OUR kidneys play a major role in the body by filtering waste material and excess fluids from the blood so these can be removed from the body through urine.

If you suffer from chronic kidney disease and it reaches an advanced stage, dangerous levels of waste, fluid and electrolytes can build up in your body. Gradually the kidneys deteriorate, possibly resulting in their eventual failure to function.

Some people who suffer chronic kidney disease can end up with complete kidney failure, although this does not commonly happen.

However, if the damage to your kidneys continues to worsen,they will slowly lose their ability to do their job. Kidney failure is the last and most severe stage of chronic kidney disease. This is why kidney failure is also called end-stage renal disease (ESRN).

Causes

In most cases, kidney failure is caused by other health problems that have done permanent damage to your kidneys bit by bit over a lengthy period.

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Diabetes is the most common cause of end-stage renal disease. High blood pressure is the second most common cause. Other problems that can cause kidney failure include autoimmune diseases such as lupus and IgA nephropathy, a kidney disease that occurs when an antibody called immunoglobulin A (IgA) lodges in your kidneys.

Damage can also be done through glomerulonephritis, which is an inflammation of the kidneys’ filtering units, and interstitial nephritis, which is inflammation of the kidney’s tubules and surrounding structures.

Genetic diseases that you are born with such as polycystic kidney disease, nephrotic syndrome and urinary tract problems can also cause end-stage renal disease.

Sometimes the kidneys can stop working suddenly. In some cases it can happen within two days. This type of kidney failure is called acute kidney injury or acute renal failure.

Common causes of acute renal failure include suffering a heart attack, drug abuse orinsufficient blood flowing to the kidneys, as well as some urinary tract problems.

However, this type of kidney failure is not always permanent. Your kidneys may go back to normal or almost normal with treatment if you do not have other serious health problems.

Having one of the health problems that can lead to kidney failure does not mean that you will inevitably have kidney failure. Living a healthy lifestyle and working with your doctor to control these health problems can help your kidneys work better for as long as possible.

Symptoms

If you have kidney failure, you may notice several symptoms which include itching, muscle cramps, nausea and vomiting, lack of appetite, swelling of your feet and ankles and spending too much or not enough time urinating.

You may also experience trouble catching your breath as well as have sleeping problems.

If you have acute kidney failure and your kidneys stop working suddenly, you may have symptoms that include abdominal pain, back pain, diarrhoea, fever, nosebleeds, a rash and sometimes vomiting.

Treatment

If you have end-stage renal disease, you will need dialysis or a kidney transplant to remain alive. There is no cure for end-stage renal disease but many people live long lives while on dialysis or after having a kidney transplant.

Being diagnosed with kidney failure can come as a shock, even if you have known for a long time that your kidneys have not been working well.

A complete lifestyle adjustment will have to be implemented, which may make coping with this new reality even harder. In some cases you may have to stop going to work or be advised that there are certain things that you can no longer do such as go to the gym for exercise.

Starting dialysis often means creating a new normal for yourself and your family.

There will be a lot to think about, from choosing a treatment option, to finding new ways to enjoy your favourite activities as well as manage a new diet. Professional advice for all of this will be required.

Complications

Your kidneys do many jobs to keep you healthy. Cleaning your blood is only one of their jobs. They also control chemicals and fluids in your body, help control your blood pressure and help make red blood cells.

Dialysis can do some but not all of the jobs that healthy kidneys do. Therefore, even when you are being treated for kidney failure, you may have some problems that come from having kidneys that donot function well.

Diet

Dialysis does some of the work that your kidneys did when they were healthy but it cannot do everything that healthy kidneys do. The main functions of the kidneys are taken over by an artificial process so even when you are on dialysis, you will need to limit what and how much you eat and drink.

Your dietary needs may depend on the type of dialysis you are on as well as your treatment schedule. There are two types of dialysis namely haemodialysis or peritoneal dialysis.

Haemodialysis is the commonest form of dialysis. Cimas Haemodialysis in Harare provides dialysis for up to 30 patients a day but has the capacity to treat as many as 60 a day.

During haemodialysis blood is diverted from your body through a dialysis machine, which acts as an artificial kidney. This may need to be done for three to five hours twice or three times a week for the rest or your life, unless you have a kidney transplant.

Another form of dialysis is peritoneal dialysis, which uses the lining of your abdomen or belly to filter your blood inside your body.A few weeks before you start peritoneal dialysis, a surgeon places a soft tube called a catheter in your abdomen.

When treatment starts, a dialysis solution containing water with salt and other additives is placed in a bag that is positioned so that the solution in it flows through the catheter into your abdomen.

When the bag is empty, you disconnect it and place a cap on your catheter so you can move around and do your normal activities.

While the dialysis solution is inside your stomach, it absorbs waste and extra fluid from your body.

After a few hours, the solution and the waste are drained out of your stomach into an empty bag and the waste can be disposed of in the toilet or tub.

When the solution is fresh, it absorbs wastes quickly. As time passes, filtering slows. For this reason, you need to repeat the process of emptying the used solution and refilling your bellywith fresh solution four to six times every day.

  • The information in this article is provided as a public service by the Cimas iGo Wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. — igo@cimas.co.zw or WhatsApp 0772 161 829 or phone 024-2773 0663