Kidney failure

What is renal insufficiency?

Renal insufficiency refers to the kidneys' inability to adequately fulfill their detoxification function, resulting in the accumulation of harmful substances in the body that impair internal organs.

The kidneys are responsible for filtering out hazardous metabolic products and excess water from the blood and passing them into the urine. They feature a complicated network of small channels called tubuli, which use osmosis to cleanse the blood of substances that are present in high concentrations.

Causes and types of renal insufficiency

Renal insufficiency can occur spontaneously or develop chronically the course of many years. Its causes are very diverse. 

Acute kidney injury

Acute kindey injury can be prerenal, renal or postrenal, depending on the underlying cause. Prerenal means "before the kidneys" and is caused by a greatly reduced blood supply to the kidneys, such as after a blood clot event or circulatory arrest due to an accident.

Renal refers to the failure originating withinin the kidneys and is the result of damage to the organ itself through lack of oxygen or by certain medications.

Postrenal means the failure is "behind the kidneys" and is occurs when urine is not properly drained from the kidneys due to urinary tract obstruction by kidney stones or a tumor.

Chronic renal failure

Chronic renal failure develops over a period of several years. in most of the cases, diabetes mellitus is the underlying cause. However, severe atherosclerosis and chronic inflammation of the kidneys or renal pelvis may also lead to chronic renal insufficiency.

Symptoms of renal insufficiency

During early stages, renal insufficiency produces fairly nonspecific symptoms, like fatigue or lack of appetite. As time goes by, the urine produced and peed out becomes less and less. Consequently, the electrolyte levels in the blood fall out of balance. This has many effects on the patient's health, some of which can be serious: fluid can build up (edema) in the lower limbs and lungs. Anemia, hypertension, nervous and coagulation disorders can be enocutered as well. Changes in electrolytes influence menstruation and potency, too. Once renal insufficiency is highly advanced, patients are at an increased risk of developing cardiac rhythm disturbances and heart failure.

How can renal insufficiency be treated?

The first step is the correct diagnosis of renal insufficiency and to determine whether it is acute or chronic. The acute form is more readily identified, as patients experience symptoms and discomfort more abruptly. First of all, the doctor will ask the patient about the symptoms, their onset date and find out any underlying diseases or previous operations. A physical examination is then performed to check for water retention or skin changes. Subsequently, the blood is examined and especially creatinine and urea levels are important. Creatinine is a product of the muscle breakdown and is excreted through the kidneys, so it is the most important indicator of kidney function.

Additional tests include urine tests for the presence of proteins, which should be absent in a healthy persons' urine. Also an ultrasound examination can provide evidence of damage or changes in the kidneys.

If the kidneys failed due to trauma, disease or medication, then the respective underlying cause has to be treated. Diabetes mellitus should be well controlled at all times, and patients suffering from high blood pressure should be treated with appropriate medications and follow a healthy diet. For inflammation of the kidneys, medicationsbe may prescribed and obstruction of the urinary tract needs to be cleared.

Once the cause is eliminated, the kidney function may recover. Sometimes, patients may require temporary support from medications or renal replacement therapy. Should this not occur, a patient must undergo dialysis. Known colloquially as blood washing, dialysis removes the patient's blood from the body, filters out harmful substances by means of osmosis and returns it to the circulation. It is necessary to undergo this procedure several times a week for several hours. For patients with an incurable renal insufficiency, a kidney transplant is another option. This involves transplanting one kidney of a deceased or alive donor to the patient, as one organ is enough to adequately detoxify the body. The defect kidney is left in place, and patients have to take lifelong medication to prevent a rejection reaction.

Which doctors and clinics specialize in renal insufficiency?

Nephrologists and urologists are specialists for the diagnosis and therapy of renal insufficiency. While nephrologists mostly deal with diagnosis and conservative management of renal failure, urologists are responsible for problems with the lower urinary tract. Surgeries of the kidneys are carried out predominantly in urology clinics.

Let us help you find an expert for your condition. All doctors and clinics listed have been evaluated by us for their outstanding specialization in the field of renal insufficiency and are looking forward to your inquiry or wish for treatment.