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Chronic Renal Failure
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page
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Chronic renal failure is a gradual and progressive loss of the
ability of the kidneys to excrete wastes, concentrate urine, and
conserve electrolytes.
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Kidney failure - chronic; Renal failure - chronic; Chronic renal
insufficiency; CRF; Chronic kidney failure
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Unlike acute renal failure with its
sudden, reversible failure of kidney function, 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. Progression may continue to end-stage renal
disease(ESRD).
Chronic renal failure results in the accumulation of fluid and waste
products in the body, causing azotemia and uremia. Azotemia is the
buildup of nitrogen waste products in the blood. It may occur without
symptoms. Uremia is the state of ill health resulting from renal
failure. Most body systems are affected by chronic renal failure. Fluid
retention and uremia can cause many complications.
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Initial symptoms may include the following:
- Unintentional weight loss
- Nausea, vomiting
- General ill feeling
- Fatigue
- Headache
- Frequent hiccups
- Generalized itching
Later symptoms may include the following:
- Increased or decreased urine output
- Need to urinate at night
- Easy bruising or bleeding
- May have blood in the vomit or in stools
- Decreased alertness
- drowsiness, somnolence lethargy
- confusion delirium
- coma
- Muscle twitching or cramps
- Seizures
- Uremic frost -- deposits of white crystals in and on the skin
- Decreased sensation in the hands, feet, or other areas
Additional symptoms that may be associated with this disease:
- Excessive nighttime urination
- Excessive thirst
- Abnormally dark or light skin
- Paleness
- Nail abnormalities
- Breath odor
- High blood pressure
- Loss of appetite
- Agitation
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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.
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Creatinine levels progressively
increase
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BUN is progressively increased
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Creatinine clearance progressively
decreases
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Potassium test may show elevated
levels
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Arterial blood gas and blood
chemistry analysis may show metabolic acidosis
Changes that indicate chronic renal
failure, including both kidneys being smaller than normal, may be seen
on:
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Renal or abdominal x-ray
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Abdominal CT scan
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Abdominal MRI
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Abdominal ultrasound
This disease may also alter the results
of the following tests:
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Urinary casts
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Renal scan
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PTH
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Serum magnesium - test
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Erythropoietin
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ant skin infection
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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.
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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.
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Kidney - blood and urine
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