KIDNEY FAILURE, CHRONIC (Uremia)
DESCRIPTIONChronic kidney failure is the inability of the kidneys to eliminate the body's nitrogen waste products. Uremia usually develops gradually. Poor kidney function eventually affects all body systems.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Kidney transplant, if possible.
Kidney dialysis (See Glossary), if available.
Hospitalization for complications and care in final stages.
SIGNS & SYMPTOMSListlessness, mental confusion, and drowsiness.
High blood pressure.
Shortness of breath.
Inflamed, bleeding gums and mouth ulcers.
Numbness, tingling, and burning in the legs and feet.
Decreased sex drive.
Cessation of menstruation.
Anemia, with paleness and fatigue.
Muscle and bone pain. Bones break easily.
None or few symptoms until 60% to 75% of kidney filtration fails. Then, one or more of the following:
CAUSESCollagen diseases, such as systemic lupus erythematosus.
Chronic urinary-tract infections.
Congenital kidney abnormalities, such as polycystic kidney disease.
Kidney damage due to diabetes mellitus.
Overdose of many drugs and chemicals, especially phenacetin or streptomycin.
Blood-vessel diseases, such as hardening of the arteries in, or leading to, the kidney.
Use of mind-altering drugs.
PREVENTING COMPLICATIONS OR RECURRENCEObtain medical treatment for underlying diseases that lead to uremia before uremia results.
MEDICAL TESTSLaboratory blood and urine studies of kidney function; X-rays of kidneys; kidney biopsy (See Glossary).
POSSIBLE COMPLICATIONSPericarditis; myocarditis; pneumonia; pancreatitis; hormone deficiencies; fluid and electrolyte imbalance; gastrointestinal ulcers.
Kidney transplants can sometimes cure younger patients. Otherwise, kidney failure is a condition that worsens gradually and causes death. Kidney dialysis treatment can improve the quality of life and prolong life for several years.
HOME CAREInstructions for your child:
To decrease itching, add 1 cup of oatmeal to your daily bath.
Brush teeth and use mouthwash often to minimize gum and mouth problems.
Weigh daily and keep a record.
Measure the fluids you drink and the urine you pass each day. Keep a record and take it with you to doctor visits. You should pass about 2500cc or more of urine a day. If you pass less, decrease fluid intake so intake does not exceed output by more than 800cc a day. For example, if you pass 2000cc in 24 hours, don't drink more than 2800cc in the next 24 hours.
Your doctor may prescribe: diuretics to reduce fluid accumulation; iron and folic-acid supplements for anemia; stool softeners to prevent constipation; digitalis for congestive heart failure.
Your child must reduce activity, being careful not to become overheated or fatigued. The child should sleep more at night and take rests during the day. If your child is confined to bed, encourage flexing the legs often to reduce the chance of blood clots in leg veins.
DIET & FLUIDS
Urge your child to eat a low-salt, low-potassium, low-protein diet with added fiber. Serve the child frequent small, high-calorie meals.
OK TO GO TO SCHOOL?Not until kidney function returns to normal.
CALL YOUR DOCTOR IF
Your child has symptoms of uremia.
The following occurs during treatment: fever, vomiting or diarrhea, urine output of less than 2000cc, severe headache, and convulsion.