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Why Are My Kidneys Failing?

Kidney failure, also known as renal failure, occurs when the kidneys lose their ability to perform their primary functions effectively. These vital organs are responsible for filtering waste products and excess fluids from the blood, maintaining electrolyte balance, and producing hormones that regulate blood pressure and red blood cell production. Kidney failure can be acute or chronic, with a wide range of potential causes. In this article, we will discuss the various reasons for kidney failure, including underlying medical conditions, lifestyle factors, and other contributing elements that can lead to this serious health issue.

Some of the most common causes of kidney failure include:

  1. Diabetes: High blood sugar levels associated with diabetes can damage the delicate filtering system in the kidneys, leading to kidney disease and, ultimately, kidney failure if left untreated.

  2. High blood pressure (hypertension): Elevated blood pressure can harm blood vessels in the kidneys, impairing their ability to function efficiently. Uncontrolled hypertension is a major risk factor for kidney failure.

  3. Chronic kidney disease (CKD): This progressive condition involves the gradual loss of kidney function over time. CKD can be caused by various factors, including diabetes, hypertension, and autoimmune diseases.

  4. Glomerulonephritis: This group of diseases involves inflammation of the tiny filtering units within the kidneys, known as glomeruli. Glomerulonephritis can be triggered by infections, immune system disorders, or other factors.

  5. Polycystic kidney disease (PKD): A genetic disorder characterized by the formation of numerous cysts within the kidneys, PKD can lead to kidney damage and eventually kidney failure.

  6. Urinary tract obstructions: Blockages in the urinary tract, such as kidney stones or an enlarged prostate, can impede the flow of urine and cause pressure to build up in the kidneys, resulting in kidney damage.

  7. Certain medications: Some drugs, including over-the-counter pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) and certain prescription medications, can have harmful effects on kidney function when used excessively or improperly.

  8. Infections: Severe infections, such as sepsis, can damage the kidneys and lead to acute kidney failure.

  9. Autoimmune diseases: Conditions like lupus and Goodpasture syndrome can cause the immune system to mistakenly attack and damage the kidneys, leading to kidney failure.

What Happens When Kidneys Fail?

When kidneys fail, they lose their ability to effectively perform their essential functions. This can lead to a range of complications and symptoms, which may vary depending on the underlying cause and severity of the failure. The following list outlines some of the most common consequences and symptoms associated with kidney failure:

  • Accumulation of waste products and toxins in the blood, leading to a condition called uremia

  • Fluid retention and swelling (edema) in the extremities and lungs

  • Electrolyte imbalances, such as high potassium levels (hyperkalemia)

  • Anemia due to decreased production of erythropoietin, a hormone that stimulates red blood cell production

  • Fatigue and weakness

  • Nausea, vomiting, and loss of appetite

  • Shortness of breath

  • Changes in urine output, including decreased production or dark, bloody, or foamy urine

  • Mental confusion and difficulty concentrating

  • Persistent itching

  • Chest pain or pressure

Can I Reverse Failing Kidneys?

The possibility of reversing kidney failure depends on the underlying cause and the severity of the damage. In some cases, acute kidney failure may be reversible if the cause is promptly identified and treated, such as by addressing a urinary tract obstruction or managing a medication-related issue. However, chronic kidney failure is generally progressive and irreversible, as the damage accumulates over time. In such cases, the focus shifts to managing the condition and slowing the progression of kidney disease through medical intervention and lifestyle modifications.

What Are The Stages of Failing Kidneys?

Kidney failure is often classified into five stages, based on the glomerular filtration rate (GFR), a measure of kidney function. These stages help physicians determine the severity of kidney disease and guide the appropriate course of treatment. The stages are as follows:

  1. Stage 1: GFR ≥ 90 mL/min - Normal kidney function but with evidence of kidney damage, such as protein in the urine or structural abnormalities detected through imaging.

  2. Stage 2: GFR 60-89 mL/min - Mildly reduced kidney function and signs of kidney damage.

  3. Stage 3: GFR 30-59 mL/min - Moderate reduction in kidney function.

  4. Stage 4: GFR 15-29 mL/min - Severe reduction in kidney function, approaching kidney failure.

  5. Stage 5: GFR < 15 mL/min or on dialysis - Kidney failure, requiring dialysis or a kidney transplant for survival.

The following peer-reviewed studies provide insights into the various aspects of failing kidneys and the progression of kidney disease:

  1. Coresh, J., Selvin, E., Stevens, L. A., Manzi, J., Kusek, J. W., Eggers, P., ... & Levey, A. S. (2007). Prevalence of chronic kidney disease in the United States. JAMA, 298(17), 2038-2047.

  2. Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., & Hsu, C. Y. (2004). Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New England Journal of Medicine, 351(13), 1296-1305.

  3. Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The Lancet, 379(9811), 165-180.

  4. Levin, A., & Stevens, P. E. (2005). Summary of KDIGO 2012 CKD Guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney International, 85(1), 49-61.

  5. Tonelli, M., Wiebe, N., Culleton, B., House, A., Rabbat, C., Fok, M., ... & Klarenbach, S. (2006). Chronic kidney disease and mortality risk: a systematic review. Journal of the American Society of Nephrology, 17(7), 2034-2047.

Article Highlights:

  • Kidney failure can result from various causes, including diabetes, hypertension, chronic kidney disease, glomerulonephritis, and polycystic kidney disease.

  • Kidney failure leads to numerous complications, such as uremia, fluid retention, electrolyte imbalances, anemia, and mental confusion.

  • The possibility of reversing kidney failure depends on the cause and severity, with acute kidney failure potentially reversible in some cases, while chronic kidney failure is generally progressive and irreversible.

  • Kidney failure is classified into five stages based on the glomerular filtration rate (GFR), ranging from stage 1 with normal kidney function and evidence of damage to stage 5, requiring dialysis or a transplant.

  • Several peer-reviewed studies provide insights into the prevalence, risks, and progression of kidney disease.

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