Total Kidney Failure
To stay alive, a patient with total kidney failure must go on dialysis—hemodialysis or peritoneal dialysis—or receive a new kidney through transplantation. Patients with CKD who are approaching total kidney failure should learn as much about their treatment options as possible so they can make an informed decision when the time comes. With the help of dialysis or transplantation, many people continue to lead full, productive lives after reaching total kidney failure.
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Points to Remember
- The kidneys filter waste and extra fluid from the blood.
- The filtering process takes place in the nephron, where microscopic blood vessel filters, called glomeruli, are attached to fluid-collecting tubules.
- A number of different disease processes can damage the glomeruli and thereby cause kidney failure. Glomerulonephritis and glomerulosclerosis are broad terms that include many forms of damage to the glomeruli.
- Some forms of kidney failure can be slowed down, but scarred glomeruli can never be repaired.
- Treatment for the early stages of kidney failure depends on the disease causing the damage.
- Early signs of kidney failure include blood or protein in the urine and swelling in the hands, feet, abdomen, or face. Kidney failure may be silent for many years.
The Nephrotic Syndrome
- The nephrotic syndrome is a condition marked by very high levels of protein in the urine; low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol.
- The nephrotic syndrome is a set of symptoms, not a disease in itself. It can occur with many diseases, so prevention relies on controlling the diseases that cause it.
- Treatment of the nephrotic syndrome focuses on identifying and treating the underlying cause, if possible, and reducing high cholesterol, blood pressure, and protein in the urine through diet, medication, or both.
- The nephrotic syndrome may go away once the underlying cause, if known, is treated. However, often a kidney disease is the underlying cause and cannot be cured. In these cases, the kidneys may gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the patient will need to be on dialysis or have a kidney transplant.
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Definitions
Signs and Symptoms of Glomerulonephritis
edema (eh-DEE-muh): Swelling caused by the accumulation of fluid in cells and tissues. In kidney failure, fluid may collect in the feet, hands, abdomen, or face.
hematuria (HEE-muh-TOOR-ee-uh): Blood in the urine. Blood may turn the urine pink or cola-colored.
hypoproteinemia (HY-po-PRO-teen-EE-mee-uh): Reduced levels of protein in the blood.
proteinuria (PRO-tee-NOOR-ee-uh): Large amounts of protein in the urine.
uremia (yoo-REE-mee-uh): Accumulation of urea and other wastes in the blood. These wastes, which become toxic in large amounts, are normally eliminated through urination.
Diseases and Conditions
autoimmune (AW-toh-ih-MYOON) disease: A disease in which the body’s own disease-fighting cells attack the body itself.
hypertension (HY-per-TEN-shun): High blood pressure, a condition that can cause kidney damage or be caused by kidney disease.
idiopathic (id-ee-o-PATH-ik) disease: A disease that occurs without a known cause.
nephrotoxic (NEF-ro-TOKS-ik): Damaging to the kidneys.
sclerotic (skleh-ROT-ik) disease: A disease in which tissues become hardened or scarred.
systemic (sis-TEM-ik) disease: A disease that affects multiple parts of the body, often as a result of substances circulating in the blood.
Treatments and Procedures
biopsy (BY-op-see): A procedure in which a needle is used to obtain small pieces of tissue from an organ for examination under different types of microscopes, each of which shows a different aspect of the tissue.
dialysis (dy-AL-ih-sis): A medical treatment that removes wastes and extra fluid from the blood after the kidneys have stopped working.
immunosuppressant (im-YOON-oh-suh-PRESS-unt): A medicine given to block the body’s immune system.
plasmapheresis (PLAZ-muh-fer-EE-sis): A medical treatment in which the blood is treated outside the body to remove harmful antibodies, and then returned to the patient.
Kidney Parts and Organic Substances
antibody (AN-tee-BOD-ee): A molecule that protects the body against disease by attacking foreign tissues or organisms. Antibodies are also called immunoglobulins.
antigen (AN-tih-jen): A substance that triggers a response from the body’s immune system.
autoantibody (AW-toh-AN-tee-bod-ee): An antibody that attacks the body itself.
creatinine (kree-AT-ih-nin): A waste product in the blood that results from the normal breakdown of muscle. Healthy kidneys filter creatinine from the blood.
glomerulus (gloh-MEHR-yoo-lus): The tiny cluster of looping blood vessels in the nephron, where wastes are filtered from the blood.
lipid (LIP-id): One of several fatty substances used in cells. Excess lipids in the blood may result in harmful deposits in blood vessels.
nephron (NEF-rahn): One of a million tiny filtering units in each kidney. Each nephron is made up of both a glomerulus and a fluid-collecting tubule that processes extra water and wastes.
protein (PRO-teen): A substance found in food and used by the body to grow, repair tissue, and fight disease.
urea (yoo-REE-uh): A waste material found in blood after protein has been broken down. Healthy kidneys remove urea from the blood. Damaged kidneys may allow urea to accumulate in the blood, thus causing uremia
