Kidney failure is a condition where the kidneys are incapable of performing its normal functions. Certain toxic substances which should have been excreted such as urea and creatinine are accumulated in the body. These levels if high enough cause symptoms such as tiredness, weakness, loss of appetite and vomiting. Creatinine is the breakdown product of muscles. The blood creatinine level is often used by doctors as a measure for the degree of kidney failure. Generally, when the creatinine level in the blood reaches a level of 900 µmol/L the patient should start on dialysis.
In kidney failure, the volume of water in the body increases and swelling of the tissues results. Excess salt and water retention may cause high blood pressure, swelling of the legs, face and abdomen and breathlessness. The kidneys fail to excrete phosphate, causing the blood phosphate level to increase and calcium level to fall. This results in bone disease and may predispose the patient to fractures of the bones. The bone problem is also worsened by the lack of active Vitamin D. Inadequate production of erythropoeitin leads to anaemia.
CAUSES OF KIDNEY FAILURE
The common causes of kidney failure are glomerulonephritis (inflammation of the kidney) and diabetes mellitus. Other causes are kidney stones, polycystic kidneys, systemic lupus erythematosus, uncontrolled hypertension and drugs.
WHAT ARE THE SYMPTOMS OF KIDNEY FAILURE?
In mild kidney failure, no symptoms are present although kidney tests show some abnormalities. As kidney failure worsens, the patient may experience the following:-
- pale and sallow complexion
- shortness of breath
- body itch
- poor appetite, sometimes accompanied with nausea and vomiting
- swelling of the face and legs
- frequent urination at night or
- passes little urine
PREVENTING KIDNEY FAILURE
General measures in preventing renal failure
1. Diet Restriction
Uncontrolled glucose level in blood cause changes in large and small blood vessels as well as chemical changes in the tissues itself. These changes affect the kidneys as well as the heart, nerves, intestines, eyes and even the circulation to the limbs.
By reducing the intake of protein such as poultry, seafood and soya products helps to reduce the level of protein waste products in the body. However, one must be cautious not to reduce this too low or malnutrition will occur. The dietician would usually be consulted on this and advise the patient on the appropriate proportion of protein to take.
b) Salt intake
Beware of the salt content in sauces and seasonings as well. Too much salt makes you feel thirsty, and drinking too much fluid can cause swelling of the face, legs and abdomen, and increase in blood pressure.
If you have a significant amount of swelling, your doctor will instruct you to reduce your fluid intake. Fluid allowance for the day depends on the fluid status of the patient. It may be restricted to a range of 300 ml to 500 ml a day.
You may be referred to a dietician who will assess your needs and make recommendations accordingly.
Medications specific to different kidney diseases may be prescribed by the doctor.
3. What other points do kidney failure patients have to note?
Potassium affects the heart muscles to contract, too much or too little potassium can harm the heart. Therefore, intake of high potassium food has to be restricted. Leafy vegetables, fruits and fruit juices are some of the food that contain high potassium.
Beans, peas, mushrooms, nuts, milk, soya products, and legumes are examples of food which contains phosphate and should be avoided. Phosphate is retained in the blood due to the inability of the kidneys to excrete waste and toxins, As a result the body is unable to maintain a balance between calcium and phosphate, which may lead to bone problems.
Besides blood pressure medications, your doctor may prescribe other medications such as:
b) Calcium supplements
c) Phosphate binders - This is to bind the phosphate in the gut and prevent excessive absorption of phosphate which can cause bone problem.
4. Some healthy habits
If you want to stay healthy, you have to look after yourself, including all your important organs.
1. Avoid eating sweet and oily food
2. Avoid drinking alcohol
3. Drink more water
4. Prevent or treat diabetes and high blood pressure
5. Eat well-balanced diet
6. Control any infection
7. Go for routine check-ups
5. General Advice
1. Remember!! Kidney failure can be silent in its early stages.
2. Dietary restriction and blood pressure control are important to retard the progression of kidney failure.
3. All appointments with your doctors must be kept.
4. Your doctor will inform you in advance if dialysis is necessary.
5. In the advanced stages of kidney failure, your kidney can deteriorate very rapidly.