleed.
How to test for chronic renal failure?
The examinations for patients with chronic kidney failure are divided into several aspects: First, it is necessary to confirm the presence of chronic kidney failure and assess its severity. This requires blood tests for kidney function, observing levels of blood creatinine and urea nitrogen, and performing endogenous creatinine clearance tests to determine the degree of kidney failure; Second, it is important to determine whether there are complications associated with kidney failure. Therefore, routine blood tests are necessary to check for renal anemia, blood pressure measurements to observe if there is renal hypertension, and blood tests for electrolytes to check for any electrolyte disorders. These patients also need to have their parathyroid hormone levels checked and undergo iron metabolism tests to provide a basis for further treatment.
Causes of Anemia in Chronic Renal Failure
The causes of anemia in chronic renal failure, also known as renal anemia, occur in chronic kidney disease and are related to chronic renal failure. There are multiple reasons for this anemia, such as the lack of raw materials for red blood cell production caused by chronic renal failure, including deficiencies in iron, folic acid, and vitamin B1, shortened lifespan of red blood cells, and blood loss including non-gastrointestinal blood loss. Moreover, uremic toxins including parathyroid hormone can suppress the production of red blood cells in the bone marrow. However, the primary cause is the decreased production of erythropoietin by the kidneys during chronic renal failure.