The acute and chronic kidney diseases, arterial hypertension and diabetes, as well as the prolonged use of certain medications and intoxication by some heavy metals, can irreversibly damage the kidneys and lead to a ' renal insufficiency. Any significant kidney damage that lasts more than three months and does not recede with the treatment can be considered chronic, therefore, what we call chronic renal failure is the effect of a progressive and slow decline in the ability of the kidneys to filter the blood and purify it from the waste products of the body's metabolism, especially that of protein substances.
Causes of Renal Failure
Among the causes of renal failure, the most serious are currently diabetes and arterial hypertension because, if not properly controlled, they cause a rapid decrease in renal function. But they are not the only ones. Among the causes of chronic kidney disease that can lead to kidney failure, we also find:
- The glomerulonephritis and acute and conical pyelonephritis - inflammation of the small renal blood vessels (glomeruli) and the small tubes (tubules) through which the urine passes to be eliminated
- Obstruction of the urinary tract often with pyelonephritis, or a strong inflammation that involves all the urinary tract and the kidney itself
- Autoimmune diseases (such as systemic lupus erythematosus), in which antirene antibodies irreversibly damage the organ
- Some renal anomalies such as the presence of polycystic kidney disease.
As a result of these diseases there is an accumulation of waste substances or waste from the metabolism which lead first to the increase in the concentration of nitrogen (azotemia) and other substances in the blood, compromising its optimal balance and making it more acidic. This causes numerous other ailments that we will now see.
The blood and urine tests are essential to confirm the presence of poor renal function." In particular, for the complete diagnosis of renal insufficiency we perform:
Blood and urinary tests
Renal ultrasound test
Possible renal biopsy, KFT (Kidney function test), or the removal of a tissue sample from a kidney for examination (it could be the most accurate test, but it is not advisable if the results of an ultrasound examination show that the kidneys are small and with scars).
Urinalysis can detect the presence of proteins, abnormal cells and other problems. Azotaemia and above all, creatininemia (which analysescreatine, a substance contained in the muscles, present in the blood) are the best indicators for assessing the degree of renal failure (based on renal filtration capacity). Furthermore, there may be other blood changes- such as increased potassium, phosphate and parathyroid hormone in the blood, decrease in calcium, calcitriol and vitamin.
The ultrasound, which is done to exclude an obstruction or abnormality of the urinary tract and to verify the size of the kidneys, shows, in chronic renal insufficiency, the shrinking and irregularity of the kidney.
Having identified symptoms and diagnoses of chronic renal failure, we now want to understand what the consequences for the body are.