Can Failed Kidneys Recover Their Lost Function?
A 20-year-old with kidney failure faces the risk of dying. 100 times more compared to a healthy 80-year.old! Nothing emphasises the importance of functioning kidneys more than this particular statistic. Kidneys are your life and failed kidneys put you at an unacceptable risk of dying. Hance, it is crucial to make every attempt to enhance kidney recovery after an episode of kidney failure.
There are three types of kidney failure – Acute Kidney Failure, Chronic Kidney Failure. The causes, treatment, and outcome of these types of failure are different and it is imperative to distinguish between them in a patient with kidney failure.
Acute Kidney Failure
This is more commonly called Acute Kidney Injury (AKI). Any recent onset kidney disease (within the last three months) falls under this category Hence. a documented normal kidney function three months before the episode of renal failure is mandatory to make a diagnosis of AKI. Common causes of AKI include dehydration due to vomiting, diarrhoea or less fluid intake, Infections, medications, kidney stones and other organ damage like heart, liver or lung disease.
Symptoms often include swelling of the body, decreased urine output, breathlessness. nausea and vomiting, confusion and cramps, Investgatjons reveal elevated creatinine levels in the blood, urine examination abnormalities and normal-sized on ultrasound examination.
Chronic Kidney Failure
This is more commonly called Chronic Kidney Disease (CKD). Any kidney disease Which has been persisting f« more than three months. falls in this category Common causes of CKD include diabetes. hypertension. abuse, genetic kidney diseases, and untreated kidney stone disease.
Symptoms include lethargy. weakness, low hemoglobin levels, bone pains. skin lesions and loss of appetite. Investigations reveal gradually rising b100d creatinine levels, urine abnormalities and small. sized kidneys on ultrasound.
Acute On Chronic Kidney Failure
This is more commonly called Acute Kidney Injury on Chronic Disease (AKI on CKD). Here, an unexpected failure of kidney function develops in someone who already has a pre-existing kidney disease. Hence a diabetic with CKD due to diabetic kidney disease can develop dramatic loss of kidney function due to dehydration because of loose motions. Or a patient With genetic kidney disease develops this condition due to a lung infection.
Recovery From Kidney Failure
Acute Kidney injury by definition, should recover over a period of one to twelve weeks with the appropriate treatment. On the other haM, Chrcynic Kidney Disease, by definition, does not recover even with all available treatment. Acute On Chronic Kidney Disease Shows a partial recovery with treatment. but later behaves like Chronic Kidney Disease Chronic Kidney Disease inexorably progresses to finally lead to a condition called End stage Renal Disease (ESRD). ESRD IS a condition whereby the patient dies, unless treated With either kidney transplant or dialysis Thus. it is desirable that every kidney failure be treated and every attempt be made to recover kidney function and avoid ESRD.
Naturally, the first step in this battle to recover kidney function would be to establish if the kidney failure is acute or chronic Gathenng records of kidney function prior to three months, is one way of checking this Intact, if a nephrologist was allowed just one question to ask a patient with kidney failure. it would be ‘have you ever had this problem If the answer is ‘yes’ it is very likely to be a Chronic Kidney Disease! If the ultrasound of the kidneys shows smaller-sized kidneys (as against the standard of 9 to 11 centimeters Of length). it is likely to be a Chronic Kidney Disease.
However, all these methods are indirect and have their limitations. The gold standard to decide if a kidney failure is acute or chronic is a kidney biopsy. Here, two small Pieces are taken from the kidney using a thin needle and these are studied under a müoscope This procedure reveals not only if the kidney failure is acute or chronic, but also the likely cause of failure, the appropriate treatment and the possible outcome of treatment Kidney biopsy, if performed properly, is painless and safe. Of course, biopsy can be avoided if the cause of kidney failure is evident by indirect means.
Once the type of kidney failure is established, attempts to identify the cause should be nude and treated aggressively. So. infection should be treated with appropriate antibiotics, dehydration should be treated with fluid replacement, stones Should be treated with surgery and so on. Chronic Kidney Disease cannot be reversed but existing kidney function should be preserved zealously.
Your kidneys are a game-changer in the gart8 of life. Therefore. kidney failure should be tackled aggressively, as it can be reversed and this could save and change your life!