Ryan Filkins 1

March 25, 2009

Chronic Renal Failure

Chronic renal failure, also known as chronic kidney failure and chronic renal

insufficiency, is the slowing ability of the kidneys to remove wastes, concentrate urine, and

conserve electrolytes. The National Kidney Foundation defines chronic renal failure as kidney

damage or a glomerular filtration rate of less than 60 mL per minute per 1.73 m2 for three

months or more. Chronic renal failure, unlike the disease acute renal failure, slowly gets worse.

Most often it results from any number of diseases that cause a gradual loss of kidney function.

Chronic renal failure can range from a mild dysfunction to severe kidney failure. Chronic renal

failure may lead to end-stage renal disease (ESRD). Usually chronic renal failure is a

progressive disease that occurs over a number of years as the internal kidney structures are

slowly damaged. In the earlier stages of the disease, one may not have any symptoms.

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 1 out of 500 people in the

United States. Some common causes are diabetes and high blood pressure. Other major causes

of chronic renal failure may include alport syndrome, analgesic nephropathy, glomerulonephritis

of any type, and kidney stones. Glomerulonephritis is another one of the most common causes

for this disease. Chronic renal failure is a result of an accumulation of fluid and waste products

in the body, which leads to a buildup of nitrogen waste products in the blood and ill health. Most

of the body symptoms are affected by chronic renal failure. Some of the initial symptoms of

chronic renal failure may include fatigue, frequent hiccups, generalized itching, headache,

nausea, vomiting, and unintentional weight loss. Symptoms that may occur later in the disease
 Ryan Filkins 2
March 25, 2009

include blood in the vomit or stools, decreased alertness, decreases sensation in the hands, feet,

or other areas, easy bruising or bleeding, increased or decreased urine output, muscle twitching

or cramps, seizures, or white crystals in and on the skin. Some other symptoms associated with

this disease include abnormally dark or light skin, agitation, breath odor, excessive nighttime

urination, excessive thirst, high blood pressure, loss of appetite, nail abnormalities, and paleness.

The goal of treatment is to control symptoms, reduce complications, and slow the progression of

the disease. Disease that result from or cause chronic kidney failure must be controlled and

treated. Fluids may be restricted, often to an amount equal to the volume of urine produced.

Protein restriction in the diet may slow the buildup of wastes in the blood and control the

associated symptoms such as nausea and vomiting. Some other components in the diet that may

be restricted include salt, potassium, phosphorus, and other electrolytes. Eventually dialysis or a

kidney transplant may be needed. Unfortunately, there is no cure for chronic renal failure. If left

untreated it usually progresses to end-stage renal disease. Lifelong treatment may control the

symptoms of chronic renal failure. There are many complications associated with chronic renal

failure. These may include anemia, cardiac tamponade, congestive heart failure, dementia,

encephalopathy, end-stage renal disease, fractures, hemorrhage, high blood pressure, increased

infections, joint disorders, liver inflammation, hepatitis B or hepatitis C, nerve damage,

pericarditis, peripheral neuropathy, platelet dysfunction, ulcers, seizures, skin dryness,

weakening of the bones, and changes in blood sugar metabolism. Treatment of the underlying

disorders may help prevent or delay the development of chronic renal failure. Diabetics should

control blood sugar and blood pressure levels closely and should also refrain from smoking.