Kidney or Renal Failure Can be:
- End stage (requiring dialysis or transplantation)
Renal or kidney failure occurs when the excretory function of the kidney fails. The kidneys are unable to filter out metabolic waste products (creatinine and blood urea nitrogen) and to concentrate urine, and this is accompanied to a variable degree by a failure of the regulation of the composition of body fluids, the control of red blood cell production (through the hormone erythropoietin), blood pressure (through the hormone renin), Vitamin D metabolism, and salt balance.Acute renal failure is a rapid decline in kidney function, which takes place over days or weeks, and which is usually reversible, whereas chronic renal failure is a much more slow but progressive process, which takes place over a period of months or years, and is normally irreversible. Chronic renal failure may progress to ESRD (end-stage renal disease).
Both acute and chronic renal failure may be treated by dialysis, those with acute renal failure normally recover.
Acute Renal Failure
Acute renal failure may or may not be accompanied by oliguria (reduced urine production) or anuria (ceasing of urine production) and should be treated as a medical emergency.
Acute renal failure successfully treated, usually lasts several days to several weeks at the most, and therefore would not fulfil the qualifying criteria for DLA.
Chronic Renal Failure
Chronic renal failure results from any progressive, destructive condition affecting both kidneys. The loss of kidney (renal) function progresses slowly over a period of months or years, and is not reversible.
The most common causes are diabetes mellitus (around 20- 40%) and hypertension (high blood pressure 5- 25%), which both harm small blood vessels in the body:
Other causes are:
- Glomerular diseases (diseases affecting the glomeruli in the nephrons of the kidney). Glomerulonephritis accounts for 10- 20% of cases.
- Congenital / inherited abnormalities in the kidneys such as polycystic kidney disease or Alport’s Syndrome. (5%)
- Systemic inflammatory disease where both the glomeruli and the small tubes (tubules) of the kidneys are damaged. An example of this is Systemic Lupus Erythematosis (SLE) and vasculitis. (5%)
- Interstitial Disease (5-15%) (nephritis)
- Drugs, especially analgesics, and non-steroidal anti- inflammatories, (and phenacetin in the past)
- Obstruction in the urinary tract, such as stones or prostatic disease
- Atherosclerotic renal vascular disease (more common in the elderly)
- Renal artery stenosis (narrowing)
- HIV- associated nephropathy
- Chronic infection such as chronic pyelonephritis
- Cancers affecting the body as a whole, the abdominal cavity, the pelvis or the urogenital system, and which may cause blockage to the vessels entering the kidneys, affect the kidneys themselves, or block the tubes or vessels leaving the kidneys