3. Kidney
The kidneys are a pair of organs located in
the back of the abdomen. Each kidney is
about 4 or 5 inches long -- about the size
of a fist.
• The kidneys' function are to filter the
blood. All the blood in our bodies passes
through the kidneys several times a day.
The kidneys remove wastes, control the
body's fluid balance, and regulate the
balance of electrolytes. As the kidneys
filter blood, they create urine, which
collects in the kidneys' pelvis -- funnel-shaped
structures that drain down tubes
called ureters to the bladder.
• Each kidney contains around a million
units called nephrons, each of which is a
microscopic filter for blood. It's possible to
lose as much as 90% of kidney function
without experiencing any symptoms or
problems.
4. Kidney failure
• There are numerous causes of
kidney failure, and treatment
of the underlying disease may
be the first step in correcting
the kidney abnormality.
• Some causes of kidney failure
are treatable and the kidney
function may return to
normal. Unfortunately, kidney
failure may be progressive in
other situations and may be
irreversible.
5. Kidney failure Symptoms
Symptoms of kidney failure are due to the build-up of
waste products in the body that may cause, weakness,
shortness of breath, lethargy, and confusion. Inability
to remove potassium from the bloodstream may lead
to abnormal heart rhythms and sudden death. Initially,
there may be no symptoms of kidney failure.
Puffy eyes, hands, and feet (called edema)
• High blood pressure
• Fatigue
• Shortness of breath
• Loss of appetite
• Nausea and vomiting
• Thirst
• A bad taste in the mouth or bad breath
• Weight loss
• Generalized, persistent itchy skin
• Muscle twitching or cramping
• A yellowish-brown tint to the skin
• Urine that is cloudy or tea-coloured
6. Diagnosis of kidney failure
• The diagnosis of kidney failure usually is made by blood tests
measuring BUN, creatinine and glomerular filtration rate
(GFR).
• Blood tests :- Kidney function tests look for the level of
waste products, such as creatinine and urea, in your blood.
• Urine tests :- Analyzing a sample of your urine may reveal
abnormalities that point to chronic kidney failure and help
identify the cause of chronic kidney disease.
• Imaging tests :- Your doctor may use ultrasound to assess
your kidneys' structure and size. Other imaging tests may be
used in some cases.
• Removing a sample of kidney tissue for testing :- Your
doctor may recommend a kidney biopsy to remove a sample
of kidney tissue. Kidney biopsy is often done with local
anesthesia using a long, thin needle that's inserted through
your skin and into your kidney. The biopsy sample is sent to a
lab for testing to help determine what's causing your kidney
problem.
7. DIET
• Diet is an important consideration for
those with impaired kidney function.
Consultation with a dietician may be
helpful to understand what foods may or
may not be appropriate.
• Since the kidneys cannot easily remove
excess water, salt, or potassium, these
may need to be consumed in limited
quantities. Foods high in potassium
include bananas, apricots, and salt
substitutes.
• Phosphorus is a forgotten chemical that is
associated with calcium metabolism and
may be elevated in the body in kidney
failure. Too much phosphorus can leech
calcium from the bones and cause
osteoporosis and fractures. Foods with
high phosphorus content include milk,
cheese, nuts, and cola drinks.
8. Medications
• Medications may be used to help control some of the issues associated with
kidney failure.
• Phosphorus-lowering medications
(calciumcarbonate [Caltrate], calcitriol[Rocaltrol], sevelamer [Renagel])
• Red blood cell production stimulation (erythropoietin, darbepoetin [Aranesp])
Red blood cell production (iron supplements)
• Blood pressure medications
• Vitamins
• Once the kidneys fail completely, the treatment options are limited to dialysis or
kidney replacement by transplantation.
9. Treatment of kidney failure
• Treatment of the underlying cause of kidney
failure may return kidney function to normal.
Lifelong efforts to control blood pressure and
diabetes may be the best way to prevent chronic
kidney disease and its progression to kidney
failure. Usually, kidney function gradually
decreases over time.
• If the kidneys fail completely, the only treatment
options available may be dialysis or transplant.
10. Dialysis
Kidney dialysis is a life-support treatment that uses a special machine to filter
harmful wastes, salt, and excess fluid from your blood. This restores the blood
to a normal, healthy balance. Dialysis replaces many of the kidney's important
functions.
There are two types of kidney dialysis :-
Hemodialysis
• Hemodialysis. Blood is
filtered using dialyzer and
dialysis machine.
Peritonial dialysis
• Peritoneal dialysis. Blood is
filtered inside the body
after the abdomen is filled
with a special cleaning
solution.
11. Transplantation
• Kidney transplants may provide
better quality of life than dialysis.
After one year, 95% of
transplanted kidneys are still
functioning and after five years
the number is 80%. It seems that
the longer a patient is on dialysis,
the shorter the life of the
transplanted kidney.
• If the transplanted kidney fails,
the alternative is another kidney
transplant or a return to dialysis.
