Kidney Failure

Prevention

Many forms of kidney failure cannot be prevented. People who have diabetes, high blood pressure or coronary artery disease should try to control the illness with appropriate diet, medication and lifestyle changes. If chronic kidney failure already has developed, treating the other medical problems and avoiding other kidney injury (by avoiding certain medications, for example) may prevent worsening of kidney function. If you have chronic kidney failure, you should tell any physician who treats you so that he or she can avoid prescribing certain medicines or treatments.

Treatment

Treatment depends on the type of kidney failure.

  • Acute renal failure Treatment begins with measures to correct the cause of renal failure (shock, hemorrhage, burns, heart attack, etc.). After this has begun, more specific kidney treatment may include fluids given intravenously (into a vein) to correct any abnormal fluid loss, medicines called diuretics that increase urine output, limited fluids by mouth, a diet low in protein and high in carbohydrates, medications to adjust high or low levels of blood chemicals such as potassium, and medications to control high blood pressure. If the patient develops severe high blood pressure, severe fluid overload, congestive heart failure, symptoms of altered brain function or severe abnormalities in blood chemistry, short-term dialysis may be necessary.
  • Chronic renal failure People with chronic renal failure are monitored closely with frequent physical examinations, blood pressure checks and blood testing. Treatment includes a low-protein and low-salt diet, medications to adjust blood chemical levels, medications to treat high blood pressure and sometimes a hormonal medication called erythropoietin (Epogen, Procrit) to correct anemia (a low level of red blood cells).
  • End-stage renal disease End-stage renal disease is treated with dialysis until a suitable donor can be found for a kidney transplant. Dialysis mechanically removes waste products from the blood. In patients with severe high blood pressure or chronic pyelonephritis, both kidneys may need to be removed surgically before a transplant.

When To Call A Professional

Many people with acute renal failure already are hospitalized for their other medical conditions when kidney failure develops. Other people should call a health care professional whenever the amount of urine they produce either increases or decreases markedly. In people with decreased urine output, swelling of the face and ankles is another danger sign, especially if there is also shortness of breath. For people with chronic renal failure, it is a good idea to check with your health care professional whenever a new medication is prescribed.

Prognosis

Most children with acute renal failure have a good outlook for recovering their kidney function, although in rare cases, end-stage renal disease can develop. Among adults, the chances of recovery depend primarily on the underlying reason for acute renal failure rather than the renal failure itself. Among people who recover, about 50 percent have some permanent kidney damage, but in most cases, this is not severe enough to prevent them from living a normal life.

People with chronic renal failure may have a continuing decrease in kidney function, but not everyone develops end-stage renal disease. For those who do, the time it takes for end-stage renal disease to develop varies from person to person.

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