Kidney failure, or renal failure, is divided into:

• Acute kidney failure
• Chronic kidney failure

Acute kidney failure

It is the condition where the kidneys suddenly lose their ability to perform their functions, which are to:

• maintain water-electrolyte balance
• remove metabolic products

In cases of acute renal failure, fluids and metabolic products are accumulated in our body and this can be life-threatening.

Causes of acute kidney failure

There are 3 main causes of acute kidney failure:

• Prerenal causes: they cause reduction of the blood flow to the kidney. This may occur in cases of bleeding, injury, dehydration and severe infection.
• Renal causes: they are commonly due to damage in the renal parenchyma, administration of drugs or contrast agents used in radiology
• Postrenal causes: they are conditions which create an obstruction in the normal passing of the urine from the kidneys, e.g. tumor, kidney stones, prostate hyperplasia

Symptoms of acute kidney failure

The following symptoms may appear:

• Oliguria (low output of urine) or anuria (non-passage of urine)
• Edema (swelling) in the legs, ankles or feet
• Confusion, drowsiness
• Dyspnea (difficulty in breathing)
• Anorexia (loss of appetite)

Diagnosis of acute kidney failure

Diagnosis is made based on:

• Symptoms
• History
• Clinical examination findings

and followed by:

• Blood tests (urea, creatinine)
• Ultrasound-assisted imaging study of the urinary tract

Treatment of acute kidney failure

This depends on the underlying cause of renal failure.

The therapeutic measures include:

• Administration of fluids
• Discontinuation of medication or dose adjustment
• Removal of the obstruction and restoration of the urine flow in the kidneys

Chronic kidney failure

The condition is characterized by a progressive destruction of the kidney’s functional units which regulate the fluid balance in our body and remove the metabolic products.

Causes of chronic kidney failure

The most common causes of chronic kidney failure are:

• Arterial hypertension
• Diabetes mellitus
• Glomerulonephritis
• Polycystic kidney disease
• Long-term medication intake, e.g. anti-inflammatory drugs

Symptoms of chronic kidney failure

No symptoms may occur in the early stages of the disease.

Because damage to the renal parenchyma develops slowly, the first symptoms may manifest after months or even years.

The symptoms include:

• Oliguria
• Edema (swelling) in the legs, ankles or feet
• Weakness and exhaustion
• Nausea and vomiting
• Anorexia (loss of appetitie)
• Confusion

Diagnosis of chronic kidney failure

The diagnosis is made based on the symptoms and lab test results.

However, additional tests may be required, such as:

• Urinary tract ultrasound
• CT scan
• In specific cases, a kidney biopsy may be ordered to determine the cause of the kidney failure and administer the appropriate therapy

Treatment of chronic kidney failure

It is worth mentioning that the disease is progressive and the damage is not treatable.

The aim of the therapy is to slow down the progress of the disease.

First, we need to identify the causes responsible for the development of the disease.

In any case, loss of excess weight and physical exercise certainly help.

Patients suffering from diabetes mellitus and arterial hypertension are required to receive the appropriate treatment for the regulation of their blood sugar and blood pressure.

Finally, a special nutritional program and adjustment of the medication received for the treatment of other conditions will be required.

If the above do not prove effective during the final stages of the disease, a need may arise for:

• Dialysis
• Kidney transplant