Renal Failure

Renal Failure Overview:

The kidneys are responsible for filtering the blood, and play a major role in regulating blood pressure through the RAAS system. When kidneys fail, toxic metabolites begin to build up in the blood which can affect a wide range of systems throughout the entire body. This is why late stage kidney failure has such a wide range of symptoms.

The kidneys are very good at compensating from damage to maintain homeostasis. Unfortunatly, this means that many of the symptoms of the condition will go unnoticed until the disease has progressed significantly. In order to prevent this, at risk individuals should be tested regularily to determine kidney function.

 

Aetiology:

+ Acute Renal Failure (ARF)

Acute renal failure involves a sudden decline of renal function that is significant enough to produce azotemia and perhaps even oliguria. This normally occurrs over a period of a few days or a few weeks, and is often irreversible.

Diagnosis relies on urea and/or creatinine levels, as well as loin pain and symptoms including azotemia and oliguria.

Acute renal failure can be cause by shock, acute glomerulonephritis, or obstructive disorders that interfere with the elminiation of urine from the kidney.

+ Chronic Renal Failure (CRF/CKD)

Chronic renal failure is much slower progressing than acute kidney failure, and is often reversible if caught early, but can be difficult to catch in time. Chronic renal failure is often asymptomatic in the early stages and therefore hard to catch before more significant implications appear.

Chronic renal fialure presents with raised blood urea and creatinine levels, and may be accompanied by hypertension, proteinuria, and/or anemia.

Chronic vs Acute Renal Failure

Acute Renal Failure Chronic Renal Failure
Onset Sudden Slow, progressive
Most Common Causes Sudden loss of blood Diabetes, hypertension
Symptoms Rapid reduction in urine output Can be asymptomatic up to 75% loss of function.
Prognosis Reversible if due to pre- renal causes Not reversible
Pathophysiology Tubular cell death and regeneration Nephron loss
 

Symptoms:

Postural Hypotension

Malignant hypertension

Autoimmune conditions

Loin pain

Fever

Oliguria

Low urine output

Nausea/Vomiting

Tachypnoea (metabolic acidosis)

Hematuria

Hyperkalemia

Frothy urine (Proteinuria)

Clammy skin

 

Diagnostic Considerations:

Kidney Function Testing Considerations:

Parameter Reference Range Considerations High Considerations Low
Serum Creatinine 0.6–1.1 mg/dL (Women)
0.7–1.3 mg/dL in (Men)
insert insert
Creatinine Clearance 88–128 mL/min (Women)
97–137 mL/min (Men)
insert insert
Glomerular Filtration Rate (GFR) 90-140 mL/min/1.73 m2 insert Lowered kidney function. Lower than 15 indicates renal failure.
Urine Albumin 0-8 mg/dL Kidney disfunction insert
Urine Microalbumin <30 mg 30-300 indicates early CKD. Over 300 indicates later stages of CKD insert
Albumin to Creatinine Ratio < 30 mg/g insert insert
Blood urea Nitrogen (BUN) 7-20 mg/dL insert insert
 

Therapeutic Aims:

1. Seek immediate medical intervention.

Hospitalisation may be required and herbal or nutritional medicine is to be used as a supportive treatment only.

2. Reduce Dysuria

  • Urinary Demulcents (Eltrygia repens, Zea mays, Althaea officinalis)

3. Prevent & Treat Opportunistic Urinary Tract Infections

  • Inhibit Bacteria Adhesion (Vaccinum macrocarpon)
 

Differential Diagnosis:

  • Chronic kidney disease (CKD)
  • Diabetes
  • Acute renal failure (ARF)
  • Chronic renal failure (CRF)
 

Cautions:

Both chronic and acute renal failure demand immediate medical attention. Risk of cardiovascular failure is significant. Long term supportive therapies should only be used as an adjunctive treatment to conventional treatment for this condition.

 

Treatment For Renal Failure

Herbal approaches not recommended. Immediate medical attention necessary.

 

Herbs For The Renal System:

Other Herbs:

  • Zea mays
  • Vaccinium macrocarpon
  • Urtica diocea
  • Apium graveolens
  • Calendula officinalis

Author:

Justin Cooke

The Sunlight Experiment

Updated: July 2018


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