Definition

Chronic renal failure is an deficiency in kidney function. Kidneys clean waste from the blood, which passes out of the body in urine.

Causes

Chronic renal failure is often caused by diseases such as:

• High blood pressure
• Diabetes
• Vascular diseases
• Kidney diseases
• Obstructive diseases, such as kidney stones
• Polycystic kidney disease
• Acute tubular necrosis
• Glomerulonephritis
• Renal tubular disorders
• Toxin/drug-induced kidney disease
• Severe infection
• Autoimmune diseases

Risk Factors

Factors that may increase your chance of chronic renal failure include:

• Race: African Americans more than Caucasians
• Genetics
• Diabetes
• High blood pressure
• Smoking cigarettes
• Heavy alcohol consumption
• Vesicoureteral reflux
• Chronic urinary tract infections
• Exposure to high levels of lead
• Being overweight or obese
• Other family members with kidney disease
• A previous kidney transplant

Symptoms

Chronic renal failure may cause:

• Fatigue
• Weakness
• Sleeping problems
• Weak appetite
• Nausea
• Itching
• Shortness of breath
• Altered taste
• Altered mental state

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include

• Blood tests
• Kidney biopsy
• Ultrasound

Those who are already at high risk for kidney disease should be tested more frequently so any damage can be diagnosed early. People with kidney disease will be referred to a nephrologist (a doctor who specializes in treating kidney disorders).

Treatment

Chronic renal failure cannot be cured. It is possible to slow the progression of kidney damage.

Treatment may include:

• Controlling protein in the urine by restricting the amount of protein in the diet or medication
• Taking ACE inhibitors or angiotensin II receptor antagonists
• Reducing the use of and the dosages of drugs that may be toxic to the kidneys
• Managing the complications of chronic renal disease such as fluid overload, high blood phosphate or potassium levels, low blood level of calcium, and anemia
• Lowering high blood pressure
• Controlling blood sugar and lipid levels
• Staying hydrated
• Controlling salt in the diet
• Participating in an exercise training program to keep you physically fit and reduce the chance of depression
• Quitting smoking
• Undergoing dialysis, a medical process that cleans the blood
• Having a kidney transplant
• Counseling for you and your family about dialysis and/or transplant options

Prevention

To help reduce your chance of chronic renal failure:

• Get a physical exam every year that includes a urine test to monitor your kidney’s health.
• If you smoke, talk to your doctor about how you can successfully quit..
• Maintain a healthy weight.
• Drink water and other fluids to stay hydrated.
• People who have diabetes, previously known kidney disease, high blood pressure, or are over the age of 60 should be screened regularly for kidney disease.
• People with a family history of kidney disease should also be screened regularly.

National Kidney Foundation http://www.kidney.org

The Kidney Foundation of Canada http://www.kidney.ca

Pendse S, Singh AK. Complications of chronic kidney disease: Anemia, mineral metabolism, and cardiovascular disease. Med Clin N Am. 2005;89(3):549-561.

Snyder S, Pendergraph B. Detection and evaluation of chronic kidney disease. Am Fam Physician. 2005;72(9):1739-1746.

Zandi-Nejod K, Brenner BM. Strategies to retard the progression of chronic renal disease. Med Clin N Am. 2005; 89:489-509.

8/26/2014 DynaMed’s Systematic Literature Surveillance
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Heiwe S, Jacobson SH. Exercise training in adults with CKD: A systematic review and meta-analysis. Am J Kidney Dis. 2014;64(3):383-393.