Definition
Renal failure is the kidney injury which leads to reduced renal function and causes body waste accumulation. When the injury is irreversible, it is called chronic renal failure (CRF) or chronic kidney disease (CKD). When the kidney dysfunction is severe and leads to some particular symptoms, like edema, nausea, vomiting, and conscious disturbance, the condition is thus called as the advanced kidney failure with uremic symptoms.
Clinical Symptom (Uremic Symptoms)
Common symptoms of advanced renal failure include fatigue, nausea, vomiting, poor appetite, hiccup, itchy, edema, dyspnea, pale looking, and ecchymosis.
Treatment
Identifying the cause of renal failure and avoiding further aggravation of kidney function is important. When uremic symptoms develop, dialysis is the main treatment.
A. Diet control of renal failure patient:
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Protein: Chronic renal failure patients should receive protein restriction diet before dialysis. Because the nitrogen waste produced by protein catabolism can’t be eliminated by an impaired kidney, the uremic symptom will be more severe and the kidney will also be injured with high protein diet. Generally, the protein intake (including meat, eggs, mild and beans) should be restricted to 2/3 of normal amount.
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Sodium/salt: Salt intake should be restricted in chronic renal failure patients. Salt is mainly eliminated by kidney; salt retention will develop in patients with excessive salt intake which was presented by hypertension, pulmonary and generalize edema, heart failure and ascites.
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Potassium: Potassium is eliminated by the kidney and should be restricted in chronic renal failure patients. Retention of potassium will lead to hyperkalemia. Severe hyperkalemia may lead to arrhythmia and sudden death. Potassium is found particularly in leafy vegetables, most fruits (esp. orange, banana, and kiwi), fruit juice, and in potatoes, especially if they are fried or baked. Low sodium soy-bean oil also contains high potassium and should be avoided in renal failure patients. Never eat star fruit because it’s neurotoxic to renal failure patients.
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Phosphate: Phosphate should be restricted. Phosphate retention will lead to itchy skin and bone disorder. Phosphate is found in association with protein intake, especially milk and cheese. Other sources are convenient foods which have phosphates added by the food manufacturers.
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Fluid: Most people drink 1-2 liters a day and don't need to reduce fluid intake until kidney failure with decreased urine output.
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Energy and nutrition: Too few calories intake lead to the breakdown of muscle to provide energy. If you lose muscle you become weak and debilitated. Once this happens, it takes months to recover strength. Appetite is decreased in many patients with kidney failure, and in some it is necessary to provide supplements. Malnutrition can be a serious problem in severe kidney disease and in some dialysis patients. It tends to be a particular problem in people who have had other illnesses. Help from expert dietitians could be valuable.
B. Renal replacement therapy:
When a kidney is not good enough to remove waste and water from the body, the work can be taken place by peritoneal dialysis and hemodialysis.
In hemodialysis, the waste and water are removed via an artificial kidney. Patient should receive blood access creation and draw out the blood and clean the blood by the dialysis machine.
In peritoneal dialysis, patient should receive a tube connecting dialysis solution and peritoneum, and then dwell the dialysis solution in the abdominal cavity which removes waste and water from the body.
Renal transplantation is also a good way to take place of a failed kidney. When a proper kidney is available, patient can receive implantation of the new kidney (kidney transplantation) to take the work of previous failed kidney.
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