{"id":4873,"date":"2019-05-17T17:12:00","date_gmt":"2019-05-17T17:12:00","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/chapter\/renal-disease-and-failure\/"},"modified":"2019-09-25T10:35:39","modified_gmt":"2019-09-25T10:35:39","slug":"renal-disease-and-failure","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/chapter\/renal-disease-and-failure\/","title":{"raw":"Renal Disease and Failure","rendered":"Renal Disease and Failure"},"content":{"raw":"<h2>Infection in Urinary system:<\/h2>\r\n[caption id=\"\" align=\"alignleft\" width=\"306\"]<a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Bladder_Infection.png\"><img class=\"thumbimage\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/e\/e5\/Bladder_Infection.png\/220px-Bladder_Infection.png\" alt=\"\" width=\"306\" height=\"306\" \/><\/a> UTI - Bladder infection[\/caption]\r\n\r\n<div class=\"thumbcaption\">\r\n<div class=\"magnify\">A\u00a0<strong>urinary tract<\/strong>\u00a0infection (<strong>UTI<\/strong>) is an infection in any part of our urinary system \u2014 kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary<strong>\u00a0tract<\/strong>\u00a0\u2014 the bladder and the urethra. Women are at higher risk of developing a\u00a0<strong>UTI<\/strong>\u00a0than are men. UTI is treated with antibiotics. Urinary tract\u00a0infections are\u00a0<em>caused<\/em>\u00a0by microbes such as bacteria overcoming the body's defenses in the\u00a0urinary tract. Researchers have supported the use of cranberry juice to prevent UTIs by preventing the attachment to infection causing bacteria to the surface of urinary tract.<\/div>\r\n<\/div>\r\n<ul>\r\n \t<li>Infection localized in the ureter is called urethritis.\u00a0 \u00a0<strong>Urethritis<\/strong>\u00a0is inflammation of the urethra. The most common symptom is painful or difficult, urination.<\/li>\r\n \t<li>If the infection spreads to urinary bladder, then it is called <strong>cystitis<\/strong>.<\/li>\r\n \t<li>If the kidneys are infected, it is called <strong>pyelonephritis<\/strong><\/li>\r\n<\/ul>\r\n<h2><\/h2>\r\n<h2>Kidney Stones<\/h2>\r\n[caption id=\"\" align=\"alignright\" width=\"314\"]<a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Blausen_0595_KidneyStones.png\"><img class=\"thumbimage\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/d\/d8\/Blausen_0595_KidneyStones.png\/220px-Blausen_0595_KidneyStones.png\" alt=\"\" width=\"314\" height=\"237\" \/><\/a> Illustration of kidney stones[\/caption]\r\n\r\nThe kidney plays a very important role in the body as it\u00a0filters out waste products. Sometimes kidney stones can form when there is a build up of specific minerals in your urine. Kidney stones are hard, pebble-like pieces of material that form in one or both of your kidneys. They\u00a0rarely cause permanent damage if treated by a health care professional.\r\n\r\nKidney stones vary in size and shape. They may be as small as a grain of sand or as large as a pea. Rarely, some kidney stones are as big as golf balls. Kidney stones may be smooth or jagged and are usually yellow or brown. A small kidney stone may pass through your urinary tract on its own, causing little or no pain. A larger kidney stone may get stuck along the way. A kidney stone that gets stuck can block your flow of urine, causing severe pain or bleeding.\r\n<h2>Polycystic Kidney Disease<\/h2>\r\n<div class=\"wp-nocaption \">\r\n\r\n[caption id=\"\" align=\"alignleft\" width=\"300\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/1940\/2017\/05\/31174418\/ss-pathology-20g0027-lores.jpeg\" alt=\"Polycystic kidney disease, or PKD, is a cystic genetic disorder of the kidneys\" width=\"300\" height=\"209\" \/> Polycystic Kidney Disease[\/caption]\r\n\r\n<\/div>\r\nPolycystic kidney disease (PKD or PCKD, also known as polycystic kidney syndrome) is a cystic genetic disorder of the kidneys. There are two types of PKD: autosomal dominant polycystic kidney disease (ADPKD), and the less-common autosomal recessive polycystic kidney disease (ARPKD). PKD is characterized by the presence of multiple cysts (hence,\u201dpolycystic\u201d), typically in both kidneys. The cysts are numerous and are fluid-filled, resulting in massive enlargement of the kidneys. The disease can also damage the liver, pancreas, and, in some rare cases, the heart and brain. The two major forms of polycystic kidney disease are distinguished by their patterns of inheritance. Polycystic kidney disease is one of the most common life-threatening genetic diseases, affecting an estimated 12.5 million people worldwide.\r\n<h3><\/h3>\r\n[caption id=\"\" align=\"alignleft\" width=\"300\"]<a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\"><img src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/c\/cd\/Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\/300px-Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\" alt=\" Benign Prostatic Hyperplasia nci-vol-7137-300.jpg Two-panel drawing shows normal male reproductive and urinary anatomy and benign prostatic hyperplasia (BPH).\" width=\"300\" height=\"185\" \/><\/a> Benign Prostatic Hyperplasia[\/caption]\r\n<h3><strong>Benign Prostatic Hyperplasia<\/strong>\u00a0(<strong>BPH<\/strong>)<\/h3>\r\nThe\u00a0<strong>prostate<\/strong>\u00a0is a walnut-sized gland of the male reproductive system between the bladder and the penis. The urethra runs through the center of the\u00a0<strong>prostate.\u00a0\u00a0<\/strong><strong>Benign prostatic hyperplasia<\/strong>\u00a0(<strong>BPH<\/strong>), also called\u00a0<strong>prostate enlargement<\/strong>, is a noncancerous increase in the size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.\r\n\r\n&nbsp;\r\n\r\n<span style=\"color: #077fab;font-size: 1.15em;font-weight: 600\">Renal Failure<\/span>\r\n\r\nMany illness can cause progressive renal diseases and renal failure, especially diabetes and hypertension.\u00a0<strong>Renal failure<\/strong> (also kidney failure or renal insufficiency) is a medical condition in which the kidneys fail to adequately filter waste products from the\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/blood\/index.html\">blood<\/a>.\u00a0\u00a0<strong>Diagnosis: <\/strong>\u00a0Renal failure is mainly determined by a decrease in the glomerular\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/filtration\/index.html\">filtration<\/a>\u00a0rate, which is the rate at which blood is filtered in the glomeruli of the kidney. This is detected by a decrease in or absence of\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/urine\/index.html\">urine<\/a>\u00a0production or determination of waste products (creatinine or\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/urea\/index.html\">urea<\/a>) in the blood. Depending on the cause,\u00a0<strong><a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/hematuria\/index.html\">hematuria<\/a><\/strong>\u00a0(blood loss in the urine) and\u00a0<strong><a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/proteinuria\/index.html\">proteinuria<\/a>\u00a0<\/strong>(protein loss in the urine) may be noted.\r\n\r\nIn renal failure, there may be problems with increased fluid in the body (leading to swelling), increased acid levels, raised levels of potassium, decreased levels of calcium, increased levels of phosphate, and in later stages, anemia. Bone health may also be affected. Long-term kidney problems are associated with an increased risk of cardiovascular disease.\r\n<h2>Categories of Renal Failure<\/h2>\r\nRenal failure can be divided into two categories: <strong>acute kidney injury or chronic kidney disease<\/strong> .The type of renal failure is determined by the trend in the serum creatinine. Other factors that may help differentiate acute kidney injury from chronic kidney disease include anemia and the kidney size on ultrasound. Chronic kidney disease generally leads to anemia and small kidney size.\r\n\r\n<strong>Acute kidney injury (AKI)<\/strong>, previously called <strong>acute renal failure (ARF),<\/strong> is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults, less than 0.5 mL\/kg\/h in children or less than 1 mL\/kg\/h in infants); and fluid and\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/electrolyte\/index.html\">electrolyte<\/a>\u00a0imbalance. AKI can result from a variety of causes, generally classified as prerenal, intrinsic, and postrenal. An underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes.\r\n\r\n<strong>Chronic kidney disease<\/strong> (CKD) can also develop slowly and, initially, show few symptoms. CKD can be the long-term consequence of irreversible acute disease or part of a disease progression.\r\n\r\nSymptoms can vary from person to person. Someone in early stage kidney disease may not feel sick or notice symptoms as they occur. When kidneys fail to filter properly, waste accumulates in the blood and the body, a condition called azotemia. Very low levels of azotaemia may produce few, if any, symptoms. If the disease progresses, symptoms become noticeable (if the failure is of sufficient degree to cause symptoms). <strong>Renal failure uremia <\/strong>is a syndrome of renal failure characterized by elevated levels of urea and creatinine in the blood.\r\n<h2>Renal Failure Uremia<\/h2>\r\n<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/renal-failure-uremia\/index.html\">Renal failure uremia<\/a>\u00a0is a syndrome of renal failure that includes elevated blood urea and creatinine levels. Acute renal failure can be reversed if diagnosed early. Acute renal failure can be caused by severe\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/hypotension\/index.html\">hypotension<\/a>\u00a0or severe glomerular disease. Diagnostic tests include BUN\u00a0 (\u00a0Blood Urea Nitrogen ) and\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/plasma\/index.html\">plasma<\/a>\u00a0creatinine level tests. It is considered to be chronic renal failure if the decline of renal function is to less than 25%.\r\n\r\nIf you catch kidney disease early, you may be able to prevent kidney failure by taking steps to keep your kidneys as healthy as possible for as long as possible. If your kidneys fail, you will need <strong>dialysis<\/strong> or a <strong>kidney transplant<\/strong> to survive.\r\n\r\n<strong>Hemodialysis<\/strong>\/<strong>dialysis<\/strong>\u00a0is a process of purifying the blood of a person whose kidneys are not working normally. Dialysis removes excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure, thus maintaining homeostasis.\r\n\r\nDuring hemodialysis, patient's blood is pumped through a filter, called a <strong>dialyzer.\u00a0<\/strong>This machine works like an artificial\u00a0 kidney and filters out extra salt, waste, and fluid.\u00a0 Cleaned blood is sent back into your body through the second needle.\u00a0<strong>Peritoneal dialysis<\/strong>\u00a0(<strong>PD<\/strong>) uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood.\r\n\r\n[caption id=\"\" align=\"alignleft\" width=\"364\"]<a href=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/9\/93\/Hemodialysis-en.svg\"><img class=\"\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/9\/93\/Hemodialysis-en.svg\/654px-Hemodialysis-en.svg.png\" alt=\"File:Hemodialysis-en.svg\" width=\"364\" height=\"314\" \/><\/a> Hemodialysis[\/caption]\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"286\"]<a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Peritoneal_dialysis.gif\"><img class=\"\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/4\/4e\/Peritoneal_dialysis.gif\" alt=\"Peritoneal dialysis.gif\" width=\"286\" height=\"311\" \/><\/a> Diagram of peritoneal dialysis[\/caption]\r\n\r\n&nbsp;\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3><\/h3>\r\n<h3>Kidney Transplantation<\/h3>\r\nKidney transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. The\u00a0<strong>transplanted kidney\u00a0<\/strong>takes over the work of the two\u00a0<strong>kidneys<\/strong>\u00a0that failed, so you no longer need dialysis.\u00a0Kidney transplantation requires a person to be at the end stage of renal failure.\r\n<div><a href=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/e\/ea\/Kidney_for_transplant_from_live_donor.jpg\"><img class=\"alignleft\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/e\/ea\/Kidney_for_transplant_from_live_donor.jpg\/800px-Kidney_for_transplant_from_live_donor.jpg\" alt=\"File:Kidney for transplant from live donor.jpg\" width=\"391\" height=\"293\" \/><\/a><\/div>\r\n\r\n[caption id=\"\" align=\"alignleft\" width=\"268\"]<img class=\"atom__components__figure__image\" src=\"http:\/\/oer2go.org\/mods\/en-boundless\/figures.boundless-cdn.com\/6776\/large\/kidtransplant.jpeg\" alt=\"\" width=\"268\" height=\"262\" \/> Kidney Transplantation[\/caption]","rendered":"<h2>Infection in Urinary system:<\/h2>\n<div style=\"width: 316px\" class=\"wp-caption alignleft\"><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Bladder_Infection.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/e\/e5\/Bladder_Infection.png\/220px-Bladder_Infection.png\" alt=\"\" width=\"306\" height=\"306\" \/><\/a><\/p>\n<p class=\"wp-caption-text\">UTI &#8211; Bladder infection<\/p>\n<\/div>\n<div class=\"thumbcaption\">\n<div class=\"magnify\">A\u00a0<strong>urinary tract<\/strong>\u00a0infection (<strong>UTI<\/strong>) is an infection in any part of our urinary system \u2014 kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary<strong>\u00a0tract<\/strong>\u00a0\u2014 the bladder and the urethra. Women are at higher risk of developing a\u00a0<strong>UTI<\/strong>\u00a0than are men. UTI is treated with antibiotics. Urinary tract\u00a0infections are\u00a0<em>caused<\/em>\u00a0by microbes such as bacteria overcoming the body&#8217;s defenses in the\u00a0urinary tract. Researchers have supported the use of cranberry juice to prevent UTIs by preventing the attachment to infection causing bacteria to the surface of urinary tract.<\/div>\n<\/div>\n<ul>\n<li>Infection localized in the ureter is called urethritis.\u00a0 \u00a0<strong>Urethritis<\/strong>\u00a0is inflammation of the urethra. The most common symptom is painful or difficult, urination.<\/li>\n<li>If the infection spreads to urinary bladder, then it is called <strong>cystitis<\/strong>.<\/li>\n<li>If the kidneys are infected, it is called <strong>pyelonephritis<\/strong><\/li>\n<\/ul>\n<h2><\/h2>\n<h2>Kidney Stones<\/h2>\n<div style=\"width: 324px\" class=\"wp-caption alignright\"><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Blausen_0595_KidneyStones.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/d\/d8\/Blausen_0595_KidneyStones.png\/220px-Blausen_0595_KidneyStones.png\" alt=\"\" width=\"314\" height=\"237\" \/><\/a><\/p>\n<p class=\"wp-caption-text\">Illustration of kidney stones<\/p>\n<\/div>\n<p>The kidney plays a very important role in the body as it\u00a0filters out waste products. Sometimes kidney stones can form when there is a build up of specific minerals in your urine. Kidney stones are hard, pebble-like pieces of material that form in one or both of your kidneys. They\u00a0rarely cause permanent damage if treated by a health care professional.<\/p>\n<p>Kidney stones vary in size and shape. They may be as small as a grain of sand or as large as a pea. Rarely, some kidney stones are as big as golf balls. Kidney stones may be smooth or jagged and are usually yellow or brown. A small kidney stone may pass through your urinary tract on its own, causing little or no pain. A larger kidney stone may get stuck along the way. A kidney stone that gets stuck can block your flow of urine, causing severe pain or bleeding.<\/p>\n<h2>Polycystic Kidney Disease<\/h2>\n<div class=\"wp-nocaption\">\n<div style=\"width: 310px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/1940\/2017\/05\/31174418\/ss-pathology-20g0027-lores.jpeg\" alt=\"Polycystic kidney disease, or PKD, is a cystic genetic disorder of the kidneys\" width=\"300\" height=\"209\" \/><\/p>\n<p class=\"wp-caption-text\">Polycystic Kidney Disease<\/p>\n<\/div>\n<\/div>\n<p>Polycystic kidney disease (PKD or PCKD, also known as polycystic kidney syndrome) is a cystic genetic disorder of the kidneys. There are two types of PKD: autosomal dominant polycystic kidney disease (ADPKD), and the less-common autosomal recessive polycystic kidney disease (ARPKD). PKD is characterized by the presence of multiple cysts (hence,\u201dpolycystic\u201d), typically in both kidneys. The cysts are numerous and are fluid-filled, resulting in massive enlargement of the kidneys. The disease can also damage the liver, pancreas, and, in some rare cases, the heart and brain. The two major forms of polycystic kidney disease are distinguished by their patterns of inheritance. Polycystic kidney disease is one of the most common life-threatening genetic diseases, affecting an estimated 12.5 million people worldwide.<\/p>\n<h3><\/h3>\n<div style=\"width: 310px\" class=\"wp-caption alignleft\"><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/c\/cd\/Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\/300px-Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg\" alt=\"Benign Prostatic Hyperplasia nci-vol-7137-300.jpg Two-panel drawing shows normal male reproductive and urinary anatomy and benign prostatic hyperplasia (BPH).\" width=\"300\" height=\"185\" \/><\/a><\/p>\n<p class=\"wp-caption-text\">Benign Prostatic Hyperplasia<\/p>\n<\/div>\n<h3><strong>Benign Prostatic Hyperplasia<\/strong>\u00a0(<strong>BPH<\/strong>)<\/h3>\n<p>The\u00a0<strong>prostate<\/strong>\u00a0is a walnut-sized gland of the male reproductive system between the bladder and the penis. The urethra runs through the center of the\u00a0<strong>prostate.\u00a0\u00a0<\/strong><strong>Benign prostatic hyperplasia<\/strong>\u00a0(<strong>BPH<\/strong>), also called\u00a0<strong>prostate enlargement<\/strong>, is a noncancerous increase in the size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #077fab;font-size: 1.15em;font-weight: 600\">Renal Failure<\/span><\/p>\n<p>Many illness can cause progressive renal diseases and renal failure, especially diabetes and hypertension.\u00a0<strong>Renal failure<\/strong> (also kidney failure or renal insufficiency) is a medical condition in which the kidneys fail to adequately filter waste products from the\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/blood\/index.html\">blood<\/a>.\u00a0\u00a0<strong>Diagnosis: <\/strong>\u00a0Renal failure is mainly determined by a decrease in the glomerular\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/filtration\/index.html\">filtration<\/a>\u00a0rate, which is the rate at which blood is filtered in the glomeruli of the kidney. This is detected by a decrease in or absence of\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/urine\/index.html\">urine<\/a>\u00a0production or determination of waste products (creatinine or\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/urea\/index.html\">urea<\/a>) in the blood. Depending on the cause,\u00a0<strong><a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/hematuria\/index.html\">hematuria<\/a><\/strong>\u00a0(blood loss in the urine) and\u00a0<strong><a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/proteinuria\/index.html\">proteinuria<\/a>\u00a0<\/strong>(protein loss in the urine) may be noted.<\/p>\n<p>In renal failure, there may be problems with increased fluid in the body (leading to swelling), increased acid levels, raised levels of potassium, decreased levels of calcium, increased levels of phosphate, and in later stages, anemia. Bone health may also be affected. Long-term kidney problems are associated with an increased risk of cardiovascular disease.<\/p>\n<h2>Categories of Renal Failure<\/h2>\n<p>Renal failure can be divided into two categories: <strong>acute kidney injury or chronic kidney disease<\/strong> .The type of renal failure is determined by the trend in the serum creatinine. Other factors that may help differentiate acute kidney injury from chronic kidney disease include anemia and the kidney size on ultrasound. Chronic kidney disease generally leads to anemia and small kidney size.<\/p>\n<p><strong>Acute kidney injury (AKI)<\/strong>, previously called <strong>acute renal failure (ARF),<\/strong> is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults, less than 0.5 mL\/kg\/h in children or less than 1 mL\/kg\/h in infants); and fluid and\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/electrolyte\/index.html\">electrolyte<\/a>\u00a0imbalance. AKI can result from a variety of causes, generally classified as prerenal, intrinsic, and postrenal. An underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes.<\/p>\n<p><strong>Chronic kidney disease<\/strong> (CKD) can also develop slowly and, initially, show few symptoms. CKD can be the long-term consequence of irreversible acute disease or part of a disease progression.<\/p>\n<p>Symptoms can vary from person to person. Someone in early stage kidney disease may not feel sick or notice symptoms as they occur. When kidneys fail to filter properly, waste accumulates in the blood and the body, a condition called azotemia. Very low levels of azotaemia may produce few, if any, symptoms. If the disease progresses, symptoms become noticeable (if the failure is of sufficient degree to cause symptoms). <strong>Renal failure uremia <\/strong>is a syndrome of renal failure characterized by elevated levels of urea and creatinine in the blood.<\/p>\n<h2>Renal Failure Uremia<\/h2>\n<p><a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/renal-failure-uremia\/index.html\">Renal failure uremia<\/a>\u00a0is a syndrome of renal failure that includes elevated blood urea and creatinine levels. Acute renal failure can be reversed if diagnosed early. Acute renal failure can be caused by severe\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/hypotension\/index.html\">hypotension<\/a>\u00a0or severe glomerular disease. Diagnostic tests include BUN\u00a0 (\u00a0Blood Urea Nitrogen ) and\u00a0<a class=\"keyterm__mention\" href=\"http:\/\/oer2go.org\/mods\/en-boundless\/www.boundless.com\/physiology\/definition\/plasma\/index.html\">plasma<\/a>\u00a0creatinine level tests. It is considered to be chronic renal failure if the decline of renal function is to less than 25%.<\/p>\n<p>If you catch kidney disease early, you may be able to prevent kidney failure by taking steps to keep your kidneys as healthy as possible for as long as possible. If your kidneys fail, you will need <strong>dialysis<\/strong> or a <strong>kidney transplant<\/strong> to survive.<\/p>\n<p><strong>Hemodialysis<\/strong>\/<strong>dialysis<\/strong>\u00a0is a process of purifying the blood of a person whose kidneys are not working normally. Dialysis removes excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure, thus maintaining homeostasis.<\/p>\n<p>During hemodialysis, patient&#8217;s blood is pumped through a filter, called a <strong>dialyzer.\u00a0<\/strong>This machine works like an artificial\u00a0 kidney and filters out extra salt, waste, and fluid.\u00a0 Cleaned blood is sent back into your body through the second needle.\u00a0<strong>Peritoneal dialysis<\/strong>\u00a0(<strong>PD<\/strong>) uses the peritoneum in a person&#8217;s abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood.<\/p>\n<div style=\"width: 374px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/9\/93\/Hemodialysis-en.svg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/9\/93\/Hemodialysis-en.svg\/654px-Hemodialysis-en.svg.png\" alt=\"File:Hemodialysis-en.svg\" width=\"364\" height=\"314\" \/><\/a><\/p>\n<p class=\"wp-caption-text\">Hemodialysis<\/p>\n<\/div>\n<div style=\"width: 296px\" class=\"wp-caption alignright\"><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Peritoneal_dialysis.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/4\/4e\/Peritoneal_dialysis.gif\" alt=\"Peritoneal dialysis.gif\" width=\"286\" height=\"311\" \/><\/a><\/p>\n<p class=\"wp-caption-text\">Diagram of peritoneal dialysis<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3>Kidney Transplantation<\/h3>\n<p>Kidney transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. The\u00a0<strong>transplanted kidney\u00a0<\/strong>takes over the work of the two\u00a0<strong>kidneys<\/strong>\u00a0that failed, so you no longer need dialysis.\u00a0Kidney transplantation requires a person to be at the end stage of renal failure.<\/p>\n<div><a href=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/e\/ea\/Kidney_for_transplant_from_live_donor.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/e\/ea\/Kidney_for_transplant_from_live_donor.jpg\/800px-Kidney_for_transplant_from_live_donor.jpg\" alt=\"File:Kidney for transplant from live donor.jpg\" width=\"391\" height=\"293\" \/><\/a><\/div>\n<div style=\"width: 278px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"atom__components__figure__image\" src=\"http:\/\/oer2go.org\/mods\/en-boundless\/figures.boundless-cdn.com\/6776\/large\/kidtransplant.jpeg\" alt=\"\" width=\"268\" height=\"262\" \/><\/p>\n<p class=\"wp-caption-text\">Kidney Transplantation<\/p>\n<\/div>\n","protected":false},"author":141992,"menu_order":8,"template":"","meta":{"_candela_citation":"[]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-4873","chapter","type-chapter","status-publish","hentry"],"part":4866,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapters\/4873","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/wp\/v2\/users\/141992"}],"version-history":[{"count":29,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapters\/4873\/revisions"}],"predecessor-version":[{"id":6033,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapters\/4873\/revisions\/6033"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/parts\/4866"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapters\/4873\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/wp\/v2\/media?parent=4873"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/pressbooks\/v2\/chapter-type?post=4873"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/wp\/v2\/contributor?post=4873"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-dutchess-ap1\/wp-json\/wp\/v2\/license?post=4873"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}