end renal stage disease

What is the end renal stage disease?

End-stage renal disease is a condition in which your kidneys fail to work. As a result, wastes and fluid build up in the body. It is a serious disease and can lead to death. It cannot be fixed. Most cases of ESRD are caused by diabetes or high blood pressure. Some problems you are born with, some reactions to medicines, and some injuries can also cause ESRD.

Causes of end renal stage disease

End-stage kidney disease (ESRD) is when the kidneys are no longer able to work at a level needed for day-to-day life. The most common causes of end-stage renal disease are diabetes,high blood pressure and glomerulonephritis.

Chronic kidney disease is another common disease causing end-stage renal disease which may occurs after 10-20 years CKD onset.

Other common causes of end-stage renal disease are High blood pressure,Atherosclerosis Autoimmune diseases like systemic lupus erythematosus (lupus),Genetic disorders, such as polycystic kidney disease,Exposure to toxic drugs.

Risk facters of end renal stage disease
·Age-Risk of ESRD increases with age

·Gender-Men are more likely than women to develop ESRD

Weight-Overweight individuals, with higher body mass indices, have a higher risk of ESRD

Proteinuria-History of protein in the urine is a risk factor for ESRD

Low hemoglobin -Individuals with a history of low hemoglobin have a higher risk of ESRD

Nocturia-Individuals who frequently have to get up at night to urinate have a greater chance of ESRD

Diabetes -Diabetes is the biggest risk factor for developing ESRD; one-third of the people who develop ESRD have diabetes.

High Blood Pressure -Hypertension is the second most common cause of renal failure.

Glomerulonephritis -This disease damages the glomeruli, which are the filtering units in the kidney. It is the third leading cause of renal failure.

Symptoms of end stage renal failure are very low output of urine, lethargy, headaches, extremely itchy skin, swelling of the abdomen, arms, legs and face, muscle twitching or cramps, blood in vomit or stools, fuzzy tongue and ammonia smelling breath. End stage renal failure generally occurs when chronic renal failure has progressed to where the kidneys are only functioning at 10 percent of their capability.Symptoms in end-stage renal disease (ESRD) are unrecognized.Prevalence studies have focused on single symptoms rather than on the whole range of symptoms experienced. This article aimed to describe prevalence of all symptoms, to better understand total symptom burden.

1.fatigue/tiredness

The patients are no spirit to do anything,they often feel tired to do anything. In a word,they fall into low spirits and no physical strength to do even trivial things.

2.Pruritus

If kidney failure symptoms go unnoticed eventually waste build up in your arteries and veins will cause your skin to itch and become irritated. See a physician if you have consistently itching skin.

3.Anorexia

During the renal failure, the gastrointestinal tract mal-functions, wriggles slowly, the accumulation of poisonous substance and some nervous and social factors will also lead to loss of appetite and nausea.

4.sleep disturbance

This mainly refers to headache,dizziness,drowsiness,even sink into a coma. The patients sleep much longer and deeper than normal level. And drowsiness belongs to nervous system problem. It is related to the following factors. Firstly, the accumulation of some poisonous substance lead to nerve cells degenerated. Secondly ,the balance of electrolyte and acid-base is disturbed. Thirdly ,cerebral angiosperm led by renal hypertension.

5.Dyspnea

The poisonous substance through some mechanism damages the respiratory system.

6Anxiety/depression

During the treatment, endocrine dyscrasia ,the long course of the treatment ,the recurrence of illness and so on ,a series of factors may lead to the appearance of anxiety,fear and depression.

7.Take note of swelling

Since the renal failure is an inability to remove fluids from the body it may cause swelling in the ankles, hands or other extremities. Report any unexplained swelling to your physician as it may or may not be a sign of kidney failure.

8.cardiovascular system

Elevation of blood pressure ,arrhythmia is often observed in the early stage. In the end stage, fibrinous pericarditis and heart-failure may occur.

9.Watch for signs of anemia

Fatigue, paleness of skin color, shortness of breath in exercise, or other signs of anemia may be kidney failure. Symptoms such as these could be related to other conditions, but should be tested to discover the cause. Kidney failure leaves waste in the blood and makes the production of red blood cells more difficult, thereby reducing oxygen carrying capability.

10.Watch for changes in urine

If your urine becomes frothier than normal, darkens considerably, or becomes considerably lighter than normal it may be a sign of a problem with your kidneys. A more troubling symptom is the urge to urinate without an ability to do so.

When you undergo dialysis, there are two options. One is hemodialysis, which is a process that uses a machine to process your blood. It then filters out the waste using a solution, and then it places the clean blood back into your body. This treatment method is usually used three times per week, and it lasts three to four hours each time. Your physician may also prescribe peritoneal dialysis—a treatment that consists of a solution being inserted into your abdomen that is later removed using a catheter.

● Kidney Transplant

Kidney transplant surgery involves removing your diseased kidneys and replacing them with a donated organ. One healthy kidney is all you need. This means that donors are often living because they can donate one and continue to function normally. Kidney transplants are among the most-common transplant surgeries in the U.S.

● Treatment in our hospital

The principle of Blood perfusion is put patient's blood in vitro derivation, and the solid adsorbent, such as HA resin, the resin) in blood perfusion, removes some metabolic product in the form of adsorption and exogenous drug or toxicant and so on, after purification, put the blood back to patients, to achieve the purpose of treating diseases. At present the most commonly used clinical blood perfusion adsorbent resin.

●Other Management Techniques

Diabetics and those with hypertension must control their conditions. Both conditions benefit from drug therapy using angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs).

A diet low in sodium, potassium, and other electrolytes may be needed, along with fluid restrictions. Caloric intake may need to be increased, and protein consumption may need to decrease.

You may not know that you have a kidney problem until it is very far along. The only way to know how your kidneys are working is to have some simple medical tests.

● Blood Urea Nitrogen (BUN) and Creatinine

To see whether your kidneys are working properly. If they are not filtering the blood properly, the blood will contain excess amounts of creatinine and urea. Creatinine is a byproduct of muscle function, while urea is a waste product of protein metabolism.

Estimated Glomerular Filtration Rate -a measurement of how well the kidneys are processing wastes. Your doctor can calculate the GFR based on gender, age, body size, and blood creatinine level.

The formula used in clinical practice is called the Cockcroft-Gault equation:

Creatinine clearance or GFR (mL per minute) = (140 – age) X body weight in kilogram ÷ 72 X serum creatinine. If calculated for a female, this product is multiplied by 0.85. The GFR determines the stage of chronic renal disease.

StageGlomerular Filtration Rate (GFR)

1 over 90 mL/min (normal)

2 60-89 mL/min (mild decrease)

3 30-59 mL/min (moderate decrease)

41 5-29 mL/min (severe decrease)

5 under 15 mL/min (kidney failure or end-stage renal disease)

● Urine Tests

To see if the kidneys are working properly. If they are not working properly, your urine will contain protein. You may be asked to collect urine in a special container over a 24-hour period. This test will also show whether your kidneys are clearing creatinine at a normal rate. The amount of urine you produce is also significant. If your kidneys are failing-or starting to fail-you may produce little or no urine.

● Renal Imaging

The use of ultrasound,magnetic resonance imaging (MRI), or computed tomography (CT scan) to take pictures of the kidneys. These pictures will show whether urine flow is blocked or whether there is a change in the size of the kidneys.

Renal ultrasound (also called sonography). A noninvasive test in which a transducer is passed over the kidney producing sound waves which bounce off the kidney, transmitting a picture of the organ on a video screen. The test is use to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.

Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. Contrast CT usually cannot be done when there is kidney failure.

● How is ESRD different from CKD?

Chronic kidney disease (CKD) is when there is permanent damage to your kidneys. Your kidneys may still work well enough for you to live, even if they have some damage. If your kidneys keep getting worse, CKD can lead to kidney failure (ESRD). ESRD is the worsened development of CKD.
● Prevention

Treatment of chronic kidney disease may delay or prevent progression to ESRD. Some cases may not be preventable but there are some feasible ways to prevent this disease.

Keep the blood pressure below 130/80 , diet, and exercises.

Maintain a healthy weight, which can help prevent other diseases like Diabetes, high blood pressure, and heart disease.

dialysis or a kidney transplant to live. If your kidneys fail, they will not do these jobs well enough. Talk to your doctor about how you can prevent problems like high blood pressure, bone disease and anemia (not enough red blood cells).

Changing some of the foods you eat is also important. You will need to have a kidney friendly diet to help you feel better and avoid other problems.

Diet

● Eat a low-protein diet It is better to take animal protein instead of vegetable protein.

● Get enough calories if you are losing weight. The patients should get enough calories to keep the daily activities.

● Limit salt, potassium, phosphorous, and other electrolytes.

● Keep a positive attitude to the treatment.

● control the blood pressure in a normal range. The high blood pressure can damage the glomerulus and increase the elimination of the protein.

Drink

Patients should never touch alcohol. Strong tea and coffee are also not suitable for the patients. Water is a better choice for end stage renal disease patients but the quantity should be controled in a proper range. It is not wise for the patients to drink too much water.