Kidney Failure Health Channel

	Feature Article Illustrations for this article Click on an image below to enlarge Kidney anatomy Kidney - blood and urine flow Show all 3 photos Chronic renal failure Definition Chronic renal failure is a slowly worsening loss of the ability of the kidneys to remove wastes, concentrate urine, and conserve electrolytes. Alternative Names Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure Causes, incidence, and risk factors Unlike acute renal failure, chronic renal failure slowly gets worse. It most often results from any disease that causes gradual loss of kidney function. It can range from mild dysfunction to severe kidney failure. The disease may lead to end-stage renal disease (ESRD). Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly damaged. In the early stages, there may be no symptoms. In fact, progression may be so slow that symptoms do not occur until kidney function is less than one-tenth of normal. Chronic renal failure and ESRD affect more than 2 out of 1,000 people in the United States. Diabetes and high blood pressure are the two most common causes and account for most cases. Other major causes include: Alport syndrome Analgesic nephropathy Glomerulonephritis of any type (one of the most common causes) Kidney stones and infection Obstructive uropathy Polycystic kidney disease Reflux nephropathy Chronic renal failure results in an accumulation of fluid and waste products in the body, leading to a build up of nitrogen waste products in the blood (azotemia) and general ill health. Most body systems are affected by chronic renal failure. Symptoms Initial symptoms may include the following: Fatigue Frequent hiccups General ill feeling Generalized itching (pruritus) Headache Nausea, vomiting Unintentional weight loss Later symptoms may include the following: Blood in the vomit or in stools Decreased alertness, including drowsiness,confusion, delirium, orcoma Decreased sensation in the hands, feet, or other areas Easy bruising or bleeding Increased or decreased urine output Muscle twitching or cramps Seizures White crystals in and on the skin (uremic frost) Additional symptoms that may be associated with this disease: Abnormally dark or light skin Agitation Breath odor Excessive nighttime urination Excessive thirst High blood pressure Loss of appetite Nail abnormalities Paleness Signs and tests There may be mild to severe high blood pressure. A neurologic examination may show polyneuropathy. Abnormal heart or lung sounds may be heard with a stethoscope. Continue reading this article

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Acute kidney failure (1 image) (Doctor-Reviewed information)
Acute (sudden) kidney failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing electrolytes. Reviewer: David M. Charytan, M.D., M.Sc., Department of Medicine, Division of Nephrology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.Date: 08/03/2006

Peritonitis - dialysis associated (1 image) (Doctor-Reviewed information)
Dialysis-associated peritonitis is inflammation of the lining of the abdominal cavity (peritoneum), which occurs in those who receive peritoneal dialysis. Reviewer: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.Date: 10/09/2006

End-stage kidney disease (1 image) (Doctor-Reviewed information)
End-stage kidney disease is a complete or near complete failure of the kidneys to function to excrete wastes, concentrate urine, and regulate electrolytes. Also called End-stage renal disease (ESRD. Reviewer: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.Date: 08/14/2007

Renovascular hypertension (1 image) (Doctor-Reviewed information)
Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys. It is a form of secondary hypertension. See also: Drug-induced hypertension; Essential hypertension; Malignant hypertension. Reviewer: Robert Mushnick, M.D., Clinical Assistant Professor, Department of Nephrology, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.Date: 05/15/2007

Chronic bilateral obstructive uropathy (2 images) (Doctor-Reviewed information)
Chronic bilateral obstructive uropathy is the prolonged or progressive blockage of urine flow from both kidneys. Reviewer: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.Date: 05/03/2006

Prerenal azotemia (2 images) (Doctor-Reviewed information)
Prerenal azotemia is an abnormally high level of nitrogen-type wastes in the bloodstream. It is caused by conditions that reduce blood flow to the kidneys. Reviewer: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.Date: 05/03/2006

Renal and urological disorders (2 images) (Doctor-Reviewed information)
Renal disorders are diseases of the kidneys. Urological disorders are diseases of the kidneys/urinary tract. Reviewer: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.Date: 08/14/2007

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