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Kindey Failure Treatment India

Definition

Acute Kidney Failure is the sudden loss of kidney function. Kidneys clean waste from the blood and manage the balance of fluid in the body. The condition can be reversed with timely medical intervention, such as dialysis, which is a process that cleans the blood.

Causes

There are many possible causes of sudden Kidney Failure because there are three anatomical sites for problems to occur in the renal system: before the blood enters the kidneys, within the kidney , and after the urine is processed by the kidney and enters the ureters.

Sudden Kidney Failure can result from problems with blood flow to the kidney, which can be caused by blood loss or dehydration. It can also result from conditions such as infections that interfere with the work of the kidney.

The most common cause of sudden Kidney Failure occurs inside the kidney. Acute tubular necrosis is the death of the cells inside the kidney that act as the blood's filter. These cells die when they are deprived of oxygen. This can be due to surgical complications or the side effects of certain medicines. Physical problems, such as swollen prostate glands or kidney stones can also cause sudden Kidney Failure.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing acute Kidney Failure. If you have any of these risk factors, tell your doctor:

• Having a chronic disease, such as diabetes, kidney disease, heart disease ( eg, congestive heart failure), liver disease, or high blood pressure

• Increased age

• Dehydration

• Bleeding, especially from the gastrointestinal tract

• Certain medications are potentially toxic to the kidney—for example, antibiotics such as sulfa drugs, chemotherapeutic drugs, radiocontrast material, and illegal drugs (eg, heroin)

• Complications following surgeries or care in an intensive care unit (ICU)

• Overuse of certain over-the-counter painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDS)—for example, ibuprofen, naproxen sodium, and ketoprofen

• Use of angiotensin converting enzyme (ACE) inhibitors

• Obstructive causes (eg, benign prostatic hypertrophy, bladder tumor)

Symptoms

Many people do not have any symptoms, but symptoms can include the following:

• Swelling throughout the body

• Less frequent urination

• Dark-colored urine

• Tiredness

• Confusion

• Nausea or vomiting

• Muscle weakness or muscle cramps

• No appetite

• Metallic taste

• In severe cases, coma or seizures

Diagnosis

You may be referred to a kidney specialist (nephrologist) for diagnosis and treatment. Your doctors will ask about your symptoms and medical history. A physical exam will be done. Your doctor will ask about any medications you are taking. You will have blood and/or urine tests to look for signs of Kidney Failure, including abnormal levels of electrolytes, blood urea, nitrogen (BUN), creatinine (an acid that promotes muscle growth), and red blood cells.

The amount of urine produced over several hours can also be considered for diagnosis, since Kidney Failure affects urine production. Urine will also be examined for color and any unusual content that might indicate infection. The nephrologist may also require a kidney ultrasound, CT scan, MRI, or even an examination of the bladder for stones.

Treatment

The treatment for acute Kidney Failure will depend on the exact cause and severity of the event. Your doctor may recommend any of the following:

• Undergoing dialysis

• Treating obstruction with a catheter or stent

• Maintaining adequate blood volume with fluids given by IV

• Stopping medications or drugs that caused the loss of function

• Treating related problems, such as kidney stones or infections

• Incorporating a diet with limited protein intake, supervised by a physician

Prevention

To help reduce your chance of acute Kidney Failure, take the following steps:

• Get a physical every year that includes a urine test to monitor your kidney's health.

• Drink water and other fluids to stay hydrated.

• Don't take drugs or other substances that can damage your kidneys. Check with your doctor to find out about the potential side effects of any medications you are taking.

• People at risk for chronic kidney disease (eg, those with a pre-existing kidney disease or kidney stone) should get more frequent check-ups at their doctor's office.

 

How is Kidney Failure Treated?

Acute Kidney Failure (ARF): Most of the time, the kidneys will regain at least part of their function if the underlying cause is corrected. In some cases, ARF is so severe that dialysis with an artificial kidney machine is necessary. The dialysis can slowly be withdrawn as kidney function returns.

Treatment of pre-renal ARF is based on identifying and attempting to reverse the cause. Most patients will be expected to recover kidney function if they survive their underlying illness. Diuretics (mannitol, furosemide) may be helpful in the early stages of pre-renal ARF.

Chronic Kidney Failure (CRF): Like ARF, the underlying disease needs to be treated. Hypertensive patients need to take their medications and diabetic patients need to control their blood sugars. Fortunately, kidneys have a large reserve of function. Even patients who have lost up to 80 percent of their kidney function do not need therapy since the small fraction of their kidneys that work is sufficient to clear the body of waste. For those patients whose CRF is so severe that they cannot survive on their residual kidney function, there are two options: dialysis and transplantation. Dialysis can be performed in one of two ways — either by hemodialysis (HD) or peritoneal dialysis (PD). HD requires that the patient be hooked to a dialysis machine at home or at a dialysis center, usually three times per week. Usually, the patient fills his/her abdomen with a solution through a tube that a surgeon implants in the abdomen. This washes the waste products away when the fluid is drained out of the abdomen.

When kidney function falls to below 10 percent of normal, conservative management is usually no longer adequate to control the symptoms of Kidney Failure. Dialysis is urgently needed when the patient has uncontrolled symptoms (e.g., nausea and anorexia), high blood potassium resistant to medical treatment, pericarditis (inflammation of the coverings of the heart) and nerve damage.

Kidney transplants have become the best treatment for many patients with end-stage Kidney Failure. Most centers have achieved very high success rates because of the development of more specific and less toxic immunosuppressant drugs over the last five to 10 years. Unfortunately, the success of transplantation has led to long waiting times for cadaveric organs and most patients remain on dialysis for years until an organ becomes available. There are now approximately 50,000 patients waiting for kidney transplants in the United States, but because of the organ shortage problems, only 12,000 to 13,000 patients receive kidney transplants per year. This has led to a special emphasis on live kidney donors. The advantage of having a live donor is the ability to perform the transplant with little waiting time, and in many cases, as a planned procedure before the recipient needs dialysis. Furthermore, the outcomes of a kidney transplant from a living donor are better than those with kidneys from deceased donors. At most large centers, living related donor and living unrelated donor kidney transplantations have become attractive options for patients to avoid the long waiting times for kidneys from deceased donors.

Frequently Asked Questions:

My primary care doctor says that my large prostate has caused slight damage to my kidneys.  What am I going to do?

Untreated bladder obstruction caused by benign prostatic hyperplasia (BPH) can lead to chronic Kidney Failure. If BPH is the only reason you have CRF you will need to be evaluated for BPH treatment. Most of the time, you will have had other symptoms of BPH before developing kidney damage. A urologist can explain the various different options for treatment.

I have diabetes but my doctor says my kidneys are fine. Will I get Kidney Failure like my grandmother?

Recent studies have shown that careful control of your sugar levels can prevent all types of problems from diabetes including Kidney Failure. Regular checkups and lab work can help your doctor plan what medications can help your diabetes and your kidneys.

I recently had acute Kidney Failure because of an antibiotic. Will my kidney function improve?

If the only reason you had acute Kidney Failure was because of the antibiotic reaction, your kidney function should return. Of course, you should never be given that antibiotic again.

I need a kidney transplant but I do not want to be on a list. Can my best friend donate his kidney?

As long as your friend is healthy, has a compatible blood type and passes several blood and screening tests, he or she can. Living unrelated kidney operations are becoming common. Even strangers are coming forward to donate kidneys to patients in need of a kidney transplant.

Can Kidney Failure be caused by exposure to contrast dyes used in various X-ray tests?

Acute Kidney Failure occurs in up to 10 percent of patients exposed to some intravenous contrast materials (dye) used for X-ray tests. It is important to ask your doctor if you have any risk of kidney damage from X-ray tests that require the use of intravenous dye. The type of contrast material is extremely important. For example, the contrast material used for magnetic resonance imaging (MRI) test is not harmful to the kidneys. Preexisting Kidney Failure is an important risk factor.