Acute Kidney Injury
Acute kidney injury, also called acute renal failure, develops rapidly, usually in less than a week in people who are already hospitalized, particularly in critically ill people who need intensive care. It causes your kidneys suddenly to become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, it can be fatal and requires intensive treatment. However, acute kidney injury may be reversible, and with days or weeks you may recover normal or nearly normal kidney function.
Sometimes acute kidney injury causes no signs or symptoms and is detected through lab tests done for another reason. When signs and symptoms are present, they may include:
• Decreased urine output
• Fluid retention, causing swelling in your legs, ankles or feet
• Shortness of breath
• Irregular heartbeat
• Seizures or coma in severe cases
Acute kidney failure can occur when you have a condition that slows blood flow to your kidneys, diseases that damage your kidneys or a blockage to the passage of urine out of the body.
• Decreased blood flow can occur when you lose blood or other fluids, in severe dehydration, infection, liver failure or as a reaction to drugs.
• Diseases that may damage the kidneys and lead to acute kidney injury includes blood clots in the veins and arteries in and around the kidneys, glomerulonephritis, medications, such as certain chemotherapy drugs, antibiotics and dyes used during imaging tests, and breakdown of tumor cells (tumor lysis syndrome), which leads to the release of toxins that can cause kidney injury.
• Urine blockage in the kidneys can be caused by kidney stones, enlarged prostate, bladder cancer, blood clots in the urinary tract, cervical cancer or colon cancer.
If not detected and treated, acute kidney injury can cause serious complications including buildup of fluid in your lungs, which can cause shortness of breath, chest pain, muscle weakness, and permanent kidney damage.
Occasionally, acute kidney injury causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis, a mechanical filtration process used to remove toxins and wastes from the body, or a kidney transplant to survive.
Chronic Kidney Disease
One in seven American adults, or 30 million people, are estimated to have chronic kidney disease (CKD). Chronic kidney disease is the gradual loss of kidney function over time. It can take months or years for the condition to develop. CKD is a silent disease and people usually do not have symptoms until the disease is quite advanced. Therefore regular health checks and screening for kidney disease in patients at risk is important.
There are five stages of CKD (1-5) with stage 5 being most severe. As the disease progresses, wastes accumulate to unhealthy levels in your blood, which can make you feel ill (stage 4-5). There are many causes for CKD with the most common being diabetes. Other causes include high blood pressure, polycystic kidney disease, glomerulonephritis, kidney stones, diseases that affect the body’s immune system (e.g. lupus) and certain medications.
Since there is no cure for chronic kidney disease, our goal of treatment is to keep the disease from progressing to kidney failure, or end-stage renal disease (ESRD). We also treat complications of chronic kidney disease, which include heart disease, high blood pressure, poor bone health, nerve damage, low blood cell count (anemia), and electrolyte disorders. Our UC CKD team promotes a holistic approach that embraces both conventional and alternative therapies. Our team includes a kidney doctor (nephrologist), pharmacist, dietician and social worker. Your individualized treatment plan may involve controlling conditions that can slow the progression of chronic kidney disease (e.g diabetes, high blood pressure), lifestyle and nutritional counseling, assistance with weight loss (if needed), review of all your medications (prescription and over the counter) to make sure they are not harmful to your kidneys, as well as adjustment of the doses to the level of your current kidney function, psychosocial support in dealing with a chronic illness, preparation for dialysis (if appropriate) and referral for kidney transplant evaluation (if appropriate).
UC Multidisciplinary Chronic Kidney Disease Clinic is the first program in the country to receive a special recognition from the Joint Commission (Disease Specific Certification) in year 2010 and has been recertified every 2 years since with no findings for improvement.
Glomerular Disease Progression