The impact of kidney failure

Dr. Douglas Street, Contributor

The kidneys are major organs of the body and their function affects all the other organs. Kidney failure can, therefore, be very detrimental to the entire body. Its impact is even greater than most persons understand.

The kidneys are like the filters for the body, removing toxins that are produced by the body or toxins that are absorbed from external (such as the skin) or internal sources (such as the gut). The liver produces most of the toxins that are excreted by the kidneys.

But the kidneys do more than remove toxins. They also help to maintain levels of acid and electrolytes (salts).

Another very important function is the production of erythropoietin. This is a hormone that stimulates the bone marrow to produce red blood cells, which carry oxygen. They are also important in regulating the amount of water in the body which, in turn, helps to control blood pressure.

The kidneys have many reserves and the body can actually survive on the function of a quarter of a kidney, so they have to be severely damaged for kidney failure to develop. When it does develop, all the functions mentioned above become lost or significantly impaired. It may be short term (acute) or long term (chronic).

Causes of kidney failure

There are many causes of kidney failure. If the blood supply to the kidneys is significantly diminished, then they cannot function properly. This may be because of blood loss, dehydration (from increased fluid loss or poor intake, or medications such as diuretics), or any factor that specifically reduces the blood flow to the kidneys.

Direct damage to the kidneys can also lead to failure. This can be caused by trauma, diabetes, hypertension, infection, medication, overload of certain substances in the blood, and immune system disorders.

Obstruction in the outflow passages from the kidneys (e.g. from stones, enlarged prostate, and tumours) may cause backflow of urine into the kidneys, which can eventually lead to failure.

Symptoms of kidney failure include reduced or absent urination, shortness of breath, swelling of the body from the legs upward, weakness, loss of appetite, confusion, coma, and death. The blood pressure usually goes up because of fluid overload and problems with heart rhythm may develop because of electrolyte problems.

If the cause of the failure is not correctable, then measures would be taken to 'outsource' the kidneys' function, e.g. haemodialyis, peritoneal dialysis, or kidney transplant, if possible.