Renal Diseases

RENAL DISEASES

Etiology of Renal Disease

Kidney disorders can be initially caused by infection, degenerative changes, diabetes mellitus, high blood pressure cysts, renal stones, or trauma (surgery, burns, poisons). When these conditions are severe, renal failure may develop. It may be acute or chronic. Acute renal failure (ARF) occurs suddenly and may last a few days or a few weeks. It can be caused by another medical problem such as a serious burn, a crushing injury, or cardiac arrest. It can be expected in some of these situations, so preventive steps should be taken.

Classification of Renal Disease

Chronic kidney disease develops slowly, causing the number of functioningnephrons to diminish. When renal tissue has been destroyed to a point at which the kidneys are no longer able to filter the blood, excrete wastes, or recycle nutri-ents as needed, uremia occurs. Uremia is a condition in which protein wastes that should normally have been excreted are instead circulating in the blood. Symp-toms include nausea, headache, convulsions, and coma. Severe renal failure can result in death unless dialysis is begun or a kidney transplant is performed.

Nephritis is a general term referring to the inflammatory diseases ofthe kidneys. Nephritis can be caused by infection, degenerative processes, or vascular disease.

Glomerulonephritis is an inflammation affecting the capillaries in theglomeruli. It may occur acutely in conjunction with another infection and be self-limiting, or it may lead to serious renal deterioration.

Nephrosclerosis is the hardening of renal arteries. It is caused by arte-riosclerosis and hypertension. Although it usually occurs in older people, it sometimes develops in young diabetic clients.

Polycystic kidney disease is a relatively rare, hereditary disease. Cystsform and press on the kidneys. The kidneys enlarge and lose function. Althoughpeople with this condition have normal kidney function for many years, renal failure may develop near the age of 50.

Nephrolithiasis is a condition in which stones develop in the kidneys.The size of the stones varies from that of a grain of sand to much larger. Some remain at their point of origin, and others move. Although the condition is sometimes asymptomatic, symptoms include hematuria (blood in the urine), infection, obstruction, and, if the stones move, intense pain. The stones are classified according to their composition—calcium oxalate, uric acid, cystine, calcium phosphate, and magnesium ammonium phosphate (known as stru-vite). They are associated with metabolic disturbances and immobilization of the client.