Symptoms and Diagnostic Path
Symptoms of renal failure depend on whether
renal failure is acute or chronic. Acute renal fail-
ure typically causes neurologic symptoms. ANEMIA,
hypertension (high blood pressure), congestive
HEART FAILURE, and OSTEOPOROSIS(loss of BONE DEN-
SITYand STRENGTH) often accompany chronic renal
failure. The diagnostic path includes URINE and
blood tests to assess kidney function, diagnostic
imaging procedures such as ULTRASOUNDand COM-
PUTED TOMOGRAPHY (CT) SCAN, and often kidney
biopsy to microscopically examine the nephrons.
RENAL FAILURE SYMPTOMSAcute Renal Failure Chronic Renal Failure
edema edema
gastrointestinal bleeding fatigue
confusion OLIGURIA(diminished URINE
loss of consciousness production)
seizures headaches
NAUSEA, VOMITING, and loss of
APPETITE
Treatment Options and Outlook
Treatment targets the underlying cause. Acute
renal failure requires immediate and intensive
medical care, often including hemodialysis.
Dietary modifications (such as reduced sodium,
protein, and fluid intake) and medications to con-
trol conditions such as diabetes and hypertension
allow many people to live with chronic renal fail-
ure for years to decades. When chronic renal fail-
ure progresses to ESRD, renal dialysis or kidney
transplantation become necessary to sustain life.
Chronic renal failure in children impairs
growth because it interferes with the ability of the
kidneys to maintain calcium balance within the
body and to produce erythrocytes (red blood
cells). Without adequate calcium the bones cannot
grow, resulting in short stature. Erythrocytes are
necessary to carry oxygen, GLUCOSE, and other
NUTRIENTSto cells throughout the body. Without
these nutrients, cells slow their rate of division.
Doctors often prescribe calcitriol supplement, a
form of vitamin D, for children who have chronic
renal failure to improve the body’s ability to retain
calcium. Many doctors also prescribe HUMAN
GROWTH HORMONE (HGH) SUPPLEMENT therapy to
achieve normal growth patterns in children who
have chronic renal failure, though not all doctors
agree this is appropriate. Human growth HORMONE
supplementation can have other deleterious
effects on the body; it is important to balance such
risks with the potential benefits.Risk Factors and Preventive Measures
The major risk factors for chronic renal failure are
diabetes and hypertension. Measures to reduce
the risk for these conditions also lower the risk for
kidney disease. Such measures include- nutritious EATING HABITS
- daily physical activity
- SMOKING CESSATION
- maintenance of healthy body weight
Diligent control of diabetes or hypertension if
these conditions are present can slow their effects
on the kidneys. Because chronic renal failure tends
to be progressive, it is important to address symp-
toms of deteriorating kidney function promptly and
aggressively for optimal quality of life.
See also HEPATORENAL FAILURE; NEPHROTIC SYN-
DROME; NEPHRON.renal tubular acidosis (RTA) A genetic disorder
in which the renal tubule within the NEPHRONfails
to release hydrogen ions into the filtrate. The con-
sequence is a buildup of acid in the BLOOD(serum
acidosis) that causes various symptoms and imbal-
ances among the body’s electrolytes. There are
numerous forms of renal tubular acidosis (RTA),
most of which are random (sporadic) though
some types are familial. Common forms of RTA
include- type 1 RTA, which affects the distal tubule and
may occur secondary to AUTOIMMUNE DISORDERS
such as SJÖGREN’S SYNDROME or after KIDNEY
TRANSPLANTATION - type 2 RTA, which affects the proximal tubule
and often accompanies conditions such as WIL-
SON’S DISEASE, FANCONI’S SYNDROME, MULTIPLE
MYELOMA, and HYPERPARATHYROIDISMas well as
after kidney transplantation
renal tubular acidosis (RTA) 219