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Kidney Failure

The kidneys filter out the waste products from the blood. They also play an important role in maintaining electrolyte balance, controlling blood pressure and stimulating the production of red blood cells.

Kidney failure is a condition in which the kidneys lose its ability to filter wastes from the blood. Kidney failure is of two types- acute and chronic. Acute kidney failure occur when the kidney stops functioning abruptly. Chronic kidney failure occurs when there is a progressive decrease in kidney function over time. In India, nearly 17% of the population suffer from kidney failure.

Signs and symptoms of kidney failure

Kidney failure is usually secondary to conditions like hypertension, diabetes, infection, dehydration and many more. Symptoms associated with kidney failure include:

  1. Decreased amount of urine
  2. Brown, red or purple urine
  3. Shortness of breath
  4. Swollen or puffy face and swelling of the feet
  5. Fatigue
  6. Abdominal pain
  7. Persistent nausea
  8. Severe drowsiness
  9. Confusion
  10. Coma(in cases of severe kidney dysfunction)

Diagnosis of kidney failure

If the physician suspects that you have kidney failure, he would ask you to take few tests. Blood and urine tests are usually prescribed first to determine kidney function.

  1. Measurement of urine output: The amount of urine that you pass during the day is monitored. Decrease in the urine output would indicate kidney dysfunction.
  2. Urinalysis: Your sample of urine would be taken to assess the following:
    1. pH of urine: Abnormal ranges of urine pH may be due to renal infection, renal stone or other kidney disorders.
    2. Protein: Healthy kidneys do not filter out protein such as albumin from the blood. When there is damage to the filtering units of the kidneys, protein may also leak into your urine.
    3. Glucose: High levels of glucose in urine is indicative of diabetes which can predispose kidney failure.
    4. Bilirubin: It is a waste product from the breakdown of RBC’s. Presence of bilirubin in urine would indicate liver dysfunction. Liver dysfunction can also cause kidney failure.
    5. Blood: Blood in urine may indicate a serious kidney problem and needs further investigation.
    6. White blood cells: Increased levels of white blood cells in the urine indicates infection.
Parameter Normal Values Interpretation
Urine pH 5.5-7.5 pH>7.5 may indicate infection
Protein ≤150 mg/d Increase indicate kidney dysfunction
Glucose ≤130 mg/d Increase indicate diabetes
Bilirubin Negative Positive indicates liver dysfunction
Blood ≤3 RBCs Increase would indicate serious renal dysfunction
WBC ≤2-5 WBCs/hpf Increase would indicate infection

Hpf- High power field

Blood test: A sample of your blood would be taken to assess the following:

  1. Serum Creatinine level: Creatinine is a waste product which is normally excreted through urine. When the kidneys don’t function well, creatinine is not filtered and its level rises in blood.
  2. Blood urea nitrogen level: Urea is a waste product formed due to breakdown of proteins. When the kidneys don’t function well, urea is not filtered and its level rises in blood.
  3. Glomerular filtration rate: This parameter indicates how well the kidneys are removing wastes and excess fluid from the blood. Fall in the GFR mean that the kidneys function is impaired.
Parameter Normal Values Interpretation
Serum Creatinine Male – ≤1.4mg/dl

Female – ≤1.2mg/dl

Increase in levels would indicate decrease in kidney function
Blood Urea Nitrogen(BUN) 7-20mg/dl Increase in levels would indicate decrease in kidney function.
Glomerular Filtration Rate(GFR) ≥90mg/dl Decrease in GFR indicates kidney failure

60-89mg/dl- mild decline in kidney function

45-59mg/dl- mild to moderate decline in kidney function 30-44mg/dl- moderate to severe decline in kidney function

<15mg/dl- severe decline in kidney function

 

Creatinine clearance test:  The amount of blood from which the kidneys can filter out creatinine each minute is called the creatinine clearance. This test is performed by collecting a 24-hour sample of urine.

Normal Values Interpretation
Creatinine clearance 500-2000 mg/day. Decrease in value indicates impaired renal function

 

Imaging tests: Imaging tests like CT-scan and ultrasound help to visualize the kidney. These tests help to detect structural abnormalities and alterations in the position of the kidneys. They also help in detection of obstructions in the kidney.

Kidney biopsy:  Kidney biopsy is done in very rare conditions. In this procedure, a small portion of kidney is sliced using a needle and is examined under microscope for evaluation. The biopsy results can help to find out the cause of kidney failure.

Management of Kidney failure

Lifestyle measures:

  1. Reduce salt intake: Increased intake of salt would aggravate hypertension and would also increase the functional load on the kidneys.
  2. Eat low potassium foods: When kidneys fail they are unable to filter out potassium. Thus, patients with kidney failure should include Low potassium foods such as apples, carrots, grapes and strawberries in your diet. High potassium foods like oranges, potatoes, spinach, bananas and tomatoes should be avoided.
  3. Maintain a healthy weight: This helps to reduce the risk of coronary artery disease, diabetes, high blood pressure and stroke.
  4. Follow the recommended diet plan: A suitable diet plan for patient with kidney dysfunction would include limited intake of protein, salt, potassium and phosphorus. Follow the diet plan as recommended by the dietitian.
  5. Avoid smoking: Smoking can lead to atherosclerosis, which results in decreased blood flow to the kidney and increased blood pressure.
  6. Take measures to control blood sugar: If suffering from diabetes, try to maintain the blood sugar levels by limiting sugar intake, exercise and medications.
  7. Blood pressure – If suffering from hypertension, try to maintain blood pressure below 130/80.

Medical treatment for kidney failure

Treatment of the symptoms and the complications of kidney failure forms the basis of the medical management of kidney failure:

  1. Medicines to treat high blood pressure
  2. Medications to treat complications of kidney failure
    1. Iron supplements for treating anemia
    2. Diuretics to prevent edema

Dialysis: It is a procedure by which waste materials and extra fluids are filtered out from the patient’s blood. A patient is recommended dialysis only when the kidney function is severely impaired.

Kidney transplantation: Kidney transplantation is a surgical procedure which is recommended to the patients with end stage kidney failure. In this procedure, the diseased kidney is replaced by a healthy kidney which is obtained from a donor.

Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 4444 2424.

References

  1. Kidney failure. http://www.healthline.com/health/kidney-failure#overview1. Accessed on 21-9-2017
  2. Some devastating statistics about chronic kidney failure in India. https://www.practo.com/healthfeed/some-devastating-statistics-about-chronic-kidney-failure-in-india-10945/post. Accessed on 21-9-2017
  3. Tests to measure kidney function damage and detect abnormalities. https://www.kidney.org/atoz/content/kidneytests. Accessed on 21-9-2017
  4. Chronic kidney disease-home treatment. http://www.webmd.com/a-to-z-guides/tc/chronic-kidney-disease-home-treatment. Accessed on 21-9-2017


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