Chronic Renal Failure
(Chronic Kidney Disease)
Chronic renal failure occurs when a kidney is damaged and cannot work effectively. Kidneys clean waste from the blood, which passes out of the body in urine. If the disease is caught early, damage to the kidney can be slowed, but not stopped completely.
Chronic renal failure is often caused by diseases such as high blood pressure, diabetes, and various kidney diseases ( kidney stone, benign prostatic hypertrophy, polycystic kidney disease, drug-induced kidney disease). In some patients, severe infections (eg, hepatitis B or HIV) or autoimmune diseases (eg, lupus) can also cause kidney disease.
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing chronic renal failure. If you have any of these risk factors, tell your doctor:
If you experience any of these symptoms, do not assume it is due to chronic renal failure. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.
The most reliable way to measure kidney disease is by testing for glomerular filtration rate. This is the speed at which blood enters, is cleaned, and then leaves the kidney. A rate of less than 60 milliliters every minute over three months indicates chronic kidney disease.
A blood test for levels of creatine is a part of calculating the filtration rate. Creatine is an acid that promotes muscle growth. When the kidney is not working effectively, the amount of creatinine in the blood increases. Other commonly ordered tests include calcium, phosphorus, parathyroid hormone, potassium, blood urea nitrogen (BUN), and bicarbonate.
A doctor also will test for protein in the urine, particularly for a protein called albumin. Questions about your personal and health histories will be asked to determine if there are any other causes for the results of the blood and urine tests.
Your doctor may order an ultrasound of the kidney.
Patients who are already at high risk for kidney disease should be tested more frequently so any damage can be diagnosed early. Patients with kidney disease will be referred to a specialist called a nephrologist, who is dedicated to managing kidney diseases. On rare occasion, a kidney biopsy is done.
Although chronic kidney disease cannot be cured, it is possible to slow the damage to the kidney in most patients. Your doctor may recommend any of the following:
To help reduce your chance of chronic kidney failure, take the following steps:
American Academy of Family Physicians
National Kidney Foundation
The Kidney Foundation of Canada
Chronic renal failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated October 18, 2012. Accessed November 1, 2012.
Pendse S, Singh AK. Complications of chronic kidney disease: anemia, mineral metabolism, and cardiovascular disease. Med Clin N Am. 2005; 89:549-561
Snyder S and Pendergraph B. Detection and evaluation of chronic kidney disease. Am Fam Physician . 2005; 72:1739-46. Available at: http://www.aafp.org/afp/20051101/1723.html . Accessed November 1, 2012.
Zandi-Nejod K, Brenner BM. Strategies to retard the progression of chronic renal disease. Med Clin N Am. 2005; 89:489-509
Last reviewed October 2012 by Adrienne Carmack, MD