Renal failure: How to choose the best treatment

The kidneys are two twin organs located in the middle of the back, above the waist, which maintain the necessary balance of many components of the blood (sodium, potassium, calcium, phosphorus, bicarbonate and other ions) so that the functions of other organs are performed properly. They also help in the formation of Erythropoietin (EPO), which stimulates the formation of red blood cells in the bone marrow and whose absence leads to anemia. It is a fundamental regulator of arterial tension through the control of body water, sodium and tension regulating hormones.

When the kidneys do not work well, there is an alteration in all the functions that are proper and the clinical and analytical manifestations will depend on the grade of loss of renal function and whether it is an acute or chronic problem.

Through a simple analysis of blood and urine, you can know the grade of impaired renal function and know if it is an acute or chronic renal failure.

Types of renal impairment

Broadly speaking we can say that renal failure can occur in 2 ways: acute and chronic.

1.- Acute renal failure: The alteration of kidney functions occurs abruptly. The most common clinical manifestations are to urinate little or even stop urinating, the appearance of edema. The causes are multiple, from medications, dehydration due to diarrhea, vomiting or excessive diuretics, very low blood pressure due to serious infections, obstruction of urine output (stones, prostate, etc.).

2.- Chronic renal insufficiency: lack of symptoms until the alterations reach very advanced stages, where the actions that can be carried out to delay their progress as much as possible, are much more limited than if an early diagnosis was made of the illness. Today, the causes that stand out as the most frequent are HBP and Diabetes Mellitus, so that if they are not controlled properly, they can injure the kidneys.

Complications

In advanced stages, it is usual to find: anemia due to lack of Erythropoietin,  edema or swollen legs due to fluid retention, Arterial Hypertension (AHT) due to poor regulation of water volume, sodium and hormones involved, elevated urea and creatinine levels due to lack of filtration; high levels of phosphorus and potassium, acidosis, all of them due to poor regulation in their elimination in the urine. It can also cause death.

 

Treatments

Peritoneal dialysis: blood is cleaned inside the body, not outside. The inner membrane of the abdomen (the peritoneum) acts as a natural filter.

Hemodialysis: Hemodialysis is a treatment that removes waste and additional fluid from the blood. During hemodialysis, blood is pumped through soft tubes into a dialysis machine where it passes through a special filter called a dialyzer (also called an artificial kidney). As the blood seeps, it returns to the bloodstream.

Kidney transplant: A kidney transplant is an operation that places a healthy kidney of another person in the body. Many patients prefer a transplant instead of dialysis because it gives them more freedom, allows them to have a less restricted diet and can improve quality and life time. A kidney transplant is a treatment, not a cure. A person with a kidney transplant still has kidney disease, and may need some of the medications he was taking before the transplant.

Despite the time spent on treatments, they remain deficient. A hemodialysis, for example, does not extract larger and more toxic molecules in the long term. The consequences can lead to myocardial infarction, pulmonary thromboembolism or calcification of blood vessels. After these alterations, life expectancy is drastically reduced.

For this reason, the implementation of new drugs that help improve renal failure is sought, without having to reach dialysis. Currently, Althian is supporting the investigation of a new drug for this disease, if you need more information about the disease or its available treatments, we will be happy to help you.