Chronic renal failure is a slowly worsening loss of the ability of the kidneys to remove wastes, concentrate urine, and conserve electrolytes .
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:
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.
Initial symptoms may include the following:
Later symptoms may include the following:
Additional symptoms that may be associated with this disease:
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.
A urinalysis may show protein or other abnormalities. An abnormal urinalysis may occur 6 months to 10 or more years before symptoms appear.
Signs of chronic renal failure, including both kidneys being smaller than normal, may be seen on:
This disease may also alter the results of the following tests:
The goal of treatment is to control symptoms, reduce complications, and slow the progression of the disease.
Diseases that cause or result from chronic kidney failure must be controlled and treated as appropriate.
Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia .
Fluids may be restricted, often to an amount equal to the volume of urine produced. Restricting the amount of protein in the diet may slow the build up of wastes in the blood and control associated symptoms such as nausea and vomiting.
Salt, potassium, phosphorus, and other electrolytes may be restricted.
Dialysis or kidney transplant may eventually be needed.
There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease . Lifelong treatment may control the symptoms of chronic renal failure.
Calling your health care provider:
Call your health care provider if nausea or vomiting persists for more than 2 weeks.
Call your health care provider if decreased urine output or other symptoms of chronic renal failure occur.
Treatment of the underlying disorders may help prevent or delay development of chronic renal failure. Diabetics should control blood sugar and blood pressure closely and should refrain from smoking.