Symptoms of Chronic Kidney Failure

Written by Wu Ji
Nephrology
Updated on September 29, 2024
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The clinical symptoms of chronic renal failure mainly include symptoms related to disturbances in electrolyte and acid-base balance, as well as symptoms of metabolic disorders of proteins, carbohydrates, fats, and vitamins. There are also manifestations in various organ systems, including the cardiovascular system, respiratory system, gastrointestinal tract, hematologic system, neuromuscular system, endocrine system, and bone lesions. Metabolic acidosis is common; patients may also exhibit water and sodium retention or hypovolemia and hyponatremia. Potassium metabolism disorders are often characterized by hyperkalemia, while disturbances in phosphorus and calcium metabolism are mainly manifested as hyperphosphatemia and calcium deficiency. Patients may also show cardiovascular manifestations, primarily hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms in patients may include loss of appetite, nausea, and vomiting. Additionally, renal anemia and a tendency to bleed are common, and skeletal changes are quite frequent, leading to malnutrition of bones, osteomalacia, and osteoporosis.

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Written by Zhou Qi
Nephrology
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Chronic Kidney Failure Various Indicators

In patients with chronic kidney failure, the primary indicator to observe is obviously kidney function. It is essential to regularly monitor the patient's blood creatinine and urea nitrogen levels, which are generally required to be tested every 1 to 3 months when chronic kidney failure is stable. Additionally, urine output should be monitored. If there is a decrease in urine output and swelling occurs, it may indicate that the patient's kidney function is continuously deteriorating. A complete blood count should also be checked to observe changes in the patient's anemia status. Chronic kidney failure often causes hypertension, so blood pressure monitoring is also necessary for these patients. Electrolyte monitoring is important as kidney failure can lead to disturbances in calcium and phosphorus metabolism and subsequent secondary hyperparathyroidism. Therefore, the levels of calcium, phosphorus, and parathyroid hormone also need to be tested.

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Written by Zhou Qi
Nephrology
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Chronic Renal Failure Treatment Plan

The treatment of chronic renal failure primarily requires a clear understanding of the cause, and treatment targeting the cause is essential to slow the progression of chronic renal failure. The most common causes of chronic renal failure are diabetes, hypertension, and chronic nephritis. Therefore, for patients with chronic renal failure caused by diabetes, insulin is often needed to control blood sugar. For patients with hypertensive kidney disease, antihypertensive drugs are certainly necessary to control blood pressure. However, in the early stages of renal failure, ACE inhibitors or ARBs are the preferred choices. For patients with chronic nephritis in the early stages, corticosteroid medications are required for treatment. However, if the serum creatinine has already exceeded 256 micromoles per liter, treatment then focuses mainly on managing complications, and corticosteroids are no longer used. (Please use medications under the guidance of a doctor.)

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Written by Wu Ji
Nephrology
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Principles of Treatment for Chronic Renal Failure

The principles of treatment for chronic renal failure include early-stage non-dialysis conservative treatment as well as end-stage renal replacement therapy. Non-dialysis conservative treatment includes delaying the progression of kidney damage, which requires treating the primary disease, implementing nutritional support, and controlling factors that accelerate kidney disease progression, such as controlling high blood pressure, proteinuria, and hyperlipidemia. Additionally, it is necessary to eliminate metabolic waste from the body, and maintain the body's water, electrolyte, and acid-base balance. Renal replacement therapy includes hemodialysis, peritoneal dialysis, and kidney transplant therapy.

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Written by Zhou Qi
Nephrology
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Can chronic kidney failure CKD5 be cured?

The so-called CKD refers to chronic kidney disease. According to the glomerular filtration rate, CKD is divided into 5 stages, where stage 5 means that the patient's glomerular filtration rate has fallen below 15 milliliters per minute, which is equivalent to uremia. Chronic renal failure is irreversible and cannot be recovered, so it is impossible for patients whose condition has progressed to later stages to recover. Therefore, for such conditions, the only option is to choose renal replacement therapy so that the patient can survive. Renal replacement therapy mainly includes hemodialysis, peritoneal dialysis, or kidney transplantation.

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Written by Zhou Qi
Nephrology
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early symptoms of chronic renal failure

Patients with chronic kidney failure often do not have any specific discomfort or noticeable symptoms in the early stages. However, some patients may exhibit clinical signs, such as edema, due to the kidneys' reduced ability to excrete water, or hypoproteinemia, which leads to a decrease in plasma colloid osmotic pressure, resulting in edema in the lower limbs or eyelids, and facial swelling. Patients may also experience visible blood in the urine, increased urinary foam, and chronic kidney failure often accompanies high blood pressure. Such patients may also suffer from mild renal anemia, hyperkalemia, and other clinical manifestations.