Kidney, or renal, failure is the deterioration or loss of kidney function, leading to the water, electrolyte, nitrogen, and other types of metabolic imbalance.
There are two forms of renal failure: chronic and acute renal failure. In both cases, the kidneys no longer function or only to a very limited extent (urine production may remain quantitatively unchanged or even increased). The difference in the clinical course is in the time period and the prediction. Acute renal failure occurs either in the context of an acute exacerbation of long-standing pre-existing renal disease including chronic glomerulonephritis, diabetic or hypertensive kidney damage by a longtime drug abuse (especially pain medication abuse, such as analgesic) or by an acute incident (acute glomerulonephritis, autoimmune disease, infections, surgery, sepsis, etc.). It is in principle in most cases reversible and does not necessarily need to develop end-stage renal failure.
Acute renal failure is a serious, intense medical disease with still high mortality. A causal treatment is not usually possible. The treatment consists in the optimization of circulatory status and renal blood flow, the omission of harmful drugs and the removal of obstacles in the outflow of the urinary tract.
Chronic renal failure may progresses into the terminal stage, ultimately, the mean a total kidney failure (when nevertheless certain sub-functions can continue to be active). The most common causes in industrialized nations are type 2 diabetes mellitus and high blood pressure due to lack of exercise and poor diet, other causes are chronic, often undetected inflammation and infections of the kidneys, narrowing of the urinary tract and congenital kidney diseases such as polycystic kidney disease.
Chronic kidney failure develops over months to years. As a rule, symptoms occur only at a very advanced stage of the disease. The patients are threatened primarily by complications of the cardiovascular system such as heart attack, stroke, and circulatory problems. There is also the risk of deterioration of renal function in the dialysis at the end-stage of the disease.
Through lifestyle changes, medication strict control of blood pressure and treatment of comorbidities, it is now possible in many cases to inhibit the progression of chronic renal failure, or even stop, thereby preventing a dialysis treatment. To detect the disease at an early stage, which is possible with a simple blood and urine test is all the more important.
At an outright loss of kidney function (stage renal disease) renal replacement therapy takes place, either in the form of dialysis or kidney transplantation.
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