Kidney Failure Due to an Electrolyte Imbalance

Electrolytes are substances in the body that help to conduct electrical impulses. Some common electrolytes are salt, potassium, calcium and sodium bicarbonate. Electrolyte imbalance is among one of the most common causes of kidney failure. Understanding how an electrolyte imbalance can occur and how it can be rectified can help prevent kidney failure.

Function

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  The job of electrolytes in the body is to keep a proper balance of fluid in and outside of cell walls. This balance is essential to almost every biochemical reaction throughout the body, from energy generation to muscle contraction. The kidneys' role in the body is to filter out toxins and wastes from the body.
  
  

  
  

Cause

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  Electrolytes most commonly become unbalanced as the result of dehydration. When a person loses more fluids than they take in, they also lose essential electrolytes. That leaves their bodies at a dangerous deficit. While mild and even moderate dehydration don't typically result in any real damage to the body, severe dehydration, or the loss of 10 percent of more of the body's fluids, can be life threatening. One of the first organs to fail will be the kidneys.
  
  
  
  

  
  

Result

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  An electrolyte imbalance affects the kidneys' ability to filter out waste products. Acute renal failure, or sudden-onset kidney failure caused by a specific event or stimuli, can very quickly become life threatening. Depending on how long the failure is allowed to continue, the kidneys may or may not be able to regain full function. Chronic renal failure is long-term and progressive kidney failure, either due to acute renal failure or another illness like diabetes, over time reduces the kidneys' ability to do their jobs effectively. Both types of kidney failure can further affect the kidneys' ability to maintain electrolyte homeostasis.
  
  

  
  

Treatment

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  Even if a patient is given fluids with electrolytes to restore the electrolyte balance, without proper monitoring and supplementation of electrolytes, an imbalance is likely to recur. Unless acute kidney failure is mild and no long-term damage to the kidneys is done, kidney failure is a deadly, progressive disease. One of the hallmarks of its treatment is monitoring electrolyte balances in the body and giving patients electrolytes as needed to maintain the necessary balance, since their kidneys are no longer able to maintain that balance on their own.
  
  

  
  

Physical Changes

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  Patients with kidney failure may experience urine that is not as concentrated, because the kidneys can no longer put a large amount of toxins in a small amount of urea. This means that urinary volume and variations in water intake will no longer be linked to each other. As the body needs to excrete more urine to get rid of the same levels of toxins previously excreted in small amounts of urine, dehydration can easily occur, further upsetting the body's electrolyte balance.
  
  

  
  

Acute Bilateral Obstructive Uropathy

Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys. The kidneys continue to produce urine in the normal manner, but because urine does not drain properly, the kidneys start to swell.

Alternative Names

Urethral obstruction; Acute urethral obstruction; Obstructive uropathy - bilateral - acute

Causes

In men, acute bilateral obstructive uropathy is most often a result of an enlarged prostate. Other causes in men include:

• Bladder cancer


• Kidney stones


• Prostate cancer

Acute bilateral obstructive uropathy is much less common in women, but may be due to:

• Bladder cystocele


• Cervical cancer


• Injury from surgery involving the reproductive organs


• Pregnancy

Other causes in men and women include:

• Blood clots


• Neurogenic bladder


• Other rare retroperitoneal processes


• Papillary necrosis


• Posterior urethral valves in infant boys

Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.

Symptoms

• Abnormal urine flow -- dribbling at the end of urination


• Blood in the urine


• Burning or stinging with urination


• Decrease in the force of the urinary stream, stream small and weak


• Decreased urine output (may be less than 10 mL per day)


• Feeling of incomplete emptying of the bladder


• Fever


• Frequent strong urge to urinate


• Recent increase in blood pressure


• Leakage of urine (incontinence)


• Nausea and vomiting


• Need to urinate at night


• Sudden flank pain or pain on both sides


• Urinary hesitancy


• Urine, abnormal color

Exams and Tests

The doctor will perform a physical exam. The exam may show:

• Large and full bladder


• Swollen or tender kidneys


• Enlarged prostate (men)

There may be signs of chronic kidney failure, high blood pressure, and infection. Fever is common with an infection.

Tests that may be done include:

• Arterial blood gas and blood chemistries


• Basic metabolic panel -- will reveal kidney function and electrolyte balance


• Blood BUN


• Creatinine clearance


• Complete blood count


• Potassium test


• Serum creatinine test


• Urinalysis and a urine culture (clean catch)


• Ultrasound of the bladder


• Uroflowmetry

The following tests may show hydronephrosis (swelling of kidneys):

• IVP


• Renal scan


• Ultrasound of the kidneys


• Abdominal CT scan

This disease may also alter the results of the following tests:

• Creatinine - urine


• Radionuclide cystogram

Treatment

The goal of treatment is to relieve the blockage, which will allow urine to drain from the urinary tract. You may need to stay in a hospital for a short while.

Short-term treatment may include:

• Antibiotics and other medications to treat symptoms


• Catheterization-- the placement of a tube into the body to drain urine (See: Urinary catheters)

Long-term treatment involves correcting the cause of the blockage. This may involve:

• Surgery such as transurethral resection of the prostate (TURP)


• Laser or heat therapy to shrink the prostate if the problem is due to an enlarged prostate

Surgery may also be needed for other disorders that cause blockage of the urethra or bladder neck.

Outlook (Prognosis)

If the acute obstruction is quickly relieved, symptoms usually go away within hours to days. If untreated, the disorder causes progressive damage to the kidneys. It may eventually lead to high blood pressure or kidney failure.

Possible Complications

• Acute kidney failure


• Chronic bilateral obstructive uropathy


• High blood pressure


• Reflux nephropathy


• Urinary tract infection


• Urinary retention or incontinence

Prevention

You may not be able to prevent this condition. Routine annual physicals with a primary care doctor are recommended. If your doctor finds you have acute obstructive uropathy, you should be referred to the nearest emergency room and seen by a urologist.

10 reasons to take care of your kidneys

 Kidneys’ function is vital

 Kidneys clean blood from wastes

 Kidneys help to keep your internal water balance

 Kidneys help to keep mineral balance

 Kidneys can retain essential elements needed by the body

 Kidneys help to maintain your blood composition and pH

 Kidneys help to control your blood pressure

 Kidneys help to keep strong bones

 Kidneys help to produce red blood cells

 Kidneys are the silent partner to good health!

Interesting Facts About Our Kidneys

Kidneys are vital organs, performing some of the most important functions in our body. They are sophisticated processing machines that keep our blood clean and chemically balanced.

It goes without saying that the more you know about your body and your health, the more control you have over your life.

As a Nephrologist, specializing in Chronic Kidney Disease and Hypertension, I decided to share some interesting information with my readers, pertaining to Kidney disease and Kidney health. I hope you will find the facts outlined below interesting and useful.

• Our Kidneys have a higher blood flow than our brain, liver or heart.

• The Kidneys absorb and distribute 99.9% of the blood volume. Only 0.1% of the blood filtered turns into urine.

• Each Kidney is about 5 inches long (13 centimeters) and weighs approximately 4 to 6 ounces (120-140 grams).

• The Kidneys filter almost 200 quarts of blood every day.

• 1 in 9 adults in America, or at least 26 million Americans, have Chronic Kidney Disease (CKD) and millions more are at increased risk. According to The American Society of Nephrology, the number of people diagnosed with Kidney disease has doubled for the last decade. I would strongly recommend blood and urine tests to detect early signs of the disorder.


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• Risk factors for CKD include: diabetes, hypertension, high cholesterol, obesity, advanced age, family history of CKD, and tobacco use.

 

• Each kidney has about a million tiny nephrons. A nephron is the basic functional unit of the kidney. It has a group of tiny blood vessels called a glomerulus, the small structure responsible for filtering and cleaning blood as it flows through the kidney. Most kidney diseases attack the nephrons, causing them to lose filtering capacity. Interestingly, Kidney diseases destroy the nephrons slowly and silently. The damage will become apparent only years or even decades later.

• The most frequent causes of Kidney disease are Diabetes and High blood pressure. Other causes include, Glomerulonephritis (inflammation of the glomerulus) and Polycystic Kidney Disease (an inherited disease, causing large cysts to form in the kidney). What most people don’t realize is that taking over-the-counter pain-relieving medicines, can also result in Kidney disorder. Please keep in mind that these medicines can be toxic to your Kidneys and may even provoke some serious damage.

• Heart disease is very common among people with Chronic Kidney Disease. CKD patients are more likely than the general population to develop heart condition. That’s why following all the necessary steps to prevent heart problems is absolutely crucial. What they should do is eat healthy foods, exercise on a regular basis and kick a smoking habit (in case they smoke). CKD patients should cut down on foods that contain saturated fat, such as eggs, milk, cheese and fried foods. Healthy foods rich in omega-3 fatty acids should become a part of their dietary regime. I cannot stress enough the importance of salmon, albacore tuna, sardines, walnuts or flaxseed oil in your diet.

• Patients with kidney dysfunction commonly develop anemia as a result of decreased hormone production in kidneys. Anemia can result in fatigue and a diminished functional status. Those with CKD and anemia can be treated effectively with medication.

• Kidney failure is not always permanent, which is great news for many people. In some cases of acute kidney failure, the kidney function returns with conservative management. Unfortunately, most causes of kidney disease are more insidious. They can progress slowly but steadily and without the proper management can lead to end stage kidney disease, requiring renal replacement therapy.

• Dialysis is the most common therapy for people suffering from end stage kidney failure. There are two types of Dialysis – hemodialysis and peritoneal dialysis. In hemodialysis, an artificial kidney used to remove waste, extra chemicals and fluid from your blood. The cleansed blood is returned to your body in a continuous circuit. Hemodialysis is the most common way to treat advanced Kidney failure. Typically it requires three treatments a week in a monitored dialysis center. The procedure may last up to three or four hours. In peritoneal dialysis, your blood is thoroughly cleaned within your body. What happens is your doctor places a plastic tube into your abdomen to make access. Sterile fluid is infused and wastes and excess fluid are removed. Peritoneal dialysis is done daily at home.

• Dialysis and Kidney Transplantation can extend the lives of people with Kidney failure. Fortunately, there are ways to prevent Kidney disease. Kidney-related disorders usually occur gradually over time. That’s why it is always better to identify potential disorder early on. Time is of the essence – early detection can slow the progression of CDK and protect your health.

• Only one donated Kidney is needed to replace two failed Kidneys. The life expectancy of someone who donates a kidney is the same as the general population. There is no increased risk of kidney disease if a well-screened person donates a kidney to someone who is in need of a transplant.

• Although most back pain has nothing to do with the kidneys, some kidney-related conditions could lead to back ache. The most common root of kidney-related back pain is a kidney stone. Please note that infections could be a less common but potentially serious cause of a kidney disorder. If you experience dull one-sided pain in the upper back, accompanied by fever and urinary symptoms, you should contact your healthcare provider. This may be a sign of a serious condition.