In the case of renal insufficiency (renal failure), a distinction must be made between chronic renal insufficiency and acute renal insufficiency. Chronic renal insufficiency causes a slow loss of renal function. It is basically the end stage of chronic renal disease, which means the patient often requires dialysis treatment. On the other hand, acute renal insufficiency develops quickly within hours and days as a complication of serious illness, such as a lack of oxygen or blood poisoning.
The most common causes of chronic renal insufficiency are chronic diseases such as glomerulonephritis, high blood pressure or diabetes mellitus. A less common cause are polycystic kidneys, which a genetic illness.
Chronic renal insufficiency develops slowly and may cause only a few symptoms or unspecific symptoms such as fatigue and loss of performance for a long period of time. With progressive loss of kidney function, this leads to fluid retention in the body, anaemia and a myriad of symptoms as a result of the increase in urea in the blood (uraemia). These can manifest, among others, as itching, nausea, uraemic breath, vomiting and cardiac arrhythmia.
Chronic renal insufficiency is diagnosed with blood and urine tests. It is essential to detect the cause of the chronic renal insufficiency to be able understand and treat the disease.
The treatment addresses the causes of the chronic kidney insufficiency (hypertension, diabetes, glomerulonephritis) on the one hand, and the loss of kidney function itself and the consequences of the kidney insufficiency on the other. As chronic renal insufficiency cannot usually be reversed, the treatment focuses on slowing down the progression of the disease and retaining the residual kidney function. Dialysis is usually necessary once the kidneys have lost a particular degree of function. Kidney transplantation is an alternative to dialysis if there is a donor kidney and surgery is an option.
Acute renal failure usually occurs as a complication of an serious acute illness, in which the blood flow to the kidneys is impacted. This can be a severe infection with blood poisoning, a condition with extensive blood loss or cardiac and pulmonary disease with a lack of oxygen. Sometimes a backup of urine can cause acute renal insufficiency if there is a drainage problem.
The symptoms of acute kidney failure are similar so those of chronic kidney insufficiency, save that the symptoms develop far more quickly and more dramatically. The urination is usually reduced to a minimum or to nothing within a short period of time. However, if the kidneys are severely damaged, there can also be increased water elimination over the kidneys.
The primary goal of the treatment of acute kidney failure is to treat the causal disease of the infection, the loss of blood or the lack of oxygen. Intensive care monitoring is also usually necessary. The kidney function can be maintained temporarily with dialysis. In contrast to chronic renal insufficiency, the kidneys are usually functional once more after successful treatment of acute renal insufficiency.