Kidney/ Renal failure

Every time went for clinical training; this is one of the common diseases among the Malaysian.
My youngest patient that I look after is 16 years old boy.
Can you imagine, in that age he got kidney failure..(may god bless him..ameen)
As a parents, relatives, and friends we have to give fully emotional support for kidney failure patients so that, all of them will feel worth it to fight for the disease.
Be with them and walk with them.
Here some info regarding kidney failure. I just read it from
www.ahdubai.com/patient education..

feel free u guys can read from there.....

ANATOMY OF THE KIDNEY

Kidneys are been-shaped organs located in the middle to lower back, on both sides of the spine.
The urine that is formed in the kidneys flows through tubes, called ureters, to be stored in the bladder.
When the bladder is full, a person feels the urge to urinate. Urine is emptied through the urethra.

The main purpose of the kidneys is to make urine by filtering harmful chemicals, called toxins out of the blood. The kidneys also help to necessary chemical substances in the blood, such as sodium, protein and sugars.

The kidneys control the amount of fluid we keep in our bodies.
For example, when we drink more fluids than we need, the kidneys secrete extra urine.
On the other hand, when we do not drink as much fluid as we need, the kidneys make less urine.
The kidneys help to regulate hormones that strengthen our bones and produce red blood cells.
Since the kidneys constantly filter the blood, they are very sensitive to anything we eat or drink, or to any medications we take.
The kidneys also help to keep our blood pressure regular; this is why many kidney diseases result in high blood pressure.

Damage to only one kidney is not a major problem, since the other kidney can take over for it. However, if both kidneys get damaged, a person will die within a few days if they do not get dialysis.

ESRD= End-stage renal failure
Develops when both kidney are not able to function. Sometimes it happens gradually and sometimes all at once.

Diseases that can lead to ESRD:
-diabetes mellitus
-hypertension
-Lupus
-repeated kidney infections
-kidney stones
-kidney cyst
-infection in the blood called sepsis
-the constant use of painkillers, alcohol, or other medications can also lead to ESRD

Medication and advice on diet been given by the nephrologists.
It’s very important to have kidney function checked regularly if you:
-have a disease that could lead to ESRD or
-take any medication regularly.

To check on how kidneys are functioning, blood tests and urine tests are needed.

Sign and Symptoms
When the kidneys are not working right, the body retains water, which leads to swelling in the face, ankles, legs, and throughout the body.
The extra fluid can cause shortness of breath.
Since toxins build up in the body when both kidneys are not filtering them out,
Patients with ESRD feel very tired and week. They have no stamina or energy and looks lethargy. This is partly due to the body not producing enough red blood cells. (anemia)
Kidney failure patients sometimes feel pain below the rib cage.
As kidney failure get worse, blood pressure tends to rise and the body makes less urine.
With time, kidney failure causes the skin become pale.
If nothing is done to treat kidney failure, death can result from toxins building up in the body, as well as high level of potassium in the blood.

TREATMENT
The main treatment for ESRD is dialysis.
Dialysis is a process that replaces the function of the kidneys.
In some cases, dialysis is temporary, and can be stopped as the kidneys are able to function again.
However, dialysis is usually a lifetime treatment.
2 types of dialysis:
-hemodialysis and peritoneal dialysis.
Each work differently to filter out of the blood, as the kidneys normally does.

Hemodialysis reroutes the blood to a dialysis machine. The machine cleans toxins from the blood and regulates the levels of essential chemicals, such as potassium.
Hemodialysis is done 3-4 times per week and ends each a time per week and each session takes around 4-5 hours.
Special intravenous (AVF/BCF/IJC) are needed for good blood flow to and from the dialysis machine.
AVF-Arterioveneous fistula
BCF-brachio cephalic fistula
IJC-internal jugular catheter

Peritoneal dialysis uses the peritoneoum, which is the lining of the abdominal cavity, to clean the blood. A tube, also known as a catheter, is surgically placed in the peritoneal cavity. A solution called “dialysate” is allowed to flow into the peritoneal cavity through the catheter.
The dialysate solution interacts with the blood through the peritoneum, filtering our toxins and cleaning it over a period of several hours.
After peritoneal dialysis, the fluid in the peritoneum is drained to the outside of the body into a special bag. The same cycle is repeated many times a week; it is sometimes started
Before the patient goes to bed and the fluid emptied in the morning.
For dialysis to be successful, patients have to follow strict dietary restrictions on the amount of salts, proteins, and fluids they eat and drink (500L/day)

A kidney transplant can cure some cases of ESRD. Unfortunately, there are not enough kidneys available for all ESRD patients. In addition, a kidney transplant is not the best option for ESRD patient.

Prevention
People who have any of the following conditions are at risk of ESRD:
-known kidney disease
-diabetes mellitus
-hypertension
-lupus

Some dietary restrictions may be needed to slow down and possibly stop the process that leads to ESRD.
Some of these restrictions include eating less:
-salt (sodium)
-potassium
-proteins

Other general healthy lifestyles changes may also help, including:
-regular exercise
-not smoking
-maintaining an ideal weight.

Summary
Kidneys are extremely important organs that filter harmful substances out of the body. The kidneys are susceptible to many diseases, some may be life threatening. Others can lead to complete kidney or renal failure, requiring dialysis.
ESRD is a very serious condition. Patients with ESRD can live normal lives within the restrictions of their dialysis schedule.

Remember once on dialysis there’s no turning back. And starting now, look after our self.
Choose and decide the best for us. Never evaluate based on crowd but evaluate based on your needs.