What are the symptoms of chronic kidney failure?

Written by Zhou Qi
Nephrology
Updated on September 04, 2024
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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 Zhou Qi
Nephrology
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Is stage five chronic kidney failure serious?

Strictly speaking, there is no condition called "chronic renal failure stage five," but there is a term "chronic kidney disease stage five." Chronic kidney disease is divided into five stages based on the glomerular filtration rate (GFR). Stage five chronic kidney disease indicates that the patient's GFR is less than 15 milliliters per minute, which is about 15% of normal kidney function and is essentially equivalent to uremia. Therefore, chronic renal failure or chronic kidney disease stage five is very dangerous and can cause many complications. Moreover, this type of kidney failure is irreversible and incurable, and the patient may need to undergo dialysis or a kidney transplant.

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Written by Zhang Hui
Nephrology
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What is best to eat for chronic renal failure?

Patients with chronic renal failure are advised to adopt a low-salt, low-fat, and high-quality protein diet. For those not undergoing dialysis, protein intake should be strictly controlled to 0.6 to 0.8 grams per kilogram of body weight per day. Additionally, patients with stage 3 CKD or above often experience electrolyte disorders, such as hyperkalemia, which can lead to cardiac arrest and arrhythmias. Therefore, it is important to avoid foods high in potassium, such as bananas, oranges, dates, kiwis, and tomatoes. Due to the strict protein intake, hypoproteinemia may occur, and these patients are also prone to hyperphosphatemia. It is recommended to choose foods with a low phosphorus to protein ratio, generally those with a ratio below fifteen. After starting dialysis, the same principles apply, but protein intake can be slightly increased, as some protein is lost during both hemodialysis and peritoneal dialysis. The protein intake can be adjusted to 1.0 to 1.2 grams per kilogram of body weight per day, while still controlling phosphorus and potassium intake.

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Written by Zhou Qi
Nephrology
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Why does chronic renal failure cause vomiting?

Patients with chronic renal failure who experience vomiting generally indicates that their condition has become very severe. Typically, from stage four of chronic kidney disease onwards, a large amount of metabolic waste accumulates in the body, and patients may have severe metabolic acidosis, among other issues. These conditions can cause edema of the gastrointestinal mucosa, and these metabolic wastes can also irritate the gastrointestinal tract, leading to symptoms like nausea, vomiting, and loss of appetite. Of course, besides these reasons, other gastrointestinal diseases such as chronic gastritis, gastric ulcers, and even gastric cancer should also be ruled out.

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Written by Wu Ji
Nephrology
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Symptoms of chronic renal failure

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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Nephrology
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How to test for chronic renal failure?

The examinations for patients with chronic kidney failure are divided into several aspects: First, it is necessary to confirm the presence of chronic kidney failure and assess its severity. This requires blood tests for kidney function, observing levels of blood creatinine and urea nitrogen, and performing endogenous creatinine clearance tests to determine the degree of kidney failure; Second, it is important to determine whether there are complications associated with kidney failure. Therefore, routine blood tests are necessary to check for renal anemia, blood pressure measurements to observe if there is renal hypertension, and blood tests for electrolytes to check for any electrolyte disorders. These patients also need to have their parathyroid hormone levels checked and undergo iron metabolism tests to provide a basis for further treatment.