Renal insufficiency: what are the causes and treatments?

Renal insufficiency: what is it exactly?

Before talking about kidney failure, first explain the kidney function. Our two kidneys fulfill three main roles: they eliminate the waste produced by the body (in particular urea, uric acid and creatinine), they guarantee the balance of the minerals (sodium and potassium, in particular) and they maintain the body's water balance (that is, the amount of water).

There are two types of kidney failure: acute renal failure and chronic renal failure.

• We talk aboutacute renal failure when, suddenly, the kidneys begin to malfunction. " Acute kidney failure rarely happens in isolation - it's often linked to another medical problemsays Prof. François Kleinclauss, urologist surgeon. Causes of acute renal failure include drug poisoning, renal colic or a dehydration strict. "
• There is a chronic renal failure when, for more than 3 months, the glomerular filtration rate (ie: the filtration capacity of the kidneys) is less than 60 mL per minute. " Chronic renal failure is a prolonged impairment of kidney function "says the surgeon.

Chronic renal failure: what are the causes and symptoms?

In France, 87,000 patients have chronic renal failure. " This pathology occurs after 60 years, especially in overweight patients "Dr. Kleinclauss analyzes," The risk factors for chronic renal failure are:

" Some genetic and familial diseases also increase the risk of developing chronic renal failure: I think, for example, with polycystic kidney-renal disease "adds the specialist.

What are the symptoms ? " They only appear at an advanced stage of chronic renal failure says Prof. Kleinclauss, for example:

• Edema (in the lower limbs, lungs ...),
• Anemia,
• Hyperkalemia (ie, high potassium levels in the blood, with potential cardiac consequences).

Renal insufficiency: what are the treatments?

For'acute renal failure, " it is a question of treating primarily the origin of the renal dysfunction Prof. Kleinclauss explains - if the problem is not advanced, rehydration of the patient (at the hospital) may be sufficient, but if the acute renal failure is more severe, haemofiltration (in the hospital) can be put in place temporarily - it is to filter the blood using a machine, to replace the functioning of the kidneys.

When'chronic renal failure is not too advanced, the establishment of dietary and lifestyle measures will be necessary to slow the evolution of the disease:

• avoid potentially nephrotoxic drugs (nonsteroidal anti-inflammatory drugs, certain treatments against high blood pressure ...),
• drink enough: about 1.5 L each day,
• do not eat too much salt,
• limit the consumption of animal proteins (red meat, white meat, cold cuts ...).

When chronic renal failure is very advanced and the kidneys do not work anymore (we are talking aboutchronic end stage renal failure), it is necessary to replace the renal function. Two possibilities :

• The dialysis. " Surgically, a connection is created between a vein and an artery (it is an arterio-venous fistula) to increase blood flow in the vein. Then, three times a week, the patient goes to the hospital (or dialysis center or even home) so that his blood is filtered using a machine, before being reinjected into his body. We are talking about dialysis or hemodialysis "explains Prof. Kleinclauss.
• The kidney transplant. " It is the best treatment for end-stage renal failure: kidney transplant increases the life expectancy and comfort of life of the patient. In concrete terms, this involves replacing the patient's kidney with a transplant. There is no age limit and contraindications are rare "develops the specialist.

Thanks to Prof. François Kleinclauss, urologist and department head CHU of Besançon.

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⋙ Camille Combal lives with one kidney and discovered it "not so long ago"