Kidney Failure

you must be careful. I am more aggressive with kidney infections because the complications can lead to kidney failure, abdominal abscess, and sepsis, and these processes are fatal. For home management, you can start with Ciprofloxacin 500mg every 12 hours for 10 days. In addition to this, take symptomatic treatment if there is pain or fever (Paracetamol 500mg every 6 hours for 5 days), and if there is vomiting, take an antiemetic every 8 hours for 3 days. Nausea and vomiting will improve as soon as the infection begins to subside. I always suggest natural therapies, especially if they are part of popular wisdom. In the case of a potentially serious infection, such as a kidney infection, I am inclined to conventional treatment to avoid damage but always rely on natural therapies to prevent and maintain kidney function. Staying hydrated is very important, especially in this case, when the symptoms of the infection lead you to lose fluid. Cranberry juice or a supplement (Cranberry dietary supplement, 1 capsule daily) is also a good ally in maintaining kidney health. In recent years, the benefit of adding algae to the diet has been studied for several organs, including the liver, the digestive system, and the nervous system. I particularly like them, especially wakame, and they have many properties, including preventing the formation of kidney stones and helping to reduce the size of existing ones. On the web, you will find many examples of diets to detoxify the body and cleanse the kidneys. I never recommend this type of eating plan unless it is endorsed by a qualified nutritionist who knows your medical history and can foresee the complications you may have. Although many foods can be harmless, remember that the chemical reaction they have in the body when eaten together can be different for each person. Don’t rely on this type of proposition but go a little further. If you don’t want to go to the nutritionist, at least check out each component of the plan before you start.

Kidney failure is a condition in which the kidneys no longer fulfill their function of filtering and maintaining the hydroelectrolytic state of the organism due to the deterioration of its structure. It is usually caused by chronic diseases that gradually damage the kidney until it no longer functions normally. The main cause of renal failure is diabetes mellitus. Diabetic patients often have circulatory problems, especially in the smaller blood vessels. When the disease is not well controlled, the damage to the kidneys and eyes is irreversible and leads to deterioration and eventually total failure of those organs. The second cause of kidney failure is high blood pressure, which, when uncontrolled, causes serious and irreparable tissue damage. In both cases, the kidney deterioration is chronic; it can take many years before you notice the first symptom of kidney disease. In the next images, you can see the comparison between a healthy, transplant-ready kidney and one with chronic failure.

HEALTHY KIDNEY

Rmarlin, Own work, CC BY-SA 4.0

CHRONIC KIDNEY DISEASE

www.scientificanimations.com, CC BY-SA 4.0

There is also a type of acute renal failure, that is, the organ begins to fail in its functions 48 hours after the disease is installed. Blockage of the urinary tract is the main cause of acute renal failure. Whether it is kidney stones, prostate enlargement, cancer, or blockage by external compression (such as a tumor from a nearby organ), it can cause such dysfunction that the kidney tissue deteriorates in a short time and does not function properly.

a) Symptoms

The symptoms of kidney failure are related to the lack of blood filtration, which is its main function. The body accumulates toxic metabolites that should be eliminated and brings consequences of intoxication or poisoning, such as dizziness, fatigue, disorientation, loss of consciousness, and, in severe cases, convulsions. The accumulation of fluids is a consequence of the electrolyte imbalance, so there is swelling of the ankles and eyelids, especially in the mornings. The decrease in the amount of urine is noticeable; in some cases, there is no discharge of urine. This state is known as anuria. In some cases, kidney damage takes so long that the body adapts to the problem and has no major symptoms. In these cases, diagnosis can be made incidentally through laboratory tests.

Klaus D. Peter, Wiehl,Own work, CC BY 2.0 de

The experience I have of patients with kidney failure has been through those who have damage from problems in kidney blood flow, such as gunshot wounds with a lot of bleeding and patients with advanced cancer of the colon or uterus. In the first case of an injured person who begins to have kidney damage because the blood supply is insufficient, the prognosis is poor. After kidney failure, other organs, such as the liver and lungs, may fail. That is why the priority is the patient’s hydration and restoration of blood cells through transfusion. Unfortunately, in some cases, the damage is very extensive and not much can be done. One case that I always remember was a wounded man who had an injury of the vena cava with a lot of bleeding. He had to be operated on in several stages because he was decompensating during the surgery. On the second day in the ICU, kidney failure began, and that same day, he was already showing signs of liver and blood failure. Because he had a wound in the vena cava, his prognosis was already poor, but with the addition of multiorgan failure, his survival chance was reduced to less than 10%. My patient died five days after his admission because of the emergency. In the case of renal failure due to compression from cancer of the colon or another nearby organ, I have seen radical improvements by removing the tumor that generates the compression. It always depends on how long the kidney has been in that state, but that kind of failure can be reversed. If it’s a chronic disease, it is not reversible due to the extensive damage to the kidney structure.

b) Management

A patient with a chronic disease such as diabetes or hypertension or who has a risk factor for acute kidney failure should contact his or her doctor immediately. Be aware of unusual symptoms that are not directly part of the urinary system, such as tiredness, fatigue, and edema, among others. In this patient, it is necessary to control blood parameters, including the evaluation of renal values.

In order to know if the patient with renal insufficiency is a candidate for dialysis or transplant, a special test called GFR (Glomerular Filtration Rate) must be performed. This test is done in a laboratory from a blood sample and takes into account several parameters to be calculated. This value indicates how much blood the kidney is filtering. The normal value is between 90 to 120 mL/min/1.73 m2. In severe renal failure, this value decreases below 15, and that patient requires dialysis. Dialysis is a process by which an external machine does the work of the kidney, filtering the blood and returning that clean product to the body. Dialysis is a vital process that cannot be left unchecked. Depending on the function of the kidney, it is decided how often the procedure should be performed. The only solution to stopping dialysis is a kidney transplant.

GYassineMrabetTalk. Own work, CC BY 3.0

I had a lot of experience with kidney transplants during my residency program as a general surgeon because sometimes patients would come to my hospital for transplants and organ procurement, and we, as graduate students, would help the surgeons who specialized in that type of procedure. I had the opportunity to see a “live to live” transplant, which is not very common. Most often, the personnel in charge of the kidney would arrive to transplant it in a special cool box that maintains the cold chain. The transplant recipient must follow a lifelong course of high-dose corticosteroids that help keep his or her body from rejecting the transplanted organ.

Bruce Blaus, Own work, CC BY-SA 4.0

c) How Do I know I Have Kidney Failure?

If you have a chronic disease such as diabetes mellitus, high blood pressure, lupus or another autoimmune disease, you should have your kidney function checked regularly. In general, a decrease in the amount of urine even though you are drinking the same amount of fluid, urinary symptoms due to an enlarged prostate, fever, and confusion are alarming symptoms. If you think you are developing kidney failure, go to an emergency room. This type of problem cannot be solved at home; it requires laboratory tests and a complete evaluation to know what type of treatment you require.