Chronic Kidney Failure

WHAT YOU SHOULD KNOW:

• Chronic kidney failure is also called chronic renal failure or CRF. It is a long-term kidney disease. The kidneys are two bean-shaped organs that remove unwanted chemicals and waste from the blood. Your kidneys slowly stop working in chronic kidney failure. This usually occurs when you have high blood pressure or high blood sugar levels (diabetes). You may have decreased urine output, edema (swelling) of arms, feet, and face, or increased blood pressure.
  
  
• Blood and urine tests can check if your kidneys are working well. Tests that take pictures of kidneys, such as ultrasound, x-rays, and computerized tomography (CT) scans can also be used. Chronic kidney failure can only be controlled with proper and timely treatment. It can get worse and become end-stage renal disease if left untreated.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Treatments for chronic kidney failure may cause unpleasant side effects. If CRF is not treated, other problems may occur. Your organs could stop working and you may die from chronic kidney failure. The risk of serious illness or death is much less if CRF is found and treated early. Ask your caregiver if you are worried or have questions about your disease, care, or treatment.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Diet: You may need to eat special food to help your kidneys work best. This can help decrease the amount of wastes made by your body. A caregiver called a dietitian may talk to you about the food you can eat. Your stomach will need to rest if you have been vomiting (throwing up). A tube put into a vein (IV) will give you the liquids and vitamins that your body needs until you can eat.

Intake and output: Your caregivers may need to know the amount of liquid you are getting. They may also need to know how much you are urinating. Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Certain foods also contain liquid. You may need more or less liquid each day. Ask your caregiver how much liquid you should have each day. Ask caregivers if they need to measure or collect your urine before you dispose of it.

Medicines: Your caregiver may give you the following kinds of medicines:

• Blood pressure medicine: This medicine may be given to lower your blood pressure. Keeping your blood pressure under control protects your heart, lungs, brain, kidneys, and other organs.
  
  
• Diuretics: This medicine is often called "water pills". Diuretics help your body get rid of extra fluid (edema) in your legs and ankles. This medicine may also help get rid of extra fluid in your lungs or around your heart. It may also decrease your blood pressure. You may urinate more often when taking diuretics.
  
  
• Erythropoietin: Your kidneys do not make enough erythropoietin in chronic kidney failure. Erythropoietin is a natural chemical that helps your body make red blood cells.
  
  
• Steroids: You may need steroids to decrease inflammation (swelling). Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.

Tests: You may need one or more of the following:

• Blood tests: You may need different blood tests.
  
  
• Imaging tests: The following tests may be used to take pictures of your kidneys:
  
  
  • Computerized tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your kidneys. Caregivers look at the kidney pictures. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the kidneys show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish.
    
    
  • Magnetic resonance imaging: Another name for this test is an MRI. During the MRI, pictures are taken of your kidneys. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.
    
    
  • KUB x-ray: An x-ray machine takes pictures of your kidneys (K), ureters (U), and bladder (B). The ureters are tiny tubes that carry urine from your kidneys to your bladder. The bladder is where the urine is stored before leaving your body. Caregivers use these pictures to check for problems with your intestines , kidneys, or abdomen.
    
    
  • Percutaneous kidney biopsy: A percutaneous kidney biopsy is when a very small piece of your kidney is taken out and tested. For this procedure, you will need to lie face-down and hold very still. You may get medicine to help you relax before the biopsy. You may also get medicine to make the area numb (lose feeling) before the needle is put in. Caregivers put a needle into your back and through to your kidney. The needle has a sharp edge that will cut out a tiny piece of your kidney. The needle may have to be put in two or more times. After the needle is taken out, a bandage will be put over the area.
    
    
  • Renal ultrasound: This is a simple test using sound waves to look at your kidneys. Pictures of your kidneys show up on a TV-like screen. An ultrasound can show if you have a kidney stone, an abscess, or certain other problems.
  
  
• Urine tests: Your urine is usually collected over a 24-hour period. The urine is measured and sent to a lab for tests.

Treatment options: Your treatment may change if the kidney failure is not being controlled by medicines. This is often decided after you have tests. You may have one or more of the following:

• Dialysis: Dialysis cleans your blood of wastes when your kidneys no longer function well.
  
  
• Kidney transplant: A healthy kidney from another person is placed into your body. The donated kidney does the work that your two failed kidneys used to do. Your diseased kidneys will be removed during the surgery.
  
  
• Surgery: You may need surgery if your kidney failure is caused by a blockage in your urine system.

Weight: You may be weighed each day. Caregivers compare your weight from day to day. This helps caregivers see how much body fluid you have. When you lose too much body fluid you can become dehydrated. If you have too much body fluid, you may have trouble breathing and get swollen ankles. Your body does not work well when it has too much or too little fluid.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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