Patient Education
Kidney and its functions:
The kidneys are among the most vital organs of the human body. Malfunction of the kidneys can lead to serious illness or even death. Each kidney has a very complex structure and function.
They have two important functions namely: to flush out harmful and toxic waste products and to maintain balance of water, fluids, minerals and chemicals i.e., electrolytes such as sodium, potassium, etc.
What is Kidney Failure?
Our kidneys perform several functions in order to maintain balance in our bodies. They filter waste products and excrete them in the urine. They adjust the amounts of water and electrolytes like sodium, potassium and calcium in the body. They also help excrete excess acid or alkali, maintaining acid base balance. A reduction in their ability to perform these tasks is called kidney/renal failure.
Two major types of kidney failures: Kidney failure may either be acute or chronic in nature.
What is Acute Kidney Failure?
Acute insults to the kidneys may cause a reduction or loss in their function within a short period of time like a few hours to days. This decline in function was previously called acute renal failure (ARF) but has been recently named Acute Kidney Injury (AKI) . This type of kidney failure is usually temporary. With proper treatment kidney functions return to normal in most patients.
What is Chronic Kidney Failure?
Gradual progressive and irreversible loss of kidney function over several months to years is called chronic kidney disease (CKD), (previously known as chronic renal failure or CRF). Declining kidney function may reach a stage when the kidneys stop working almost completely. This advanced and life-threatening stage of disease is called end stage Renal disease - ESRD.
Diet in Chronic Kidney Disease
The major role of the kidneys is to remove waste products and purify blood. Besides this, the kidney plays an important role in removing extra water, minerals and chemicals; it also regulates water and minerals like sodium, potassium, calcium, phosphorus and bicarbonate in the body. In patients suffering from chronic kidney disease (CKD), regulation of fluids and electrolytes may be deranged. Because of this reason even normal intake of water, common salt or potassium can cause serious disturbances in fluid and electrolyte balance. To reduce the burden on the kidney with impaired function and to avoid disturbances in fluid and electrolyte balance, patients with chronic kidney disease should modify their diet as per the guidance of the doctor and the dietitian. There is no fixed diet for CKD patients. Each patient is given a different dietary advice depending on clinical status, the stage of kidney failure and other medical problems. Dietary advice needs to be altered for the same patient at different times.
What is Dialysis?
Dialysis is a procedure by which waste products and excess water that accumulate in renal failure are removed from the body artificially. It is a life-saving technique for patients with End Stage Renal Disease (ESRD) or Acute Kidney Injury.
When is dialysis needed?
When the kidney function is reduced by 85-90% from the normal (ESRD) waste products and fluids build up in the body. The accumulation of toxins such as creatinine and other nitrogenous waste products leads to symptoms such as nausea, vomiting, fatigue, swelling and breathlessness. These are collectively termed as uremia. At this point, medical management becomes inadequate and the patient will need to start dialysis.
Can dialysis cure chronic kidney disease?
No. Chronic kidney disease is irreversible and once a patient reaches Stage 5 (ESRD), lifelong dialysis treatments will be needed unless successful kidney transplantation is performed. On the other hand, a patient with Acute Kidney Injury (AKI) may need dialysis support only for a short period until kidney function recovers.
What is peritoneal dialysis?
Peritoneal dialysis (PD) is another form of dialysis modality for the patients with kidney failure. It is widely accepted and effective. It is the most common method of dialysis done at home.
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The peritoneum is a thin membrane that lines the inner surface of the abdominal cavity.
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The peritoneal membrane is a natural semi-permeable membrane which allows waste products and toxins in the blood to pass through it.
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Peritoneal dialysis is a process of purification of blood through the peritoneal membrane.
What is kidney transplantation?
Kidney transplantation is a surgical procedure in which a healthy kidney (from a living donor or deceased - cadaver donor) is placed into the body of a person suffering from end-stage kidney disease (recipient). Kidney transplantation is the outcome of great advancement in medical science.
Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). Successful kidney transplantation may offer better quality of life and longer patient survival compared with dialysis. Life after successful kidney transplantation is almost normal.
What is diabetic kidney disease?
Persistent high blood sugar damages small blood vessels of the kidney in long-standing diabetes. This damage initially causes loss of protein in the urine. Subsequently it causes hypertension, swelling and symptoms of gradual damage to the kidney. Finally, progressive deterioration leads to severe Renal failure (ESRD). This diabetes induced kidney problem is known as diabetic kidney disease. Diabetic nephropathy is the medical term used for diabetic kidney disease.
What is Polycystic Kindey Disease?
Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic or inherited disease of the kidney, characterized by the growth of numerous cysts in the kidneys. In Polycystic kidney disease (PKD) other organs in which cysts can be seen are the liver, brain, intestines, pancreas, ovaries and spleen. In autosomal dominant PKD multiple clusters of cysts (fluid-filled sacs) are seen in both kidneys.
Sizes of cysts in PKD are variable (diameter ranging from a pinhead to as large 10 cm. or more). With time cysts increase in size and slowly compress and damage healthy kidney tissue. Such damage leads to hypertension, loss of protein in urine and reduction in kidney function, causing chronic kidney failure. In a long period (after years) chronic kidney failure worsens and leads to severe kidney failure (endstage kidney disease), ultimately requiring dialysis or kidney transplantation.
Disclaimer: Information provided here is for educational purpose only. Please do not indulge in any self diagnosis or treatment on the basis of the knowledge gained by the use of this information. You must always consult your doctor or other health professional for treatment.