The causes of Chronic Renal Failure

Do you know Chronic Renal Failure? 

The causes of Chronic Renal Failure

Chronic Renal Failure refers to the damaged renal parenchyma with various causes. Kidney atrophies obviously, which can not maintain renal fundamental function. The clinical manifestations of Chronic Renal Failure are retention of metabolin, imbalance of water, electrolyte and acid-base as well as the involvement of the whole body.

Ⅰ Common causes:

① Infectious nephropathy: Chronic Pyelonephritis, nephrotuberculosis, etc.

② Chronic glomerulonephritis: IgA Nephropathy, Mesangial Proliferative Glomerulonephritis and focal segmental sclerosing glomerulonephritis, etc.

③ Toxic nephropathy: toxic nephropathy due to heavy metals, nephropathy due to analgesics, etc.

④ Vascular renal lesion: renal vascular hypertension, hypertension, renal arterial sclerosis, etc.

⑤ Genetic kidney disease: Polycystic Kidney Disease, Alport syndrome, etc.

⑥ Systemic disease: renal damage due to vasculitis, Multiple Myeloma and Lupus Nephritis,etc.

⑦ Renal damage due to abnormal metabolism: Diabetic Nephropathy, Amyloidosis Kidney Disease and Gouty Nephropathy, etc.

⑧ Obstructive Nephropathy: ureteral obstruction, reflux nephropathy and lithangiuria,etc.

Ⅱ Pathogenesis

① Surviving nephron theory: The majority of nephrons are damaged by various causes. And the surviving small part of nephron which is slight damaged and has normal function, has to do compensative work to maintain normal needs of the body, which causes the surviving nephrons to become compensatory hypertrophy. On this condition, both glomerular filtration rate and the function of renal tubules will increase. If this condition can not be prevented, glomerulosclerosis will occur. At last, the surviving nephrons will gradually decrease, as well as renal function.

② Uremia toxins theory: Uremic toxins may be the various substances which are accumulated in the stage of Renal Failure, such as PTH, phosphorus, urea, creatinine, guanidines, phenols and indole, etc. These substances have the following features:

1. Concentration content in the body is higher than that of normal.

2. High content is related to Uremia.

3. These substances can be detected by chemical analysis and quantitative determination.

4. The content of these substances is similar with that of the patient with Uremia.

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Stage-4 Chronic Kidney Disease and Kidney Failure

More and more patients are diagnosed with Chronic Kidney Disease because of the poor living habits. Chronic Kidney Disease is divided into five stages according to Glomerular Filtration Rate (GFR). The decrease of Glomerular Filtration Rate is closely related to the declining of kidney function. Stage-4 Chronic Kidney Disease means patients have entered into the stage of Kidney Failure. GFR in stage-4 CKD is 15-29 ml/min. Stage-4 Chronic Kidney Disease can be seen a Kidney Failure. Patients with Kidney Failure should treat disease as soon as possible. Some patients are diagnosed with stage-4 Chronic Kidney Disease when they saw a doctor for the first time. They feel confused that before they go to see a doctor, there are no uncomfortable feelings or symptoms.

Do you know the compensatory ability of kidneys?

The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. Each kidney weighs about ¼ pound and contains approximately one million to two million filtering units called nephrons. Each nephron is made of a glomerulus and a kidney tubule. The glomerulus is a miniature filtering or sieving device while the tubule is a tiny tube like structure attached to the glomerulus.

Compensatory ability of kidneys means 50% kidney function is enough for the normal work of the whole body. Normal people can give one kidney to another people. Generally speaking, if patients’ kidney function is damaged slightly or less than 50% percent, there are usually no symptoms so that people will ignore the existence of kidney disease. Therefore, people should take routine tests so as to guarantee the healthy body. As for patients with stage-4 CKD, they have already in a serious condition so there are many symptoms.

Do you know the symptoms of stage-4 Chronic Kidney Disease?

◆ Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.

◆ Swelling: A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid, someone could even feel short of breath.

◆ Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood.

◆ Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.

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The Diagnosis of Chronic Kidney Failure (CKF)

Chronic Kidney Failure is also called chronic renal failure, which means the declining of kidney function. Stage-3 chronic kidney disease is the early-stage Kidney Failure and patients at this stage begin to show symptoms. Chronic kidney disease can be diagnosed by the observation of a combination of symptoms, physical examination and elevated blood urea nitrogen (BUN) and Creatinine (Cr) levels.

Tests for people to diagnose Chronic Kidney Failure (CKF):

Diagnosis of Chronic Kidney Failure should do urine test. People with Kidney Failure all can find abnormal changes of urine such as foamy urine, light color, dark color or red color, increase or decrease of urine volume and frequency urinate at night. If there is anyone of the symptoms, they should send a urine sample to doctors and they can test it for kidney disease. The presence of blood in urine indicates the damage of blood vessels. The presence of protein called albumin in urine may indicate Chronic Kidney Failure.

Diagnosis of Chronic Kidney Failure should do blood test. Blood test is a test for Creatinine and blood urea nitrogen (BUN) levels. Creatinine is produced by muscle metabolism. If there are high Creatinine and BUN, it means the damage of kidneys and the declining of kidney function.

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Chronic Renal Failure and Muscle Twitch

Patients with early-stage Chronic Renal Failure should get treatment timely so as to prevent the deterioration of disease. Long-time Chronic Renal Failure will lead to serious damage to human body. There are some symptoms such as hypocalcemia, hyperphosphatemia and electrolyte disorder, which can cause muscle pain.
1. Hypocalcaemia
The Cause of Hypocalcaemia:
Patients with Chronic Renal Failure usually have inappetence, vomit, nausea and diarrhea, which can lead to insufficiency of calcium. At the same time, the damage of digestive tract will influence the absorption of calcium. Most calcium is discharged out of human body through urine. This is the main reason for patients with Chronic Renal Failure to cause Hypocalcaemia.
The damage to muscles from Hypocalcaemia:
The most obvious symptom coming from Hypocalcaemia is excessive excitability of nerves and muscles. Calcium Ion has the ability to restrain internal flow of Sodion. When people with Hypocalcaemia, the inhibitory ability decreased, this can lead to decreased threshold of action potential. The repeating stimulations can lead to exciting nerves and muscles such as muscle pain or muscle twitch. Slight Hypocalcaemia usually manifest with finger and toes pain, arms and legs numb or twitch, stabbing pain; when calcium loses more, there will occur tetany; more serious condition can have whole body skeleton spasm and smooth muscle spasm, and respiratory tract can have bronchospasm or even apnea; vasospasm can show headache, angina and Reynolds.
2. Hyperphosphatemia
The cause of Hyperphosphatemia:
When the kidneys are damaged, the glomerular filtration rate will decrease so that the redundant wastes such as phosphorus, serum creatinine and BUN can not be discharged out of human body. As for phosphorus, long-time accumulation in blood can lead to Hyperphosphatemia. Balanced calcium and phosphorus can promote the use of inorganic salt. Silicate can keep the metabolism of Vitamin D and then maintain homeostasis of calcium. High phosphorus can influence the absorption of calcium.
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