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Friday, September 23, 2005
Understanding kidney failure
By Henrylito D. Tacio
A COUPLE of years back, tragedy struck the wrestling world when former All Japan Pro Wrestling star Tomomi "Jumbo" Tsuruta succumbed to kidney failure. The 49-year-old "heavyweight" underwent a kidney transplant operation in a Manila hospital and died from excessive bleeding after the surgery.
In the Philippines, kidney diseases are among the top 10 leading causes of deaths, according to the Department of Health (DOH). Every year, about 10,000 Filipinos develop kidney failure that requires dialysis for life or a kidney transplant. That was what happened to former president Ferdinand Marcos, who died of kidney failure as a result of lupus, an autoimmune disease.
The kidneys--two bean-shaped organs, each about the size of a fist--perform a life-sustaining role. Located at the back of the upper abdomen, both house an elaborate filtering system that processes about 200 liters of blood--the equivalent of 500 cans of soft drink--daily. They cleanse the blood by removing waste and excess fluids, maintain a healthful balance of various body chemicals, and help regulate blood pressure.
"When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body--a condition known as kidney (renal) failure," explains the Minnesota-based Mayo Clinic.
"Sometimes kidney failure happens suddenly (acute kidney failure). This is most likely to occur after complicated surgery or a severe injury, or when blood vessels leading to your kidneys become blocked."
On the other hand, chronic kidney failure usually develops slowly, with few signs or symptoms in the early stages. "Many people with chronic kidney failure don't realize they have a problem until their kidney function has decreased to less than 25 percent of normal," informs the Mayo Clinic.
The signs and symptoms of kidney failure vary, depending on whether the failure is acute or chronic. In acute kidney failure, the signs and symptoms include fluid retention, bleeding (often in the stomach or intestines), confusion, seizures, and coma.
Unlike acute kidney failure, chronic kidney failure attacks without symptoms. They appear only until irreversible damage has occurred. They include: high blood pressure, unexplained weight loss, anemia, nausea or vomiting, malaise or fatigue, headaches that seem unrelated to any other cause, decreased urine output, decreased mental sharpness, muscle twitches and cramps, bleeding in the intestinal tract, yellowish-brown cast to the skin, persistent itching, and sleep disorders.
"If left untreated, diseased kidneys may eventually stop functioning," points out 'The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments.' "Loss of kidney function is a very serious and potentially fatal condition."
In acute kidney failure, medical science says that there are several factors that can cause the kidneys to shut down suddenly. Complicated surgery, severe burns or trauma are among them. Many cases of acute kidney failure are related to surgery or to trauma that involves shock or severe bleeding. In these cases, the cause is often a drastic drop in blood pressure that prevents an adequate amount of blood from reaching the kidneys.
Renal ischemia and heatstroke also cause kidneys to shut down. Renal ischemia occurs when an obstructed or constricted blood vessel prevents the kidneys from getting enough blood, and it may be the result of shock or dehydration. On the other hand, heatstroke occurs when the body isn't able to deal with heat stress, may lead to acute kidney failure.
In some people, acute kidney failure occurs as part of multiple organ failure in which the heart, lungs, liver, brain and kidneys totally or partially shut down. This is most often the result of major trauma or serious systemic infection (sepsis).
Certain antibiotics--especially streptomycin or gentamicin--and common pain medications, such as aspirin and ibuprofen can also damage the kidneys. Pain medications have the potential to cause acute kidney failure even in healthy people who use them regularly.
Antibiotics pose a greater risk of acute renal failure if a person has liver or kidney disease, is older, or uses diuretics or other drugs that affect the kidneys.
Kidney failure is a life-threatening condition that requires medical care.
Alternative treatments may be used to supplement that care, but before trying them a person should discuss them thoroughly with his doctor.
Dr. Dinna Cruz, a kidney specialist with the St. Luke's Medical Center, said recent researches indicate that kidney failure can be prevented or delayed if chronic kidney disease is diagnosed early enough in its progression and treated properly.
When the diabetes and hypertension are controlled by treatment, the associated kidney disease can often be prevented or slowed down.
The Philippine Society of Nephrology said diabetes is the single most common cause of kidney failure. Among those suffering from hypertension, kidney failure happens when tiny vessels in the kidneys are blocked.
The kidneys malfunctions are unable to clean the body of wastes. Patient is slowly poisoned, becomes weak and bloated.
Dr. Cruz said many effective drugs are available to treat hypertension. In addition, healthy lifestyle changes, such as losing weight and regular exercise, often help to control, and may even help to prevent, high-blood pressure.
Another important step is to stop smoking. Men who smoked were three times more likely than non-smokers to have reduced kidney function, and also have an increased likelihood of having protein in their urine. "If you don't already smoke, don't start," Dr. Cruz said.
But if these measures fail, and the kidneys deteriorate to the point where they can no longer function at all, there are only two treatments: dialysis or kidney transplant. Dialysis treatment, which uses artificial devices to perform the kidneys' functions, is necessary for cares of advanced kidney disease.
For comments and feedback, write me at tasyo2002@yahoo.com
For Bisaya stories from Davao. Click here. (September 23, 2005 issue)
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