Chronic renal failure
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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As chronic kidney failure (chronic kidney weakness) doctors describe the decline in kidney function, which progresses slowly over months or years. Usually both kidneys are affected. The most common reasons for chronic kidney failure are diabetes (diabetes mellitus) and high blood pressure. The loss of functional kidney tissue is usually irreversible. Read more about causes and therapies for chronic kidney failure.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. N18
Chronic renal failure: description
Doctors use the term "chronic kidney failure" when kidney function has dropped to less than 60 percent. The severity of the disease can be divided into five stages (read more about this in the article Renal Insufficiency - Stages). In Western Europe, around 10 in 100,000 people develop chronic kidney failure each year. It has dangerous effects on the body.
Urinary poisoning
The main tasks of the kidneys are blood purification and water excretion. Metabolic products are created in the body every day, which are transported in the blood to the kidneys and excreted in the urine. They are also called urinary substances.
If there is chronic kidney failure, the body can no longer excrete the toxic metabolic products - they collect in the blood and cause urine poisoning (uremia). In addition, there is water retention in the tissue (edema), as the kidneys can no longer completely excrete the fluid ingested with the food.
Further consequences for the body
In addition to the excretory function, the kidney has other tasks. It helps control blood pressure and regulate bone metabolism. It also produces various hormones that are important for blood formation, among other things. Chronic kidney insufficiency therefore also affects other body functions - blood pressure, hormone and vitamin balance and the blood coagulation system change. These changes as a result of kidney weakness ultimately have consequences for the whole body.
risk of death
Chronic kidney failure can lead to kidney failure and ultimately death if left untreated: patients are given artificial blood wash (dialysis) or have a kidney transplant.
Chronic renal failure: symptoms
You can read about the symptoms chronic kidney failure can cause in the article Kidney Failure - Symptoms.
Chronic renal failure: stages
Chronic kidney failure has various stages. You can find out everything you need to know in the article Renal Insufficiency - Stages.
Chronic renal failure: causes and risk factors
Each kidney consists of more than a million kidney corpuscles (glomeruli). These small, spherical structures contain a tangle of tiny veins, the walls of which have a filter structure. About 180 liters of primary urine are extracted from the blood every day through these filter vessels. Via various filters and transport mechanisms, those substances are recovered from this that the body can still use, for example various salts. About one and a half liters of urine are left over.
Chronic kidney failure makes adequate filtration and purification of the blood impossible. Various diseases can be responsible for this: They lead to the destruction of kidney tissue, that is, part of the kidney corpuscles perish. The remaining kidney corpuscles then take over the tasks of the diseased part. Usually this works well at first, which is why those affected do not notice anything of the declining kidney function. Chronic kidney failure only becomes noticeable when there is no longer enough healthy kidney tissue.
Chronic Renal Failure: Most Common Triggers
The most common causes of chronic kidney failure are:
- Diabetes mellitus: In around 35 percent of all cases, chronic kidney failure is caused by diabetes.
- High blood pressure (hypertension): On the one hand, it can be the cause of chronic kidney failure (through damage to the kidney corpuscles), but on the other, it can also be the result (when the kidney function declines, more blood pressure-increasing hormones are formed).
- Kidney inflammation: Both inflammation of the kidney corpuscles (glomerulonephritis) and inflammation of the urinary tubules and the space surrounding them (interstitial nephritis) can result in chronic kidney failure.
- Cystic kidneys: With this congenital malformation of the kidneys, numerous fluid-filled cavities occur in the kidneys, which severely restricts their function.
- Medication: Over-the-counter pain relievers such as paracetamol, ibuprofen or diclofenac have a damaging effect on the kidneys. Especially with prolonged use, they can cause chronic kidney failure.
In some cases it is not clear what caused the chronic kidney failure.
Chronic renal failure: examinations and diagnosis
In a detailed discussion with the patient, the doctor first collects the medical history (anamnesis). Among other things, he will ask about pre-existing kidney damage, chronic illnesses, the use of medication and kidney diseases in the family. This is followed by a physical examination with measurement of blood pressure and heart rate.
Blood and urine test
A blood test is also routine if chronic kidney failure is suspected. In the blood, among other things, the concentration of the urinary substances creatinine and urea is measured - they accumulate in the red body juice when there is chronic kidney failure. The so-called creatinine clearance is more meaningful than the creatinine value.It allows a statement to be made about the functionality of the kidneys, because chronic kidney failure leads to a reduced creatinine clearance.
If the patient excretes protein in the urine, this corroborates the suspicion of kidney weakness. With the help of another laboratory value (glomerular filtration rate, GFR), the doctor can determine the severity of the disease.
Further investigations
Once the diagnosis of "chronic kidney failure" has been made, the search for the causes follows. Depending on the suspected diagnosis, doctors carry out further urine and blood tests as well as imaging tests such as ultrasound (sonography). Sometimes it is also necessary to take a tissue sample from the kidney (kidney biopsy). The examinations also look for possible sequelae of kidney weakness, for example anemia (renal anemia).
Chronic renal failure: treatment
Chronic kidney failure is treated based on its cause and severity. If possible, the cause of the kidney weakness is eliminated or treated so that the chronic kidney weakness does not progress any further. However, once destroyed kidney tissue cannot be restored.
The following measures are important for renal insufficiency therapy and the treatment of possible secondary diseases:
- Plenty of fluids (two to two and a half liters) and administration of water tablets (diuretics)
- Regular monitoring of blood salts (blood electrolytes) and body weight
- Treating high blood pressure with medication (especially ACE inhibitors and AT1 blockers)
- Drugs that lower blood lipids (lipid-lowering drugs)
- Treatment of anemia caused by kidney failure (renal anemia)
- Treatment of bone diseases (vitamin D deficiency due to kidney failure)
- Right nutrition
Despite treatment, chronic kidney failure continues to worsen in many cases, so that patients eventually need artificial blood washing (dialysis) or a kidney transplant.
Chronic Renal Failure: Prevention
The most common causes of chronic kidney failure are diabetes mellitus and high blood pressure. A good adjustment of the blood sugar and blood pressure values can therefore prevent chronic kidney weakness.
Since many medications can also cause chronic kidney failure, you should discuss any medication intake with your doctor. This also applies to over-the-counter drugs. If the kidneys are already weak, the dose of medication often needs to be adjusted. In general, you should carefully coordinate the use of medication for kidney dysfunction such as chronic kidney failure with your doctor.
Diet for chronic renal failure
Diet also has an impact on the course of chronic kidney failure. More on this in the article Nutrition in Renal Insufficiency!
Chronic renal failure: disease course and prognosis
The sooner chronic kidney failure is diagnosed and treated, the better the chances of success. However, a complete cure is usually not possible - the loss of functional kidney tissue cannot be reversed.
Chronic kidney failure tends to progress faster in men and older patients than in women and younger patients. High blood sugar and blood pressure values as well as obesity and smoking also have a negative effect on the course of the disease.
Chronic kidney failure can shorten the life expectancy of those affected. This is particularly the case if diabetes mellitus is the cause of the kidney failure. Some patients die from consequential damage to the diseased kidneys, for example from diseases of the cardiovascular system.
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