Key points:
- Acute kidney failure is characterized by a quick and sudden onset and is potentially reversible. Depending on the magnitude, it may or may not require kidney function replacement therapy (hemodialysis).
- Chronic kidney failure, better called chronic kidney disease, has an evolution of more than 12 weeks, a slow progression, and, in advanced stages, requires kidney function replacement therapy (hemodialysis, peritoneal dialysis, or transplant).
- The causes, symptoms, treatments, and consequences of each type of kidney failure are different.
The kidneys have multiple functions, one of which is the removal of toxins or waste from the blood. When this capacity is lost and high levels of toxins are reached, various symptoms caused by the imbalance in blood composition can occur. It is also important to consider how quickly and how much this function has been lost regarding the symptoms.
There are two types of kidney failure depending on the time of evolution. Acute kidney failure (AKF) has a sudden onset, it can be reversible, depending on the cause, and treatment will be aimed at its cause. On the other hand, chronic kidney failure, better called chronic kidney disease (CKD), has a greater progression – over 12 weeks -, it is generally not reversible and in advanced stages, when kidney function is less than 15%, kidney substitution treatment such as transplant, or hemodialysis or peritoneal dialysis should be considered.
As mentioned, the causes of both diseases, AKF and CKD, are different, so their symptoms, treatment, and consequences are also different.
“Adopting a healthy lifestyle and improving the treatment and control of diabetes and hypertension are effective ways to prevent chronic kidney disease. There are other prevention measures, for example, modifying poor working conditions and the use of agrochemicals, which are also considered risk factors, as has been observed in agricultural communities in Central America.”1
Acute kidney failure
It is considered as acute kidney failure, or acute kidney injury, when the kidneys suddenly lose their ability to filter waste from the blood and the ability to produce urine. This disease develops in a few days and can have many causes such as severe dehydration, severe infections, and drugs that are toxic to the kidneys. It is frequent in people who are already hospitalized, mainly in people suffering from critical illnesses who need intensive care. It must be identified early to prevent aftereffects since it is considered one of the main risk factors for developing chronic kidney disease. If not treated in time, acute kidney failure can be fatal.
The accumulation of uremic toxins is the cause of most of the symptoms since they accumulate in all organs and systems. Acute kidney failure symptoms include:
- Disorientation
- Decreased urine volume
- Chest pain
- Shortness of breath
- Fatigue
- Nausea
- Body fluid retention
- Irregular heart rhythm
- Seizures
- Coma,in severe cases
In its early stages, acute kidney failure may have no signs or symptoms and may be detected by laboratory tests performed for other reasons.
Chronic kidney failure
Chronic kidney failure, also known as chronic kidney disease (CKD), is a progressive and irreversible deterioration in kidney function for more than 12 weeks. It is considered that when kidney function is below 60%, symptoms related to it may occur, initially few and mild, and they increase when less than 15% of its capacity is reached. Therefore, it is common for the diagnosis to be made in advanced stages.
There are different symptoms such as:
- Muscle cramps
- Decreased mental agility
- Chest pain
- Shortness of breath
- Fatigue
- Swelling in feet or ankles
- Difficult-to-control hypertension
- Changes in urination (several times during the day and night)
- Nausea and vomiting
- Loss of appetite
- Sleeping problems
- Dry skin
Chronic kidney failure symptoms are not specific and may be caused by other diseases, which leads to a late diagnosis.
Chronic kidney disease has complications such as anemia and mineral and bone metabolism disorders that further complicate the patient’s health.
Treatments for kidney failure
Acute kidney failure treatment focuses on its prevention and/or progression, especially in its initial stages. When significant deterioration occurs, especially in critically ill patients, it may be necessary to perform kidney replacement therapy with intermittent hemodialysis, continuous hemodialysis (CRRT), or in some cases peritoneal dialysis.
Chronic disease treatment contemplates having the progression factors such as diabetes or high blood pressure controlled, as well as the treatment of associated complications such as anemia or bone mineral disorder. In advanced stages, it will be necessary to consider kidney function replacement therapy, with kidney transplant being the best option, so all patients in these stages must be evaluated as potential recipients. Other forms of replacement therapy are chronic intermittent hemodialysis or peritoneal dialysis.
Dr. Ernesto López Almaraz, a nephrologist at ABC Medical Center, says that individualized care is important, considering the cause of these diseases, whether the patient suffers from diabetes or lupus among other diseases, establishing their stage and proposing the best treatment for each patient according to their clinical condition.
At the ABC Medical Center’s Kidney Health Clinic we can provide you with specialized care. Contact us!
Fuente:
Dr. Ernesto López Almaraz – nephrologist at ABC Medical Center
https://youtu.be/gXZOkJRxxSI
https://www.niddk.nih.gov/health-information/informacion-de-la-salud/enfermedades-rinones/insuficiencia-renal/que-es
https://www.mayoclinic.org/es/diseases-conditions/kidney-failure/symptoms-causes.
https://www.mayoclinic.org/es/diseases-conditions/chronic-kidney-disease/symptoms-causes
1https://www3.paho.org/sociedad-latinoamericana-nefrologia-enfermedad-renal-mejorar-tratamiento
