Symptoms of chronic renal failure

Written by Wu Ji
Nephrology
Updated on September 14, 2024
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The clinical symptoms of chronic renal failure vary at different stages. In the compensatory and early decompensatory stages of chronic renal failure, patients may experience no symptoms or only mild discomforts such as fatigue, back pain, and increased nocturia, while a few may suffer from reduced appetite, metabolic acidosis, and mild anemia. The main clinical symptoms include disorders of water, electrolyte, and acid-base balance, presenting metabolic acidosis, sodium retention or hypovolemia, or hyponatremia, along with hyperkalemia. Moreover, there are significant manifestations of excess phosphorus and calcium deficiency. Patients may also experience disruptions in the metabolism of proteins, carbohydrates, fats, and vitamins. Cardiovascular symptoms mainly include hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms can manifest as loss of appetite, nausea, and vomiting. Hematological manifestations may include renal anemia and a tendency to bleed.

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Can chronic renal failure be cured by dialysis?

Patients with chronic renal failure can undergo dialysis treatment to sustain life and improve quality of life. However, dialysis merely uses artificial means to excrete accumulated metabolic wastes and fluids in the body, regulate the internal environment, and simply substitutes for the function of the kidneys. Dialysis has no therapeutic value for renal failure itself. Therefore, patients with chronic renal failure should not expect dialysis to restore kidney function. Nonetheless, as a renal replacement therapy, dialysis can provide patients with a relatively good lifespan and quality of life. Dialysis treatment is necessary for patients with uremia.

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What are the symptoms of chronic kidney failure?

The symptoms of chronic kidney failure are related to the severity of the condition; the more severe the kidney failure, the more symptoms the patient will have. In the early stages, patients may not feel uncomfortable or show any symptoms. Some patients may experience swelling in the lower limbs and facial area. Others may display clinical signs such as elevated blood pressure and visible blood in the urine. As kidney failure progresses and blood creatinine levels exceed 442 umol/L, patients may experience fatigue, which is due to renal anemia. Some patients may also experience a loss of appetite, nausea, vomiting, and other gastrointestinal symptoms.

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Written by Zhang Hui
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Chronic Renal Failure Clinical Manifestations

Patients with chronic renal failure may exhibit fatigue, which is mainly due to anemia. Patients with stage three or higher chronic renal failure generally have anemia, which can lead to symptoms such as fatigue, palpitations, and pallor. Additionally, patients may experience nausea and vomiting, which are primarily caused by an increase in toxins. Furthermore, patients may also exhibit symptoms such as edema and shortness of breath, as individuals with chronic renal failure typically experience reduced urine output. A higher intake than output over time can lead to an increased circulating blood volume, resulting in heart failure.

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Written by Zhang Hui
Nephrology
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Chronic renal failure anemia treatment

Patients with chronic renal failure generally have anemia combined with stage three or above of chronic kidney disease (CKD). When the hemoglobin falls below 100 grams per liter, it is necessary to start treatment to correct anemia. At this point, relevant lab tests should be conducted to check for abnormalities in folate, vitamin B12, ferritin, and serum iron levels, and specific treatments should be administered accordingly. Treatments generally include iron supplements, erythropoiesis-stimulating agents, folate, and vitamin B12 to help correct anemia.

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Written by Zhou Qi
Nephrology
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What should I do about edema from chronic renal failure?

Chronic renal failure often leads to edema, which is a common symptom associated with the decreased ability of the kidneys to excrete water, resulting in significant water retention in the body. There are two treatment options for this disease. First, medication can be used, typically diuretics such as loop diuretics. After administration, the patient's urine output increases, which can help reduce edema. Second, for patients who do not respond well to medication, and in cases where edema leads to heart failure or pulmonary edema, dialysis treatment may be considered. Through dialysis ultrafiltration and dehydration, edema can also be alleviated.