Kidney failure Prevention is better than cure
Faced with a daily stressful routine most of us forget to take enough water but as we neglect this necessity, we forget that inadequate water intake may result in severe kidney complications
The function of the kidneys is, among other things, to get rid of the waste products that result from the body’s metabolism. One of the major by-products of the metabolism of protein (muscle) is urea. The kidneys remove the waste products by extracting them from the blood and sending them along the ureter to the bladder, from where they are excreted in the urine.
If the kidney function fails, the waste products accumulate in the blood and the body. The term for this build-up is azotaemia.
Very mild levels of azotaemia may give little or no symptoms, but if the kidney failure continues then symptoms will start to appear.
If the kidney (or renal) failure is of sufficient degree to cause symptoms, it is called uraemia.
What causes renal failure?
Renal failure can happen rapidly - over days, weeks or months (acute renal failure) or slowly over a period of years (chronic renal failure).
Acute renal failure
This may occur with any serious illness or operation, particularly those complicated by severe infection. If the blood supply to the kidneys is reduced considerably from blood loss, a fall in blood pressure, severe dehydration or lack of salt, then the kidneys may be damaged. If this problem lasts long enough there can be permanent damage to the kidney tissue.
Sudden blockage to the drainage of urine from the kidney can cause damage. A kidney stone is a possible cause of this.
Acute kidney damage can occur as a rare side effect of some medications and other rare conditions.
Chronic renal failure
There are many causes of chronic renal failure, including inflammatory conditions affecting the kidney tissue, as a complication of long-standing diabetes mellitus (sugar diabetes), chronic blockage to the drainage of the kidneys and as a result of certain inherited conditions such as polycystic kidney disease. Often, the cause has occurred many years earlier and cannot be identified.
What are the symptoms?
Acute renal failure
Here the symptoms are largely those of the condition causing the kidney failure, such as:
l blood loss, causing a drop in blood pressure.
l vomiting and diarrhoea, causing dehydration.
l crush injuries. If large amounts of muscle are damaged there is a release of toxic protein substances that are harmful to the kidneys.
l Sudden blockage of urine drainage.
Chronic renal failure
The damage to the kidneys is usually ‘silent’ and not noticed at an early stage. It may be discovered incidentally from blood or urine tests done for other reasons. High blood pressure very commonly occurs with it. Symptoms are uncommon unless kidney failure is far advanced, when any of the following may be present:
l tiredness
l itching
l loss of appetite
l nausea and vomiting
l breathlessness
l fluid retention, shown as ankle swelling (oedema)
l weakness.
How is renal failure treated?
Acute renal failure
Most causes of acute renal failure can be treated and the kidney function will return to normal with time. Replacement of the kidney function by dialysis (artificial kidney) may be necessary until kidney function has returned.
Chronic renal failure
Chronic kidney damage is usually not reversible and if extensive, the kidneys may eventually fail completely. Dialysis or kidney transplantation will then become necessary.
Chronic kidney failure is a serious condition which needs urgent attention when it is diagnosed, but the kidney damage is usually ‘silent’ and not noticed at an early stage.
Occasionally it may be possible to identify and treat the cause of the renal failure itself. More commonly the treatment has to be non-specific. In all cases, careful blood pressure control is extremely important in slowing the progress of kidney failure. One or more medicines to lower blood pressure may be given.
Changes in diet may be necessary and include reducing salt intake, avoiding foods containing a lot
of potassium and reducing the
amount of protein and phosphate in the diet.
Anaemia commonly results from chronic renal failure, but can be easily treated with injections of the hormone erythropoietin.
Supplements of vitamin D in the form of alfacalcidol or calcitriol help to prevent a bone condition that can occur in chronic renal failure, called renal osteodystrophy.
Itching is a common complaint in people with renal failure, and antihistamines such as chlorpheniramine may be prescribed to control this.
It is important to avoid certain medications, eg ibuprofen, non-steroidal anti-inflammatory drugs (NSAIDs), that may worsen kidney function.
Dialysis
There are two main types: peritoneal dialysis and haemodialysis.
Peritoneal dialysis
The peritoneum is the clear membrane that covers the internal organs inside the abdomen. To carry out dialysis, a plastic tube is placed within the abdomen and led out to the skin surface on the tummy (the tube can be left in place for a long time). Specially made fluid is run into the abdomen, left for a few hours and then run out again to wash out the toxic substances from the body.
This is a successful form of treatment that most people can learn to carry out themselves at home, with support from the renal team and the family practice.
Haemodialysis
This is carried out by leading the person’s blood through an ‘artificial kidney’ machine that cleans the blood and returns it by tubing to a vein. It can be carried out over a few hours, and needs to be repeated, on average, every couple of days. It is done in a specialised dialysis unit attached to a hospital.
If renal failure is irreversible (a condition known as end stage renal failure or ESRF), then long-term dialysis becomes necessary. Kidney transplantation is carried out whenever possible.
— Discovery Health
Common cold
A cold is a contagious viral disease which infects the soft lining (mucous membrane) of the nose. There are more than 100 different viruses which can result in a cold. The characteristic symptom is a runny nose.
Usually, it is a mild condition, recovery taking place within about a week. However, sometimes the same symptoms occur with other illnesses like influenza.
It is most common during the cold winter months and affects children and adults of all ages. Most people will catch a cold two to four times a year.
How do we catch a cold?
A person is contagious from the day before the illness breaks out until one to three days after they feel better. The infection is spread by airborne droplets when the sufferer coughs or sneezes. It can also be spread by hand if someone has the virus on their hands and then puts them close to their eyes or nose. This is possibly the most common way of catching a cold.
What are the symptoms of a cold?
l A sore throat.
l There may be pain on swallowing.
l Sneezing.
l The nose begins to run with a water-like secretion which gradually becomes thicker and more yellow.
l As the mucous membrane of the nose swells it may be hard to breathe through the nose.
l An oppressive feeling in the ears.
l Headache.
l Coughing.
l A feeling of being unwell.
l A high temperature. Children are more likely to run a temperature than adults.
What can you do to avoid catching a cold? \
l If possible, stay away from people with colds.
l Avoid crowded places where the risk of infection is greater.
l Do not touch your nose or eyes after being in physical contact with somebody that has a cold.
l Wash your hands thoroughly, especially after blowing your nose.
l Keep rooms well aired.
How does the doctor make a diagnosis?
Consultations with a doctor are unnecessary, unless the cold causes other infections.
Outlook
Usually a common cold causes no serious trouble and symptoms will clear up in one to two weeks. Possible complications include inflammation of the eyes, sinusitis, inflammation of the middle ear, tonsillitis, and pneumonia. The reason for these complications may be that a germ infects the irritated mucous membrane.
How do you treat a cold ?
There is no effective way of treating an ordinary cold. If the sufferer has no other diseases than the common cold, and it goes away in one to two weeks, there is no reason to see a doctor. Since a cold is caused by a virus, antibiotics are not appropriate.
Symptoms such as cough, sore throat, nasal congestion and headache can be relieved by a variety of over-the-counter medicines. You can get advice from a pharmacist about which are most suitable for you and your symptoms.
There is no need to reduce daily activities but you should expect to become tired more easily.
The symptoms can be relieved by warm drinks.
Medicines (nasal decongestants) that prevent a swelling of the mucous membrane of the nose may ease breathing.
Sleep with the head on a high pillow.
Avoid smoking; it irritates the mucous membrane of the nose further.
Throw away paper tissues after use to prevent the spread of infection.
— Discovery Health
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