Conditions

Kidney Disease/Renal Failure

There are many different forms of kidney disease that can eventually lead to kidney (or renal) failure. The two most common are glomerulonephritis (sometimes called nephritis for short) and Polycystic Kidney Disease.

Nephritis is an inflammation of the glomeruli, the tiny tufts of capillaries that filter the blood in the kidneys by removing fluid and waste products.

Polycystic kidney disease is an inherited disorder that produces multiple cysts on the kidneys. This causes enlargement of the kidneys and can interfere with kidney function.

Both forms of kidney disease can lead to kidney failure. The two forms of kidney failure, acute and chronic, can lead to death.

Acute kidney failure is a sudden loss of kidney function that is often related to a severe decrease in blood pressure (usually occurs with trauma or complicated surgery), severe infection, or severe/complicated illness. Acute kidney infection is a serious condition that is likely to require hospitalization; however, the kidneys are almost always able to resume normal function over a period of several weeks or months.

Chronic kidney disease failure is a slow, progressive destruction of kidney function, usually as a result of disease. When the kidney functions drop below 25% of capacity, it is usually considered end-stage kidney failure.

Once a patient reaches end-stage kidney failure, he or she will need kidney dialysis or transplantation to continue to survive.

Signs and Symptoms:

Glomerulonephritis:

• Smokey/red urine
• Flulike feelings
• Nausea
• Vomiting
• Limited ability to produce water
• Fluid retention

Polycystic kidney disease:

• High blood pressure
• Pain in the back & upper side
• Frequent nighttime urination
• Kidney stones
• Blood in urine

Acute kidney failure:

• Fluid retention
• Gastrointestinal tract bleeding
• Seizures
• Coma
• Nausea
• Vomiting
• Fatigue
• Agitation
• Confusion
• Drowsiness
• Possible coma

Chronic kidney failure:

• Abnormal urinalysis
• Hypertension
• Weight loss
• Nausea
• Vomiting
• Malaise
• Headache
• Decreased urine output
• Fatigue
• Decreased mental acuity
• Muscle twitches and cramps
• Gastrointestinal bleeding
• Jaundice
• Itching

Diagnosis:

Glomerulonephritis: Doctors look for protein or red blood cells in the urine. Kidney ultrasound, computer tomography scan or intravenous phyelogram may also be employed during the diagnosis procedure. In most cases, a kidney biopsy is needed in order to make a diagnosis.

Polycystic kidney disease: Ultrasound, magnetic resonance imaging, or computer tomography scan are the most common diagnostic procedures.

Acute kidney failure: If you are not already in the hospital, you will need to be admitted. There your doctor will attempt to determine whether you have acute failure or some other kidney disease that affects kidney function. This can be done through a complex system of laboratory tests and imaging procedures.

Chronic kidney failure: An x-ray study will be used to determine if both of your kidneys are smaller than normal (a sign of chronic damage). Occasionally, x-ray dye can worsen renal failure. Your doctor may use diagnostic studies that do not involve such dyes.

End-stage kidney disease is typically diagnosed when kidney functions fall below 25% of normal capacity. Since end-stage kidney disease is the end of a long progress of chronic kidney disease, most people diagnosed with end-stage have been under doctors care for 10, 15 or even 20 years.

Treatment Options:

Treatment depends on the type of disease and the overall health of the patient. Diet restrictions, medications, and surgical procedures are all employed to treat the more serious conditions involved in kidney disease.

Traditional Treatments:

Nephritis:
Treatment for acute nephritis involves avoiding salt and taking diuretic medication to increase urination. In more severe cases, corticosteroids are used to reduce inflammation and other medications are prescribed for complications such as high blood pressure and anemia. More potent immunosuppressive drugs may also be prescribed as necessary.

Polycystic kidney disease:
Cysts may be drained to prevent the enlarged kidneys from interfering with the function of other organs. High blood pressure is treated with medication.

Acute renal failure:
Acute renal failure is monitored closely for signs of infection, heart or neurologic problems, hypertension or gastrointestinal bleeding. Laboratory tests are used to detect any possible uremic poisoning or other chemical imbalances. Should problems occur, treatment with appropriate medications is necessary. Your doctor will monitor your fluid intake so that it is equal to the output. Usually a high-carbohydrate, low-protein diet will be recommended. Essential amino acids and glucose may be given by IV if your nutritional status is doubtful. This treatment sometimes provides a quicker recovery. Salt and potassium intake is usually restricted.

Chronic renal failure:
Treatment should begin immediately after chronic diagnosis. There's no cure for chronic renal failure but treatment can help control the symptoms, minimize the complications and slow the disease's progression. The most important component of treatment is control of any underlying diseases and complications. Hypertension, congestive heart failure, urinary tract infection, kidney stones, abnormalities of the urinary tract or some cases of glomerulonephritis should be treated appropriately. Moderate restrictions in dietary protein may be important in slowing the progression of chronic kidney failure. Restricting salt intake may decrease abnormally high blood pressure. Water intake should be regulated carefully. As the disease progresses, restriction of phosphate and potassium may be necessary.

End-stage disease:
Conservative measures are not enough once the disease has reached the end-stage. In some cases kidney transplantation is not in the best interest of the individual because of poor general health. Dialysis then becomes the only option.

Complementary and Alternative Therapies:

Generally, kidney disease does not respond well to alternative therapies and professional medical services should be sought. However, complementary and alternative therapies may help speed recovery of some forms of kidney disease and may help lessen the severity of symptoms.

Nutritional Supplementation:

• Digestive enzymes help to ensure complete digestion of foods, which relieves stressed kidneys. Take a full-spectrum digestive enzyme supplement providing 5,000 IU of lipase, 2,500 IU of amylase, and 300 IU of protease, plus 500 to 1,000 mg of pancreatin, with each meal.
  Warning: Long-term supplementation with pancreatin is not advised, as it can cause your pancreas to reduce its own production of this enzyme.
• Vitamin C is important for the health of the kidneys. Take 500 to 1,000 mg at least twice a day.
• Acidophilous is especially important if you are taking antibiotics. This supplement helps maintain the balance of healthy flora versus harmful bacteria in the digestive system. Follow the label directions.

Alternative Therapies:

• Dandelion root helps cleanse toxic metabolites from the kidneys. Take 500 mg twice a day for six weeks. Stop for one month, then repeat.
• Celery and parsley seeds are natural diuretics. Taken in combination, they are especially helpful if high uric acid levels are present in the blood.
• Other herbs that are beneficial for kidney problems include goldenrod tea, juniper berries, marshmallow root, nettle, parsley, red clover, and watermelon seed tea.

General Recommendations:

• Reduce your intake of potassium and phosphates if your levels of these are elevated.
• Avoid salt.
• Follow your doctor's fluid intake recommendations.
• Reduce your intake of animal proteins.
• If you are taking antibiotics for a kidney problem, do not take iron supplements as long as the problem exists.

Warnings:

Long-term supplementation with pancreatin is not advised, as it can cause your pancreas to reduce its own production of this enzyme.