Chronic Renal Failure, also known as Chronic Kidney Disease (CKD), is a long-term and progressive loss of kidney function. Over months or years, the kidneys lose their ability to filter blood, remove toxins, balance electrolytes, and regulate fluid levels. Early stages are often silent, but as CKD worsens, waste products build up in the body, leading to serious complications.
Causes of Chronic Renal Failure
The most common causes include:
- Diabetes mellitus – leading cause
- Hypertension
- Chronic glomerulonephritis
- Polycystic kidney disease
- Long-term NSAID use
- Obstructive uropathy (stones, enlarged prostate)
- Recurrent kidney infections
Stages of Chronic Kidney Disease
CKD is classified based on GFR (Glomerular Filtration Rate):
- Stage 1: Kidney damage with normal GFR (≥90)
- Stage 2: Mild reduction (60–89)
- Stage 3: Moderate reduction (30–59)
- Stage 4: Severe reduction (15–29)
- Stage 5: End-stage renal disease (GFR <15)
Symptoms of Chronic Renal Failure
Symptoms develop gradually as kidney function declines:
- Fatigue and weakness
- Loss of appetite
- Nausea and vomiting
- Swelling in legs, ankles, and face
- Shortness of breath
- Muscle cramps
- Itching
- Decreased urine output (in late stages)
Diagnosis
- Serum creatinine and GFR to assess kidney function
- Urine protein tests (proteinuria indicates kidney damage)
- Electrolytes: potassium, sodium, calcium
- Ultrasound for kidney size and structure
- Kidney biopsy if cause is unclear
Complications of CKD
- Anemia
- Bone disease (renal osteodystrophy)
- Heart failure and hypertension
- Fluid overload
- Metabolic acidosis
- High potassium levels
Treatment of Chronic Renal Failure
CKD cannot be reversed, but progression can be slowed significantly with proper treatment.
1. Control of Underlying Diseases
- Maintain blood sugar in diabetics
- Manage blood pressure (ACE inhibitors/ARBs preferred)
2. Diet Management
- Low sodium intake
- Restricted protein diet (to reduce kidney workload)
- Limit potassium and phosphorus-rich foods
- Adequate calorie intake
3. Medications
- ACE inhibitors/ARBs – slow kidney damage progression
- Diuretics – for fluid overload
- Erythropoietin – to treat anemia
- Iron supplements
- Phosphate binders
- Vitamin D supplements
- Bicarbonate for metabolic acidosis
4. Dialysis
Required when kidney function drops to end-stage (Stage 5).
- Hemodialysis
- Peritoneal dialysis
5. Kidney Transplantation
The best long-term treatment option for eligible patients.
Indications for Dialysis
- Severe fluid overload
- High potassium not responding to treatment
- Severe acidosis
- Symptoms of uremia (confusion, seizures, pericarditis)
Prevention Strategies
- Maintain healthy blood pressure and blood sugar
- Avoid long-term NSAID use
- Stay hydrated
- Manage weight and diet
- Regular kidney function tests in high-risk individuals
Patient Counseling
- Follow low-salt and low-protein diet
- Take medications regularly
- Avoid over-the-counter NSAIDs
- Come for regular kidney function monitoring
- Report reduced urine output or breathlessness immediately
- Stay vaccinated (flu, hepatitis B)
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