Chronic Renal Failure
Chronic renal failure describes the condition where kidney function deteriorates over a period of time as a consequence of other disease processes such as diabetes mellitus, polycystic kidneys or uncontrolled high blood pressure. The high levels of urea and creatinine are the cause of the symptoms of lethargy, nausea and itch, and as kidney function deteriorates further it can produce fluid overload and retention (oedema) in both the limbs and the lungs, confusion and coma. In many patients the decline in kidney function proceeds at a steady rate: one measure of kidney function is called the glomerular filtration rate, and in a normal healthy adult this is 120 millilitres per minute. Monitoring the level of creatinine - produced as a result of muscle contraction -provides a sensitive measure of glomerular filtration rate and allows us to maximise remaining kidney function (by avoiding, for example, drugs such as non-steroidal anti-inflammatory agents which may be toxic to the kidney) and thereby delay the need to start dialysis. Chronic renal failure due to diseases such as diabetes or high blood pressure may be reduced by making sure the underlying diseases are properly controlled.
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