Renal insufficiency

Overview

When the kidneys no longer function properly, we speak of renal insufficiency or kidney failure. Acute renal insufficiency appears very suddenly, and urine production is reduced or totally absent. Chronic renal insufficiency gradually causes uraemia, i.e. high levels of waste products in the blood. Severe cases can only be treated with kidney dialysis or a kidney transplant.

Symptoms

Acute renal insufficiency

• Decreased urine output
• During the recovery phase, the kidneys make up for the neglect by producing abnormally large amounts of urine (polyuria)
• Uraemia (see below) can occur if renal insufficiency persists

Chronic renal insufficiency

Kidney function worsens progressively; in the end stages of the disease, uraemia can lead to death. Uraemia occurs when waste compounds that are normally eliminated by the kidneys accumulate in the blood. Symptoms include:

• High blood pressure
• Collection of fluid in the tissues (oedema), e.g. in the legs or lungs (causing weight gain and shortness of breath)
• Fatigue
• Headaches
• Loss of appetite
• Pale, yellowish grey skin
• Itching
• Nausea, vomiting, diarrhoea
• Heart sac inflammation
• Anaemia
• Confusion, cramps, disorientation, coma
• Tingling, partial paralysis

Causes and treatment

Causes

Acute renal insufficiency

• The kidneys don’t receive enough blood (e.g. owing to a cardiovascular disease, blood poisoning, persistent vomiting/diarrhoea, severe bleeding, etc.)
• The kidneys have been damaged (e.g. renal infarction, medication)
• Obstruction of urine outflow (e.g. kidney stone, urinary stone, bladder tumour, etc.)

Chronic renal insufficiency

• Diabetes mellitus (diabetes)
• High blood pressure
• Kidney infection
• Polycystic kidney disease (inherited disorder)
• Damage caused by medication

Further treatment by your doctor / in hospital

Possible tests

• Blood test (including measurement of kidney function such as the amount of creatinine)
• Urine test
• Ultrasound of the kidneys
• Removal of tissue samples (biopsy)
• CT scan (computed tomography)
• MRI (magnetic resonance imaging)

Possible therapies

• Kidney dialysis
• Kidney transplant in severe cases

What can I do myself?

• A healthy lifestyle with sufficient exercise and a balanced diet prevents high blood pressure and diabetes, and thus the risk factors for renal insufficiency

When to see a doctor?

• Cloudy or bloody urine
• Back ache in the vicinity of the lower ribs

Synonyms

Renal insufficiency, kidneys