Chronic Kidney Disease
Renal failure happens when the kidneys fail to function adequately, and usually happens in both kidneys at the same time However, it is important to point out that one healthy kidney is enough to keep a completely normal renal function.
Renal failure can be acute, when it has a rapid onset, in this case, normally, the kidney tends to recover and, chronic when there is a slowly and progressive loss of renal function, without the possibility of recovering the kidney function.
The initial kidney disease can differ, from patient to patient, but usually the progression is similar and the needed care are also very similar.
Table I considers the more common group of conditions that can be the cause of reanl failure. This, however, does not mean that these conditions have to forcefully end up in renal failure, especially if the treatment provided is adequate.
Table I
- Glomerulonephritis
- Pyelonephritis
- Polycystic kidneys
- Diabetes
- Hypertension
The kidneys are organs with high levels of functional reserve, meaning that they are capable of adapting to the progressive loss of their function. This means that the symptoms of the disease only manifests when the loss of the kidney function is very high. A patient with chronic kidney disease may be asymptomatic until the kidneys are 15-20% of the normal values. However, this situation does not mean that one should not immediately see the nephrologist. On the contrary, when one of the above mentioned diseases, which we know can progress into chronic kidney failure, is diagnosed, a specialist in the area must be seen as soon as possible, in order to:
- Delay, as possible the progression of the disease.
- Keep the patient at its best physical conditions, possible.
The progressive tiredness, the generalized debility and the fatigue when making light or medium efforts are some of the symptoms which come out first and are a consequence of the anaemia, usual at the kidney failure. Sometimes the symptoms are trouble sleeping, in a way that the patient has to take medication to sleep as it was usual. Very often, when the kidney failure is already severe, there are digestive symptoms, such as the loss of appetite, for which the two main contributing factors are the nausea caused by food and the halitosis, causing the refusal to eat. Some other times, eating is followed by vomiting.
The kidneys are the organs responsible for eliminating part of the liquids excessive to the body. So, in the cases of kidney failure, there is usually the accumulation of liquids, or oedemas, more usual in the legs as the day progresses and on the face, during the first hours, after waking up.
High blood pressure or hypertension is also very frequent, in such a way that in very advanced phases of the kidney failure, up to 90% of the patients can suffer from it. The consequences of this change can vary. In some patients it only causes headaches or migraines but in others, with more severe hypertension, can cause fatigue when performing light efforts (such as climbing one staircase), the need urinate more often, leading them to get up at night (nicturia) or inclusively, the need to sleep with several pillows due to the orthopnea. Some patient’s have a itchy skin, forcing them to be constantly scratching, and the skin is also more dry and paler.
Other symptoms, much less frequent, include menstruation changes in young females and skin or digestive system haemorragies.