Things you need to know about Kidney Failure!

Have you ever wondered how much work these two little kidneys in our body do? Sometimes, these kidneys can fail. When that happens, we call it Kidney Failure. While this may be a scary topic for some, it is important to be aware of it.

What is Kidney Failure?

Simply put, kidney failure is a condition where one or both of your kidneys are not working properly. This means they can't do their job on their own. This can happen in two ways. One is acute kidney failure . This is a condition that comes on suddenly. But sometimes it's temporary and can be treated. The other type is chronic kidney failure . This is a gradual, slow deterioration of the kidneys over time. This is the most common condition for most people.

This condition of kidney failure can gradually progress to the final stage, which is End-Stage Kidney Disease (ESKD) . In fact, if left untreated, ESKD can be life-threatening. A person with this condition can only survive for a few days or weeks without treatment. But don't worry, with proper treatment, kidney failure can be managed and lead a good quality of life.

What happens to our kidneys?

Now let's see what these organs called kidneys do to our bodies. Your kidneys are like two beans. They're about the size of your fist. Do you know where they are? They're located just below your rib cage, towards the back. Most people have two kidneys that work well. But if one kidney works well, you can live comfortably.

The main job of the kidneys is to remove toxins from our bodies . Think of them as a filter. They filter your blood and remove the unwanted waste products from it as urine (which we also call urine ).

So think about it, what happens if these kidneys don't work properly? Those waste products build up inside the body. When that happens, you start to feel sick, and if left untreated, you can eventually die. But, as I said before, most people can control this condition with proper treatment.

How common is kidney failure?

Let's see how common this condition is called kidney failure. In a country like America, this disease affects about 7.5 lakh people per year. If you look around the world, about 2 million people suffer from this disease. There are quite a few people with this condition in our country too, especially because diseases like diabetes and high blood pressure are common.

What are the five stages of kidney disease?

When we talk about the stages of kidney disease, we look at your eGFR (Estimated Glomerular Filtration Rate).The value is called. This is a blood test.

Simply put, eGFR is a measure of how well your kidneys filter things. A healthy person's eGFR is usually above 90. An eGFR of 0 means that the kidneys are not functioning at all.

There are five main stages of kidney disease:

• Stage I: Your GFR is above 90. At this point, your kidneys are functioning normally, although there is some damage.
• Stage II: Your GFR may be between 60 and 89. The kidneys are more damaged than in stage I, but they are still functioning well.
• Stage III: Your GFR may be between 30 and 59. In this stage, kidney function may be mild or severe.
• Stage IV: Your GFR may be between 15 and 29. This is where kidney function is severely reduced.
• Stage V: Your GFR is less than 15. This means your kidneys are close to or have completely failed. This is when symptoms usually begin to appear.

What are the early warning signs of kidney failure?

Often, early kidney disease has no symptoms , or only mild symptoms. But even if you don't notice anything, chronic kidney disease (CKD) can cause damage from within.

Symptoms of kidney failure can vary from person to person. If your kidneys are not working properly, look for one or more of the following symptoms:

• Feeling extremely tired (fatigue). Not just tiredness, but fatigue that doesn't go away no matter how much sleep you get.
• Nausea and vomiting. This may be accompanied by loss of appetite.
• Feeling confused or having trouble concentrating. Imagine feeling a little dizzy, unable to concentrate on something.
• Swelling (edema). Swelling, especially around the hands, ankles, or face. Some people report swelling around their eyes when they wake up in the morning.
• A change in how often you urinate. You may either need to urinate more often or the amount of urine you pass may decrease. You may also have foamy urine.
• Muscle spasms or limping.
• Dry or itchy skin.
• Loss of appetite, or a metallic taste in the mouth.

Don't worry if you have one or two of these symptoms, but if they persist, you should definitely see a doctor .

What are the main causes of kidney failure?

Two of the main causes of chronic kidney disease and kidney failure are diabetes mellitus and high blood pressure . Both of these are very common diseases in our country.

If you have diabetes, if it is not well controlled, your blood sugar levels will be constantly high (hyperglycemia). If your blood sugar levels remain high, it can damage your kidneys and other organs.

High blood pressure means that blood is moving through the blood vessels too hard, too forcefully. If left untreated for a long time, this extra force can damage the tissues of the kidneys.

Kidney failure is not something that happens suddenly. There are other factors that can affect it:

• Polycystic Kidney Disease (PKD): This is a genetic disease inherited from one of the parents. In this, fluid-filled cysts (cysts) form inside the kidneys.
• Glomerular diseases: These diseases affect the kidneys' ability to filter waste products.
• Autoimmune kidney diseases: For example, a disease called lupus . This is an autoimmune disease, meaning the body's immune system attacks its own cells. This can cause organ damage, joint pain, fever, and skin lesions.

Sometimes, kidney failure can occur suddenly for an unexpected reason. This is called Acute Kidney Injury . In this case, the kidneys suddenly lose their ability to function. This condition can occur within a few days. But most of the time, it is temporary.

Common causes of sudden kidney failure are:

• Certain medications, especially certain painkillers, can cause this.
• Severe dehydration. When the body doesn't have enough water.
• Urinary tract obstruction. This can be caused by something like a urinary stone.
• Untreated systemic diseases. For example, heart disease or liver disease.

What are the risk factors for kidney failure?

Kidney failure can happen to anyone. However, you may be at increased risk if you have any of the following factors:

• If you have diabetes .
• If you have high blood pressure (hypertension) .
• If you have heart disease .
• If someone in your family has had kidney disease (a hereditary predisposition).
• If you have structural abnormalities in your kidneys .
• If you are black (due to some genetic reasons).
• If you are over 60 years old .
• If you have been taking painkillers for a long time , especially NSAIDs (Nonsteroidal Anti-inflammatory Drugs) that you can easily get from the pharmacy.

What are the complications of kidney failure?

The kidneys perform various functions in our body. So when the kidneys fail, it can cause various complications. For example:

• High blood pressure.
• Anemia. That means a lack of blood. The kidneys produce a hormone that helps make red blood cells. When the kidneys are damaged, it decreases.
• Bone disease.
• Fluid around your lungs.
• Nerve damage.
• Electrolyte imbalance. This is a change in the amount of salts such as sodium and potassium in the blood.

But don't assume that just because you're diagnosed with kidney failure, you're going to die. If you follow your doctor's treatment plan—which may include medications, lifestyle changes, and limiting salt and certain foods—you can manage your condition well. However, if you don't listen to your doctor, your kidneys can get worse and you could even die.

Can end-stage renal failure cause death?

Yes, end-stage renal disease (ESKD) can be fatal. But as I said before, with proper treatment, most people can live with kidney failure. The most important thing to remember is that there is no cure for kidney failure. That means that even with treatment, your kidneys will not function as they did before you developed the disease. Treatment is aimed at preserving the remaining function of your kidneys for as long as possible and slowing down their rapid deterioration.

How is kidney failure diagnosed?

A doctor may use various kidney function tests to see how your kidneys are working and to find out if you have kidney failure. If your doctor suspects that you are at risk of kidney failure, these are the tests that are usually done:

• Blood tests: These check how well your kidneys are removing waste products from your blood. A doctor takes a small sample of blood from a vein in your arm using a thin needle. The blood sample is then tested in a lab. This blood test is also used to check the eGFR value mentioned earlier.
• Urine tests: These measure certain things in your urine, such as protein or blood. You will need to urinate into a special container at a doctor's office or hospital. The urine sample will then be tested in a lab.
• Imaging tests: These tests allow a doctor to look at your kidneys and the surrounding area to see if there are any abnormalities or blockages. Common imaging tests include a kidney ultrasound , CT urogram, and MRI .

How is kidney failure treated?

Treatment for kidney failure depends on the cause and severity of the condition. Doctors can't completely cure kidney failure, and it's a life-threatening condition. But treatment can help you live longer and manage symptoms and complications.

If your kidneys are gradually failing, a doctor may use several different methods to monitor your health and maintain kidney function for as long as possible. These methods may include:

• Frequent blood tests.
• Checking blood pressure regularly.
• Medicines.

If you have end-stage kidney failure , you need treatment to keep you alive. There are two main treatments for kidney failure: dialysis and kidney transplant .

Medications for kidney failure

Depending on the cause of your kidney disease, a doctor may prescribe one or more of the following medications:

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs): These medications help lower your blood pressure.
• Diuretics: These help remove excess fluid from the body. Some people also call these 'water pills'.
• Statins: These help lower your cholesterol levels.
• Erythropoietin-stimulating agents: These help make red blood cells if you have anemia.
• Vitamin D and Calcitriol: These help prevent bone loss.
• Phosphate binders: These help remove excess phosphorus from your blood.

Dialysis

Dialysis is a method of helping your body filter blood. Think of it like giving your kidneys a break so they don't have to work as hard. There are two types of dialysis:

• Hemodialysis: This is a machine that cleans your blood regularly. Many people with kidney failure go to a hospital or dialysis center for hemodialysis three to four days a week. This can be a bit tiring, as you have to be connected to the machine for several hours at a time.
• Peritoneal dialysis:In this procedure, a doctor inserts a small tube (catheter) under the skin of your abdomen and connects it to a bag containing dialysis fluid. This fluid flows from the bag into your abdominal cavity, where it removes waste and extra fluid and returns to the bag. Sometimes, peritoneal dialysis can be done at home.

Kidney Transplant

In a kidney transplant, a surgeon replaces your damaged kidney with a healthy kidney. This healthy kidney (donor organ) can come from a deceased donor or a living donor. You can live well with one healthy kidney. If you have a kidney transplant, you will need to take medication for the rest of your life to prevent damage to the transplanted kidney. These medications work to stop your body from rejecting the new kidney.

Is it possible to recover from end-stage renal failure?

It depends on many factors. With proper treatment, you can live a happy, fulfilling life. However, you should expect to need treatment for the rest of your life. Remember, kidney disease or kidney failure cannot be reversed , it can only be slowed down.

How to prevent kidney failure?

Although kidney failure and chronic kidney disease (CKD) cannot be reversed, there are things you can do to protect your kidney function. Healthy habits and routines can slow the rate at which your kidneys lose function.

If you have CKD or kidney failure, it's a good idea to do these things:

• Monitor your kidney function regularly (get tested as your doctor recommends).
• If you have diabetes, keep your blood sugar levels within a normal range .
• Keep your blood pressure level within a normal range .
• Avoid using tobacco products (such as smoking).
• Avoid foods high in potassium and sodium (salt) . It's best to ask a doctor or nutritionist about this, as some fruits and vegetables are also high in potassium.
• Be sure to go to every scheduled appointment with your doctor.

What can you expect if you have kidney failure?

There is no complete cure for kidney failure. However, with proper diagnosis and treatment, you can live longer without much change in your quality of life.

When should you see a doctor?

If you have risk factors for kidney failure, see a doctor. That means:

• If you have high blood pressure .
• If you notice changes in your urination pattern (frequent urination, less urination, foamy urine, blood).
• If you are experiencing brain fog or difficulty concentrating.
• If you have nausea or vomiting .
• If you have diabetes .
• If anyone in your family has had kidney disease .
• If you have had a previous kidney problem (e.g., sudden kidney failure).
• If you regularly take NSAIDs .

If you have something like this, don't ignore it. It's wise to see a doctor immediately and get advice.

What questions should you ask the doctor?

Consider asking your doctor these questions about kidney failure:

• How do you know for sure that I have kidney failure?
• If I don't have kidney failure, what other condition could I have?
• What is causing my kidney failure?
• Do I need dialysis?
• What type of dialysis do you recommend?
• Am I suitable for a kidney transplant?
• What kind of medications do you recommend for me?
• Do I need to make any changes to my diet?
• How often do I need to come for treatment?

When should hospice care be considered in cases of kidney failure?

Deciding when it's time for you or your loved one to receive hospice care is a personal decision. Your medical team can help you decide what's best for your situation. The goal of hospice care is to provide comfort and support for people with end-stage disease, such as kidney failure. Hospice care in the case of kidney failure usually occurs when treatments such as dialysis or a kidney transplant are no longer effective or cannot be done.

So, what are the things we need to remember from all of this?

Kidneys are essential organs in our body. They remove waste products and extra fluid. If your kidneys fail, it means they are not working properly. If left untreated, this can be fatal. But don't worry, dialysis or a kidney transplant can help you continue to live a good life. Your treatment plan may include taking medications and following a special diet. Be sure to keep all your appointments with your doctor. If you have any questions or concerns about your treatment, medications, lifestyle changes, or anything else in your treatment plan, talk to your doctor.

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