Why do kidneys fail, and what happens?
There are many different reasons why your kidney function may decrease, two of the most common being diabetes and high blood pressure - see details below.
If your kidneys fail (defined as when their function is reduced to 15% of normal or less), you will produce less or no urine, and waste products will not be efficiently removed from your body. This waste, and excess water, build up in the bloodstream (uraemia), and you may notice swollen hands and feet (oedema) and shortness of breath. Your blood pressure may rise, and you may stop making enough red blood cells. You may feel tired, sick and lose your appetite.
If your kidneys fail, treatment is essential, either by dialysis or transplantation. If not diagnosed and treated, kidney disease can cause seizures (fits), may lead to coma (loss of consciousness) and may ultimately cause death.
There are two main forms of diabetes, with different causes, but both can lead to kidney failure. In type 1 diabetes your body does not produce enough insulin to control blood sugar. In type 2, the insulin that is produced cannot be used effectively by the body. Uncontrolled diabetes allows sugar to build up in your blood, damaging blood vessels within the kidneys and reducing their efficiency. Many people with diabetes develop high blood pressure, which can also cause kidney damage. Although treatment of diabetes has improved, many people with diabetes still develop kidney damage.
High blood pressure/hypertension
High blood pressure occurs when the pressure of blood against your blood vessel walls increases above normal. This can damage the small blood vessels in your kidneys and stop them from filtering properly. The reasons for high blood pressure are not always known, but are often linked to other health conditions, poor diet or an unhealthy lifestyle such as too little exercise or being overweight.
Kidney inflammation (glomerulonephritis)
Kidney disease is quite common if the kidney’s filtering units, the nephrons, become inflamed. This may cause you to make less urine, blood and protein may leak into your urine and you may notice swollen hands and feet.
Other causes of kidney failure
Polycystic kidney disease is an inherited condition in which large cysts form in the kidneys, causing them to fail.
Anything that stops urine from flowing out of your body can cause urine to flow back up to your kidneys, which may damage them. Such obstructions can be caused by: narrowing of the urethra which often develops before birth, kidney stones, tumours or an enlarged prostate gland in men. Repeated urinary infections may also cause kidney failure.
In about 20 percent of all people who need dialysis, the cause of their kidney failure is never found. Such patients often come for treatment for the first time when their kidney failure is far advanced and it is difficult to establish the reason behind their disease.
Treating your kidney failure
The most common treatment offered to Diaverum patients is dialysis. To help alleviate understandable anxiety that you may have about this life-sustaining treatment, we help you to prepare well in advance, to ensure you are physically, mentally and emotionally ready.
Your medical team will discuss the various dialysis types and options with you and help you make a decision that is right for your personal and medical needs. It is quite common to prepare for dialysis and an eventual kidney transplant at the same time.