Chronic renal failure
The term "chronic renal failure" identifies the progressive loss of the purifying functions of the kidney due to various types of nephropathies. This condition is always irreversible and its development can be gradual or sudden.
The kidneys filter blood from lot of dangerous substances including nitrogenous ones that derive from protein metabolism, set hydro saline balance for arterial pressure, acid-base balance for blood acidity, and regulate calcium, phosphorous, vitamin D metabolism. They product erythropoietin hormone too that regulate the amount of red blood cells.
In the initial stage the only occurring symptom might be the need to urinate several times during the night, whereas at the subsequent phase the nitrogen levels increase and evoke the need to urinate more frequently also during the day. The deterioration of general condition indicated by paleness, poor appetite and fatigue appear in the terminal phase. In addition to these symptoms, there can appear others such as: high blood pressure, cardiocirculatory failure or acute pulmonary edema, respiratory disorders, anemia, lymphopenia, sleep disorders, difficulties in concentration, peripheral neuropathies.
The main diseases that can lead to this problem are: diabetes; hypertension; lupus; recurrent kidney infections; kidney stones; renal cysts; blood infection, or the so-called sepsis; constant usage of painkillers, alcohol and other drugs.
In the early stages of the disease, in order to keep the chronic renal failure under control, one can rely on a conservative therapy based on a diet, lifestyle changes and medications, diuretics and antihypertensives. When the residual renal function is no longer sufficient to cover the needs of the organism, the resort is to rely on the other replacement therapy: hemodialysis, in which the blood is being purified 3 three times a week for about 4 hours each time in hospital, or peritoneal dialysis, which is a more physiological variant than the previous one, and can be carried out during the night rest. However, it requires a certain cooperation from the patient. In rapidly changing forms, when there are no contraindications, the kidney transplant might be recommended. A special diet is one of the cornerstones in a conservative therapy. The patients are advised to stick to a diet that is low in proteins and low in phosphorus, or even slightly low in salt and high in calories. An adequate protein intake (thus, also phosphate intake) plays an important role in the conservative treatment of chronic renal failure because it allows:
- - the control of the urea levels, phosphorus and parathyroid hormone;
- - the control of acid-base balance (particularly in the case of metabolic acidosis);
- - the maintenance of a satisfactory nutritional status;
- - a possible slowdown of the progressing renal failure which otherwise brings to the terminal uremia.