Renal Failure

Renal failure is the result of excess retention of nitrogenous waste products and electrolyte disturbances that produce a variety of signs and symptoms. Patients are in end-stage renal disease (ESRD), the terminal stage of kidney disease; GFR is less than 5% of normal (80-95% of kidney function is gone). Can be the result of Acute Kidney Injury or Chronic Kidney Disease. Dialysis or kidney transplant is necessary for survival. MAD HUNGER

• Metabolic acidosis
• Dyslipidemia
• Hyperkalemia
• Uremia
• Na+ and H2O retention (with resulting heart failure, pulmonary edema, and hypertension)
• Growth retardation and developmental delay
• Erythropoietin deficiency (anemia)
• Renal osteodystrophy

Diabetes and high blood pressure account for the majority of cases. Less common causes include IgA nephropathy, lupus nephritis, polycystic kidney disease, and Fabry disease. Metabolic disorders, heart disease, high blood pressure, and stroke (thus, these are both signs and complications of kidney failure). We can check to see how well the kidneys are filtering the blood with an estimated glomerular filtration rate test (eGFR):

• eGFR of less than 15 for 3 months or more (with repeat testing) is indicative of kidney failure.