Kidney Failure and Kidney Disease

Kidneys are responsible for filtering waste, excess water and other impurities out of the blood, and expelling them in the form of urine. The kidneys also regulate the blood’s pH and balance its levels of minerals like sodium, calcium, phosphorus and potassium, as well as producing hormones that control blood pressure, make red blood cells and keep bones healthy.

Kidney Disease

Kidney disease, which affects about 37 million people in the United States, occurs when the kidneys become damaged and are unable to function properly, causing waste products and fluids to build up in a person’s body.

Diabetes and high blood pressure are the most common causes of kidney disease, accounting for about two-thirds of all cases.

Other causes of kidney disease include conditions such as:

  • Glomerulonephritis — an inflammation of the kidney’s filtering units
  • Interstitial nephritis — an inflammation of the kidney’s tubules and surrounding structures
  • Polycystic kidney disease — a condition that causes cysts to develop in the kidneys, interfering with their ability to filter waste products from the blood and often leading to kidney stones
  • Vesicoureteral reflux — a condition that causes urine to back up into a person’s kidneys
  • Diseases that affect the body’s immune system, such as lupus
  • Recurrent kidney or urinary infections
  • Kidney dysplasia — abnormal fetal development of one or both kidneys

Chronic Kidney Disease

Chronic kidney disease occurs when damage to the kidneys continues to get worse, causing the dysfunction of the organ to progress over time. Severe chronic kidney disease symptoms, including nausea, vomiting, anemia, shortness of breath, seizures, changes in urine output and pain or pressure in the chest can be an indication that a person is experiencing kidney failure — the last stage of chronic kidney disease.

Kidney Failure

When a person is in kidney failure, their kidneys have lost the ability to filter waste from their blood, and they will not survive without dialysis or a kidney transplant. In addition to chronic kidney disease, a sudden loss of blood flow to a person’s kidneys can also prompt kidney failure.

Some conditions that can cause this are:

  • Heart attack
  • Heart disease
  • Scarring of the liver or liver failure
  • Dehydration
  • A severe burn
  • An allergic reaction
  • A severe infection, such as sepsis

If a person’s body can’t eliminate urine, toxins build up and damage the kidneys, which can also lead to kidney failure.

This can be caused by:

  • Prostate, colon, cervical or bladder cancers
  • Kidney stones
  • An enlarged prostate
  • Blood clots within the urinary tract
  • Damage to the nerves that control the bladder

Other potential causes of kidney failure are:

  • A blood clot in or around the kidneys
  • Toxic heavy metal buildup
  • Drug and alcohol use
  • Vasculitis — an inflammation of blood vessels
  • Hemolytic uremic syndrome — the breakdown of red blood cells following a bacterial infection
  • Multiple myeloma — a cancer of the plasma cells in a person’s bone marrow
  • Scleroderma — an autoimmune condition that affects a person’s skin
  • Thrombotic thrombocytopenic purpura — a disorder that causes blood clots in small blood vessels
  • Chemotherapy
  • Dyes used in some imaging testing
  • Certain antibiotics

There are five different types of kidney failure:

  • Acute prerenal kidney failure — Caused by insufficient blood flow to the kidneys, this type of kidney failure is usually curable once the cause of the decreased blood flow is determined
  • Acute intrinsic kidney failure — This type of kidney failure is usually the result of a direct trauma to the kidneys, such as an accident or other physical impact. It can also result from toxin overload or a lack of oxygen to the kidneys, also known as renal ischemia, which can be caused by severe bleeding, shock, renal blood vessel obstruction, or glomerulonephritis
  • Chronic prerenal kidney failure — When blood flow to the kidneys is limited for a long period of time, they begin to shrink and lose function, resulting in this form of failure
  • Chronic intrinsic kidney failure — When a direct trauma to the kidneys causes long-term damage, intrinsic kidney disease can become chronic
  • Chronic post-renal kidney failure — A long-term blockage of the urinary tract can prevent urination and cause pressure, resulting in this form of chronic kidney damage

There are treatments available to slow the progression of kidney disease, so it’s critical for patients to work closely with their doctors if they notice kidney damage symptoms or signs of kidney failure. Treatment can also help manage kidney failure symptoms.

Kidney Disease and Kidney Failure Risk Factors and Complications

Diabetes and high blood pressure are the two leading causes of kidney disease and kidney failure, but there are several other risk factors to be aware of, including family history, age, race/ethnicity and other conditions like cardiovascular disease, kidney cancer, autoimmune diseases and polycystic kidney disease. People who smoke or are obese are also at an increased risk of developing kidney disease.

Because kidneys perform a vital function that affects how the entire body works, kidney disease complications can have a severe impact on many different parts of the body.

Some common complications of chronic kidney disease include:

  • Anemia
  • Gout
  • Bone disease
  • Heart disease
  • Damage to the central nervous system, which can cause seizures, personality changes and difficulty concentrating
  • High potassium levels, impairing the heart’s ability to function
  • Fluid buildup, leading to swelling in the arms and legs, high blood pressure and pulmonary edema
  • Decreased immune response
  • Pericarditis, which is an inflammation of the membrane that envelopes the heart
  • Pregnancy complications

Eventually, chronic kidney disease causes irreversible kidney damage and end-stage kidney failure, making dialysis or a kidney transplant necessary for survival.

What Is the Best Path to Kidney Disease and Kidney Failure Recovery?

There are many effective treatments for kidney diseases, most of which focus on eliminating the cause, managing the symptoms, preventing or controlling complications and slowing the progression of the disease. Underlying conditions like kidney stones and urinary tract infections can often be treated before they result in long-term kidney damage. Treatment for kidney disease complications may include dietary changes as well as medications to control high blood pressure and cholesterol, treat anemia, relieve swelling and protect a person’s bones. If chronic kidney disease has progressed to end-stage kidney failure, dialysis or a kidney transplant becomes necessary.

If you or a loved one are suffering from kidney failure or serious complications from kidney disease, transitional care might be necessary to help you achieve a successful recovery. Kindred transitional care hospitals have an interdisciplinary team of experts that focus on creating customized care plans for those with kidney disease and kidney failure. Treatment often includes dialysis, which filters impurities from your blood and maintains the chemical balance you need. Kindred’s collaborative team of doctors, nurses, therapists and experts work together to support recovery with a treatment plan designed specifically for you.

“Chronic kidney disease affects an estimated 37 million people in the United States, and almost a million of those have stage five kidney failure, requiring dialysis or a kidney transplant for survival,” says Dr. Sean Muldoon, Chief Medical Officer of Kindred Healthcare's Hospital Division. “When kidney function is limited or lost, it wreaks havoc on a person’s body and can cause serious complications. The best way to manage this medically complex scenario is with a customized care plan developed by a team of interdisciplinary doctors who can address every aspect of the disease. This is what patients who are suffering from kidney failure or complications of chronic kidney disease get from Kindred Hospitals — a collaborative team that focuses on holistic recovery and gives every patient the best chance for recovery.”


Success Spotlight: James' Story

James is a devoted husband and family man who is now semi-retired and enjoys working as a chef. One night he came home after having dinner with his family and started to experience chills and vomiting, and developed a high fever. An ambulance was called and James was rushed to the hospital, where physicians determined he was suffering from acute kidney failure and he had to be started on dialysis immediately. Physicians placed him on a ventilator and also gave him a feeding tube as he was unable to take anything by mouth.

For the next few days at the hospital, James was unconscious and unresponsive. Fortunately his physicians were able to stabilize his condition and he started to show signs of recovery. When he was strong enough he was transferred to Kindred Hospital for respiratory therapy, medical management and rehabilitation.

Although he still required dialysis and was worried at first that this might be a necessity for the rest of his life, James started to make progress toward a recovery and he had the support of his family who were at his side every day. He was able to regain his lung strength and his respiratory therapists celebrated with him the day he was able to be taken off the ventilator for good. His next accomplishment came with help from his speech therapist, who helped James relearn how to swallow safely, allowing him to begin drinking and eating a normal diet once more and the feeding tube to be removed. Not long after this achievement, James’ kidney function returned to normal and he no longer required dialysis.

With help from his physical and occupational therapists, James also made excellent progress with his rehabilitation and was nearly able to stand on his own by the time he was discharged from Kindred to continue his recovery. “I was very happy when I no longer needed dialysis,” James affirmed. “I’m glad to have overcome this problem and now I want to get my legs strong again so I can stand at the stove and cook again – that will be great! As soon as I get home I want everyone in my family to come and visit. I can’t wait to share my joy with my loved ones.”

 


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