Kidney Failure And Related Isssues

Abstract

This paper is dedicated to National Kidney Month and touches on several areas about and related to kidney disease. A brief overview of kidney failure includes what the kidneys do, why they fail, how they fail, signs & symptoms, and treatment, is given in the first section of the report. The paper then discusses the functional limitations and rehabilitation implications associated with Chronic Kidney Disease. Current issues such as the donor waiting list, Medicare, analgesic medicines and kidney failure, and government involvement are also discussed. Four websites are discussed briefly in hopes to guide readers to excellent information sources about kidney disease and the 1 in 9 Americans with the disease.

More than 20 million Americans have undetected moderate chronic kidney disease, according to the National Kidney Foundation, and another 20 million more are at risk. The kidneys are twin organs used by the body to perform a variety of functions such as controlling water and waste, producing hormones, and cleansing blood. Kidney failure results in a variety of reasons relating to damage of the nephrons and can be categorized into three groups. Signs and symptoms of kidney disease are important to know due to the slow course of failure most kidneys go through. Once kidney failure is irreversible, dialysis or transplantation are the only methods of survival. Functional limitations and rehabilitation implications are present, yet fairly manageable with kidney failure. The disease also deals with current issues such as the donor waiting list, Medicare, analgesic medicines and kidney failure, and government involvement. Four websites are discussed briefly in hopes to guide readers to excellent information sources about kidney disease and the 1 in 9 Americans it affects.

Overview:

What are Kidneys?

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) says (2005), "The kidneys are sophisticated reprocessing machines." They are vital organs essential to our everyday health. The kidneys perform a variety of functions to keep blood clean and chemically balanced. The urinary system cleanses the blood and rids the body of excess waste and water.

The kidneys are located near the middle of the back just below the rib cage. Every

day, these two fist-sized, bean-shaped organs process about 200 quarts of blood to sift out

about two quarts of waste products and extra water (Abott, 2003). The kidneys are

attached to the bladder by tubes called ureters. The ureters carry urine from the kidney to

the bladder. The body can function typically with one healthy kidney if needed.

Along with controlling the fluids in the body, the kidneys also direct cell activities through production of hormones. Blood pressure is controlled, for example, by the hormone rennin. Other important substances the kidneys manage are sodium, potassium, chloride, bicarbonate HCO3, pH, calcium, phosphate, and magnesium (American Chemistry Association 2001-2006).

Why do they fail?

Kidney disease results from damage to the nephrons, the tiny structures inside the

kidneys that filter blood. Usually, the damage to the nephrons occurs slowly and silently over years and typically happens in both kidneys. There aren't any obvious symptoms during the course of kidney failure, so it is hard to know it's happening and can be years or decades before discovered (American Association of Kidney Patients, 2006).

There are more that 100 disorders, diseases, and conditions that can lead to progressive destruction of kidney failure. Two of the most common causes of kidney disease are hypertension (high blood pressure) and diabetes (NKUDIC, 2005). The American Association of Kidney Patients (2006) notes that, "Of all the patients who have kidney failure, 43.7 percent have diabetes and 26.5 percent have high blood pressure." In diabetes, the body doesn't use glucose very well. When glucose stays in the blood stream, it can act like a poison. Damage to the structure of the nephrons from unused glucose results in diabetic nephropathy (NKUDIC, 2005). High blood pressure can damage the small blood vessels and can reduce the flow of blood to the kidneys as well. When this happens the kidneys cannot filter wastes from blood effectively.

Other causes of kidney failure include glomerulonephritis, nephrotic syndrome, polycystic kidney disease, systemic lupus erythematousus, chronic pyleonephritis or kidney infection, kidney stones, and prostate obstruction. Some kidney diseases result from hereditary factors, and can run in families. Poisons and trauma are another cause of kidney failure. It is also important to know that long-term use of some over-the-counter medicines and/or prescribed pain medications can be poisonous to the kidneys (Abott, 2003).

How do Kidneys Fail?

Kidney failure can be categorized into three sections: Acute Renal Failure (ARF), Chronic Kidney Disease (CKD), and End-Stage Renal Disease (ESRD). When both of the kidneys fail, the body begins to hold fluid causing blood pressure to rise. Harmful wastes build up in the body making it hard for the kidneys to filter blood. In turn, the body doesn't make enough red blood cells (Singh, 2003). Sudden drops in kidney function characterize ARF. Kidney function is lost quickly due to a possible accident or injury of the kidney. Large amounts of rapid blood loss can also be categorized in ARF (Falvo, 2005). Chronic Kidney Disease happens slower than ARF. Individuals diagnosed with this have typically had gradual loss of kidney function or renal insufficiency for years. End-stage Renal Disease refers to total or nearly total and permanent kidney failure. Individuals to reach this stage must undergo dialysis or transplantation to stay alive (NKUDIC, 2005).

Signs & Symptoms:

Due to the fact that kidney disease can have no signs or symptoms for years, it is important to do routine blood and urine tests. These tests detect blood or protein in the urine and abnormal chemical levels in the blood, such as creatinine and blood urea nitrogen. The National Kidney Foundation (NKF) (2006) list the following important signs of kidney disease:

. fatigue

. trouble concentrating