Kidneys are the organs that filter waste products from the blood. When kidney failure occurs, the waste products accumulate in the blood leading to fatal outcomes.
Kidney failure can be due to acute or chronic kidney disease. It is a condition that can have multiple causes depending on the type of failure. Within this article, you will find answers to some of the most common questions about the treatment options and how long anyone can live with this disease. Before reaching that point, there will be brief explanations about the basic concepts of the disease.
By reading this article, you will obtain critical insights about Kidney failure like how it happens, its signs and symptoms, and the complications. Please continue reading to get pearls on this specific topic by the hand of a doctor.
What is Kidney Failure?
Kidneys are one of the most essential organs of the bodies as they have several functions. They are two small organs with bean’s shape in the back on either side of the spine.
Moreover, kidneys are in charge of cleaning the blood, filtering it, and producing urine. Aside from producing urine, they balance the number of certain elements in the blood, such as sodium, potassium, and calcium. They as well produce hormones that control blood pressure and red blood cell production.
Renal function of a healthy kidney has four main activities which are the following:
- Blood flow enters in the kidney
- Glomeruli, a unique structure, creates an ultrafiltrate from blood and delivers it to renal tubules
- Solutes and/or water are reabsorbed/secreted in the renal tubules
- Tubular fluid (now urine) exits the kidney and goes to the bladder
Kidney damage can happen if a process interferes with any of these structures or steps. Therefore, kidney failure is when kidneys do not work as they should; this causes the body to retain waste products that can lead to other conditions.
Nonetheless, there are two main types of kidney failure. It can happen quickly with a sudden decline in renal function, which is the case of acute kidney injury or acute kidney failure.
It can also be the result of progressive damage to the kidneys due to an underlying cause, which is the case of chronic kidney disease (CKD) or chronic renal failure. Importantly, renal failure can lead to a wide variety of complications that goes from excess fluid retention to affect the heart and the brain directly. It is a potentially deadly condition that requires medical attention immediately.
What are the causes of Kidney Failure?
It depends on the type of kidney failure or kidney injury. Acute renal failure has a sudden onset that happens in days. In contrast, chronic kidney failure has a progressive and slow beginning that may take months even years.
Having kidney failure means that 85% to 90% of kidney function is gone. The following are the causes for each one of the possible scenarios of kidney failure.
Acute Kidney Failure
Acute kidney failure has 3 leading possible causes, and each one of them has different origins. The possible causes and their sources are the following:
The patient has an underlying condition that slows blood flow to the kidneys.
- Blood or fluid loss
- Heart disease
- Liver failure
- Severe burns
- Severe dehydration
- Use of drugs like aspirin, ibuprofen, naproxen or similar drugs
- Severe allergic reaction
Patient experience direct damage to the kidneys
- Blood clots in blood vessels in and around the kidneys
- Cholesterol deposits that block blood flow in the kidneys
- Toxins such as alcohol, heavy metals, and illicit drugs like cocaine
- Muscle tissue breakdown (rhabdomyolysis) that generates toxins affecting kidneys
- Glomerulonephritis, inflammation of the tiny filters in kidneys
- Lupus, an immune system disorder causing glomerulonephritis
- Kidney infections
- Medications like chemotherapy drugs (Anti-EGFR), antibiotics, ACE inhibitors and dyes for imaging tests
Kidney’s urine drainage tubes (ureters) become blocked, and wastes cannot leave the body through urine
- Kidney stones
- Bladder cancer
- Nerve damage involving the nerves that control the bladder
- Prostate cancer
- Colon cancer
Chronic Kidney Failure
On the other hand, chronic kidney failure has a wide variety of causes, including congenital conditions that may cause progressive kidney injury. The following list has some of these conditions.
- High blood sugar levels and Diabetes.
- High blood pressure
- Glomerular disease
- Congenital (birth) defects of the kidney or bladder
- Cystic kidney diseases like Polycystic kidney disease
- Recurrent kidney stone disease
- Unrecovered acute kidney injury
- Use of drugs and medications
- Liver diseases like Hepatitis B or C
What are the stages of Kidney Failure?
Kidney failure has five stages that vary from mild (stage 1) to complete kidney failure (stage 5). Doctors use serum creatinine, an organic compound of the blood that is a waste product from metabolism, to measure the kidney function as they filter it without problems. Besides, they calculate and use the Glomerular filtration rate (GFR), an index that shows how much blood does the kidneys filter in 1 minute.
This rate helps to establish the current kidney function according to age and weight. As it lowers, the stage will rise:
- Stage 1: It is a stage with normal to highly functioning kidneys. Over 90% of the kidney is still working.
- Stage 2: There is a mild decrease in kidney function, and the percent of kidney function goes from 89% to 60%
- Stage 3A: Stage 3 divides in two, A and B. It has a mild to moderate decrease in kidney function with a percentage of kidney functionality that goes from 59% to 45%
- Stage 3B: It has as well a mild to moderate decrease in kidney function. However, this is a more serious stage in which the percentage of kidney functionality goes from 44% to 30%
- Stage 4: In this stage, there is a severe decrease in kidney function. The percentage of kidney functionality goes from 29% to 15%.
- Stage 5: This is also known as an end-stage renal disease (ESRD) in which there is complete kidney failure, and the percentage of kidney functionality is less than 15%
Each stage has its own symptoms and signs. Besides, the disease progression comes with significant damage in kidneys and other organs due to the effects of the concentration of waste products in the body. Importantly, stage 4 and stage 5 patients are candidates for receiving therapy with kidney dialysis or even kidney transplantation.
What do the kidneys stop doing as the damage progresses?
In the presence of kidney injury, the kidney can maintain the blood’s glomerular filtration rate despite the progressive destruction of healthy glomeruli.
The remaining glomeruli enlarge and filtrates more than usual to maintain normal levels in the blood. This situation is sustainable until the kidney function decreases to 50%. Later this may result in a major cause of progressive renal dysfunction. The increase of pressure within glomeruli may damage the small blood vessels leading to further damage.
Before reaching those stages, the kidneys initially decrease the production of erythropoietin, the hormone responsible for bone marrow stimulation for red blood cell production. This leads to the onset of anemia, and it becomes more severe with the progression of the disease.
Kidneys also lose the ability to filter sodium, leading to sodium retention and the inability to eliminate liquids, causing edema and accumulation of liquids within the body.
The kidneys also lose the ability to eliminate potassium through the urine, which leads to an excess of potassium in the blood (or hyperkalemia). Excess of potassium can lead to multiple complications like arrhythmias and cardiovascular disease.
Bone disease is a common complication in this condition due to the retention of phosphate and low calcium levels in the blood. The kidneys also become unable to produce ammonia to excrete normal acids of the body in the form of ammonium leading to metabolic acidosis.
What are the signs and symptoms?
People with kidney failure will have several symptoms of the disease. Nonetheless, these symptoms will vary depending on the stage of kidney failure. The most common symptoms are the following:
- A decrease in urine output, although sometimes urine output remains (the usual quantity of urine reduces due to less filtration, less urine). Typically people say that they are urinating far less than they used to.
- Fluid retention causes swelling in legs, ankles, and feet. This is due to the kidneys’ inability to eliminate water waste.
- Shortness of breath
- Excessive drowsiness or fatigue
- Persistent nausea
- Pain or pressure in the chest
- Irregular heartbeat
- Seizures or coma in severe cases
What are the complications of Kidney Failure?
As the kidneys stop working progressively, kidney failure develops more complications.
Kidneys play an essential role in eliminating the waste products of our organism and maintaining adequate liquid levels within the body.
When some of these products build up inside our body, it may lead to further complications that may affect a patient’s health. These are the most common complications.
- Anemia: Kidneys progressively stop producing erythropoietin, a hormone that induces red blood cell production in the bone marrow. This causes fatigue, chest pain, and many more symptoms as the red blood cells transport oxygen to the tissues through the body.
- Bone disease and high phosphorus levels: Phosphorus is a common mineral that works along with calcium and Vitamin D to keep bones healthy. Kidney failure causes phosphorus to build up within the body, creating a misbalance in the blood. This misbalance leads the body to pull calcium out of the bones. This makes the bones unhealthy and is a risk factor for developing fractures and other conditions.
- Heart disease: When the kidneys are not working well, the hormone system that regulates blood pressure must work harder to increase blood supply to the kidneys. When this happens, the heart has to pump harder, leading to heart disease.
- High potassium (Hyperkalemia): Potassium is a mineral that helps muscles work, including the muscles that control breathing and the heartbeat. When having too much potassium in the blood, this may affect the way the heart beats, it may beat irregularly and in the worst cases may lead to a heart attack.
- Fluid buildup: When kidneys begin to fail, fluid begins to build up inside the body. This can cause problems in the heart leading to high blood pressure, and it can cause problems with the lungs as fluid builds up inside of them.
How is Kidney Failure diagnosed?
After the patient’s initial evaluation by the doctor of its signs and symptoms, it will suggest that the patient has Kidney Failure, these are some of the tests that the doctor will ask for.
- Urine output measurements in 24 hours to determine the cause of kidney failure.
- Urine tests: Analyzing a sample of the urine may reveal abnormalities that suggest kidney failure.
- Blood tests: A sample of blood may reveal a sudden increase in urea and creatinine. These two are the most common substances used to measure kidney functionality.
- Imaging tests: The doctor may ask for imaging studies like ultrasound or computerized tomography to see the kidneys.
- Kidney biopsy: Removing a sample of kidney tissue for testing may reveal a lot from the disease and what causes it. The doctor inserts a needle through the skin and into the kidney to remove the sample.
What are the treatment options for Kidney Failure?
There are many kinds of treatments for kidney failure. However, the type of treatment will depend on the reason for kidney failure.
Dialysis treatment helps the body to get rid of waste and extra fluids. Nonetheless, it cannot do everything that healthy kidneys do. There are two types of dialysis.
- Hemodialysis: It is a treatment in which the blood travels from the body through some tubes into a dialysis machine. The blood goes through a filter called a dialyzer, cleans the blood by removing some of the waste and extra fluid. Then the clean blood goes back from the machine into the body.
- Peritoneal dialysis: It uses the peritoneum, an area of the belly as a filter. Doctors put a catheter in the abdomen that allows the patient to fill the peritoneum with dialysate. This liquid pulls fluid and waste from the blood into the peritoneum. The liquid holds onto the waste and removes them from the body when the patient does an exchange of liquid.
This approach is considered as the best treatment option for people facing kidney failure. It can increase the chances of living a longer and healthier life. It is a surgery that is considered safe and very successful. However, the kidney transplants’ success depends on how healthy the patient is before the procedure and following doctor orders and recommendations after the transplant.
How long does it take to die from Kidney Failure?
It depends on many factors, and there is not an exact answer for that as each patient is different from each other. Kidney failure is most common in elderly patients, but it can affect young patients as well.
The age of the patient at the time of the disease’s onset plays a major role, and if there are any other underlying conditions like diabetes.
A dialysis is an option for people who suffer from kidney failure. It is a very effective treatment that may help to increase the life expectancy of the patients. Nonetheless, the remaining life of patients with kidney failure depends on the remaining percentage of functional kidney and the age of the patient.
If the patient is young (0 to 14 years old), the average remaining time is 24 years for males and 22 for women if they receive treatment.
Individuals from 30 to 35 have an average remaining life of 14 years for males and 13 for women. Those aged between 70 and 75 years have an average of 4 years for both males and females.
Statistics show that even with treatment, as people grow older, the remaining life with this disease grows shorter as it reduces with age.
If patients decide to not receive dialysis treatment, life expectancy significantly reduces. Kidney failure is a life-threatening condition. The patient’s remaining time depends on the residual kidney functionality, and it can go from days to several weeks.
How long can you live with Chronic Kidney Disease?
The life expectancy of the chronic kidney disease depends on the stage at the time of diagnosis. It is a condition that affects old people differently from young adults. Life expectancies decrease with age when diagnosis occurred.
People with a diagnosis at the age of 30 have a possibility of living 10 to 20 years. However, due to renal treatment and technology improvement, the lifespan may go up with a few years.
Studies show that patients with a GFR of 60 and above (a relatively well-preserved kidney functionality, please kindly refer to kidney disease staging a few questions above) and aged between 30 and 50 years when diagnosed. They have a life expectancy of between 24 years and 12 years.
Those patients facing stage 4 of the disease have a life expectancy of 20 years for those with 30 years old and 7 years for those with 50 years old.
When these patients reach end-stage renal disease or stage 5, the life expectancy shortens even further. Individuals aged 60 years and 85 years have a life expectancy of 6 years and between twelve and eighteen months, respectively.
These statistics are only approximated and averages, these are not absolute numbers as the situation. Life expectancy varies from case to case, but as people grow older, life expectancy reduces.
Are you afraid of kidney failure?
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