CRF ( Chronic Renal Failure )

Definition
Chronic renal failure is a gradual and progressive loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes.

Causes and risk factors
The most common causes of chronic renal failure are diseases or illnesses that damage the kidneys little by little for many years. These include high blood pressure, diabetes mellitus, polycystic kidney disease, obstructions of the urinary tract, glomerulonephritis, certain cancers, analgesic nephropathy, kidney stones and infection, autoimmune disorders such as systemic lupus erythematosus, and diseases of the heart or lungs. Using painkilling medications for a long period time may also damage the kidneys and cause chronic renal failure.

Symptoms
Because chronic renal failure progresses gradually, symptoms may be so mild
# At first, symptoms include frequent urination, especially at night. The urine is dilute, which means it has a high water content, making it appear pale to clear in color.
# Nausea, fatigue, confusion, joint pain, reduced urination, blood in the urine, seizures, headaches, itching, pain in the kidney area, and a yellowish-brown appearance to the skin.
# Chronic renal failure can lead to coma and death.
# Unintentional weight loss

Additional symptoms that may be associated with this disease:
# Excessive thirst
# Abnormally dark or light skin
# Paleness
# Nail abnormalities
# Breath odor
# High blood pressure
# Loss of appetite
# Agitation

Diagnosis
To diagnose chronic renal failure:
# physical examination, checking specifically for any enlargement or tenderness in the kidney area.
# blood and urine tests to check levels of waste products, sodium, and potassium in bloodstream and urine. Levels of waste products called creatinine and urea will be high in patients with renal failure.
# Check bladder and may need to insert a tube, called a catheter, into the bladder to remove urine.
# With abdominal ultrasound, abdominal computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans, which produce a picture of the kidneys and surrounding structures. Renal or abdominal x-ray.
# Arterial blood gas and blood chemistry analysis may show metabolic acidosis

Treatment
# Treatment for chronic renal failure depends upon the cause, focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.
# Don’t forget to Control of blood pressure .Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia.
# Fluid intake may be restricted, often to an amount equal to the volume of urine produced.
# Dietary protein restriction may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.
# Dialysis or kidney transplant may be required eventually.

Prognosis
There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic renal failure.

Complications
# End-stage renal disease
# Pericarditis
# Cardiac tamponade
# Congestive heart failure
# Hypertension
# Loss of blood from the gastrointestinal tract
# Ulcers
# Hemorrhage
# Anemia
# Decreased functioning of white blood cells
# Decreased immune response
# Increased incidence of infection
# Peripheral neuropathy
# Joint disorders
# Changes in glucose metabolism
# Electrolyte abnormalities including hyperkalemia