the college

It is an organ in the human body that has the shape of a bean, located in the abdominal area. Its function is to purify the blood and empty the waste products resulting from metabolism in the form of urine, and to regulate the concentration of ions in the body, such as: potassium, sodium, phosphate, hydrogen and others. The kidney is of great importance in regulating blood pressure and converting vitamin D into its active form in the body, and the kidney has an important role in regulating the body’s pH and the production of red blood cells. One kidney in the human body is 4 inches long, 2 inches wide, and 1 inch thick. One kidney weighs approximately 113-170 grams in an adult.[1][2]

Kidney failure

When the kidneys fail to perform their functions, or kidney failure occurs, this is called renal failure. The inability of the kidneys to perform their functions affects most parts of the body; The importance of the functions performed by the kidneys. Kidney failure is divided into two types; acute and chronic[3]

Acute kidney failure

It is a sudden failure of the kidneys to function, which leads to a defect in most of the body’s organs; The importance of the vital functions performed by the kidneys. Acute kidney failure can occur within a few hours, or occur over a few days or weeks. Acute kidney failure is a matter that requires vigorous medical care, but fortunately, the kidneys can be returned to their proper state if medical intervention is done in a timely, adequate and appropriate manner.[4]

the reasons

Acute kidney failure is caused by many things, including:[4][5]

  • Kidney injury or accident.
  • Exposing the kidney to inflammation or chemical toxins, such as taking large quantities of drugs, especially antibiotics, such as: Methicillin, heavy metals, or addiction to cocaine.[6]
  • Low blood volume through burns, dehydration or severe bleeding.[7]
  • A blockage in the urinary canal.
  • Hemolytic uremic syndrome.

Symptoms

A patient with acute kidney failure may present with one of the following symptoms:[8][5][1][4]

  • Decreased urine.
  • Swelling of the body as a result of not getting rid of excess fluid, especially in the hands and feet.
  • Diarrhea accompanied by blood.
  • general fatigue
  • Nausea, vomiting and loss of appetite.
  • Pain in the kidney area, i.e. in the flank.
  • Hypertension.
  • Chest pain or a feeling of something pressing on the chest.

Diagnosis

Diagnosis The diagnosis can be based on the symptoms that the patient complains of and the clinical examination, but there are several tests necessary to diagnose acute kidney failure, including:[9][8][5]

  • Collect a urine sample for 24 hours.
  • Urine sample analysis.
  • Kidney function analysis.
  • blood analysis.
  • Blood chemistry test.
  • The level of creatinine in the blood.
  • Glomerular filtration rate.
  • Creatinine clearance test (in English: Creatinine Clearance).
  • Ultrasound image of the kidney.
  • Cross-sectional image of the kidney.

treatment

Since many causes lead to acute renal failure; Treatment is to treat the cause. Since kidney failure is the failure of the kidneys to carry out their normal functions, the goal of treatment here is first to save the patient’s life if his condition is critical, and then to try to return the work of the kidneys to their normal functions, and attention must be paid while trying to return the kidney functions to their normal state to pay attention not to accumulate more Fluids by administering diuretics, monitoring and limiting fluids entering the patient’s body, in addition to paying attention to the patient’s diet; Where the patient must follow a diet rich in carbohydrates and low in protein, salt and potassium.

If it turns out that there is any infection, the patient must be given an antibiotic, and the doctor can also prescribe an antibiotic to protect the patient from any possible infections. If there is a defect in the ions in the body, the correct approach must be followed in treating the imbalanced ion; For example, if there is an increase in potassium in the blood, the patient should be given insulin and calcium. But if the level of calcium in the blood is less than normal, the patient must be provided with calcium. The doctor may resort to dialysis of the patient’s kidneys to expel the accumulated toxins in the body.[5][4]

Chronic kidney failure

Chronic kidney failure means the progress and continuity of the kidney by losing the ability to carry out its functions, but gradually over a period of time that extends to several years, and the symptoms of chronic kidney failure may not appear clearly and clearly except in the last stages of it. Many causes lead to chronic kidney failure, which can be divided into three causes:[3][10][9]

  • Causes that lead to inflammation of the kidneys or blockage of the urinary tract from the upper part.
  • The causes that lead to obstruction of the urinary canal from the lower part.
  • Diseases of the body, such as high blood pressure, diabetes, and imbalances in the proportion of body ions, such as high calcium levels in the blood.

the reasons

In general, there are many reasons that affect kidney functions, since the kidney is an important vital organ in the human body that affects and is affected by many organs, and the cause of chronic kidney failure is often a chronic disease as well. Among the causes that may lead to chronic kidney failure are the following:[11][12][13]

  • both types of diabetes; the first and the second, especially in patients who neglect their state of health; Diabetes affects the kidneys in the long run.
  • Hypertension.
  • Kidney disease, such as nephritis.
  • Renal artery stenosis.
  • Malaria infection.
  • Drug addiction.
  • Some immune diseases, such as systemic lupus erythematosus.
  • Congenital malformation of the kidneys.
  • taking substances that are toxic to the kidneys, such as some medicines; Such as chemotherapy drugs that treat cancerous tumors, or aspirin.
  • Smoking.

Symptoms

In the early stages of chronic kidney failure, the symptoms that appear on the patient are similar to the symptoms that accompany many diseases in the body, and these symptoms may be the only indicator that indicates the occurrence of chronic kidney failure, among these symptoms are the following:[13][12][11]

  • Anorexia.
  • a headache.
  • Dry skin and itching.
  • Nausea and feeling tired.
  • Weight loss.
  • Itchy skin.
  • Pain in the bones.
  • Dizziness and inability to focus.
  • Shortness of breath.
  • Swelling of the extremities.
  • breath odor
  • vomiting; Especially in the early morning.
  • Anemia.
  • Muscle spasms.
  • Blood in the urine, and the color of the urine is dark.
  • Hypertension.
  • frequent urination; Especially at night.
  • Pain in the flank.

Diagnosis

The doctor must know the patient’s complete medical history, with knowledge of the chronic diseases he suffers from, in addition to knowing the symptoms and the duration that the patient suffers from these symptoms and the symptoms accompanying them, and then through a clinical examination in which the doctor can find a rise in the patient’s blood pressure, and hear Strange sounds when examining the lung and heart with a stethoscope as a result of fluid accumulation, and signs of nerve damage can be found when examining the nerves clinically. Other tests needed to diagnose chronic kidney failure include the following:[13][12][11]

  • Examination of a blood sample.
  • Examination of a urine sample.
  • Kidney function check.
  • Diagnosis may require a kidney biopsy, especially if the doctor did not reach the diagnosis after doing all the necessary tests.
  • A chest x-ray to ensure that there is no pulmonary edema due to fluid accumulation.
  • Blood chemistry test.
  • The level of creatinine in the blood.
  • Glomerular filtration rate.
  • Creatinine clearance test (in English: Creatinine Clearance). * Ultrasound image of the kidney.
  • Cross-sectional image of the kidney.

treatment

The earlier the disease was diagnosed, the more controlled the decline in renal function. Treatment is first with the disease causing chronic kidney failure; Anemia must be treated if the blood test indicates the presence of anemia, and if blood chemistry tests indicate an increase in the proportion of phosphate in the blood or a lack of calcium in the blood, this must be treated by giving medications to reduce the proportion of phosphate and providing the patient with calcium supplements, if the patient’s body retains water, it must be given Diuretics, and the level of vitamin D in patients with kidneys is often low because it is converted into its active form through the kidneys. Patients must be provided with vitamin D. If the patient suffers from high blood pressure, it must be controlled so that it does not affect the condition of the kidneys worse. A patient with chronic kidney failure may need dialysis to get rid of toxins accumulated in the kidneys, especially in the late stages, so that some patients will have permanent treatment for dialysis until a kidney donor is found.[13][12][11]

the reviewer

  1. ^ AB Benjamin F. Miller and Claire Brackman Keane (1987), Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Philadelphia: WB Saunders Company, page 678-681.
  2. ↑ : Benjamin Wedro, “Kidney Failure”, Medicinenet.com, Retrieved 14-1-2017.
  3. ^ ABC Benjamin F. Miller and Claire Brackman Keane (1987), Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Philadelphia: WB Saunders Company, page 1070-1071.
  4. ^ a b c b Bree Normandin and Winnie Yu (4-11-2015), “Acute Kidney Failure”, Health Line, Retrieved 1-14-2017.
  5. ^ ABC Mayo Clinic Staff (5-7-2015), “Acute kidney failure”, Mayo Clinic, Retrieved 1-16-2017.
  6. ↑ “Antibiotic nephrotoxicity”, NBCI.
  7. ↑ Rachel Nall and Ana Gotter (28-4-2016), “Hypovolemic Shock”, Health Line, Retrieved 14-1-2017.
  8. ^ a b “Acute Kidney Injury – Topic Overview”, WebMD.
  9. ^ AP Pradeep Arora (7-25-2016), “Chronic Kidney Disease”, medscape, Retrieved 14-1-2017.
  10. ↑ Mayo Clinic Staff (9-8-2016), “Chronic kidney disease”, Mayo Clinic, Retrieved 14-1-2017.
  11. ^ a b c Pradeep Arora (7-25-2016), “Chronic Kidney Disease”, MedScape, Retrieved 1-16-2017.
  12. ^ a b c Christian Nordqvist (14-1-2016), “Chronic Kidney Disease: Causes, Symptoms and Treatments”, Medical News Today, Retrieved 1-16-2017.
  13. ^ a b c c Charles Silberberg, “Chronic kidney disease”, Medline Plus.

What are the symptoms of onset of kidney failure?