Everything about Renal Failure totally explained
Renal failure or
kidney failure is a situation in which the
kidneys fail to function adequately. It is divided in acute and chronic forms; either form may be due to a large number of other medical problems.
Biochemically, it's typically detected by an elevated serum
creatinine. In the
science of
physiology, renal failure is described as a decrease in the
glomerular filtration rate. When the kidneys malfunction, problems frequently encountered are abnormal fluid levels in the body,
deranged acid levels, abnormal levels of
potassium,
calcium,
phosphate,
hematuria (
blood in the
urine) and (in the longer term)
anemia. Long-term kidney problems have significant repercussions on other diseases, such as
cardiovascular disease.
Classification
Renal failure can broadly be divided into two categories:
acute renal failure and
chronic kidney disease.
Renal failure classification
The type of renal failure (acute vs. chronic) is determined by the trend in the serum creatinine. Other factors which may help differentiate acute and chronic kidney disease include the presence of
anemia and the kidney size on
ultrasound. Long-standing, for example chronic, kidney disease generally leads to anemia and small kidney size.
Acute renal failure
Acute renal failure (ARF) is, as the name implies, a rapidly progressive loss of
renal function, generally characterized by
oliguria (decreased
urine production, quantified as less than 400
mL per day in adults, less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants);
body water and body fluids disturbances; and
electrolyte derangement. An underlying cause must be identified to arrest the progress, and
dialysis may be necessary to bridge the time gap required for treating these fundamental causes. ARF can result from a large number of causes.
Chronic kidney disease
Stage 5 Chronic Kidney Disease (CKD) can either develop slowly and show few initial symptoms, be the long term result of irreversible acute disease or be part of a disease progression. There are many causes of CKD. The most common cause is
diabetes mellitus. Stage 1 CKD is mildly diminished renal function, with few overt symptoms.
Stage 5 CKD is a severe illness and requires some form of renal replacement therapy (
dialysis or
kidney transplant).
Acute on chronic renal failure
Acute renal failure can be present on top of chronic renal failure. This is called acute-on-chronic renal failure (AoCRF). The acute part of AoCRF may be reversible and the aim of treatment, as with ARF, is to return the patient to their baseline renal function, which is typically measured by serum
creatinine. AoCRF, like ARF, can be difficult to distinguish from chronic renal failure, if the patient hasn't been monitored by a
physician and no baseline (for example, past) blood work is available for comparison.
Use of the term uremia
Before the advancement of modern medicine, renal failure was often referred to as uremic poisoning. Uremia was the term used to describe the contamination of the blood with urine. Starting around 1847, this term was used to describe reduced urine output, that was thought to be caused by the urine mixing with the blood instead of being voided through the urethra. The term
uremia is now used to loosely describe the illness accompanying kidney failure.
Further Information
Get more info on 'Renal Failure'.
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