Renal failure can be acute, with a sudden onset, or a chronic condition that progresses slowly over years. Over 250 million Americans have chronic renal failure and more than 50,000 die annually from renal failure effects and complications. Diabetes and hypertension are the two leading causes of kidney failure. The kidneys affect fluid and electrolyte balance, blood pressure, breakdown of insulin and the removal waste products from the body. Renal failure affects multiple body systems.
General Feeling of Illness
As kidney function declines, the first symptom noted is a general feeling of illness. Donna D. Ignatavicius, MS, RN, and M. Linda Workman, Ph.D, authors of "Medical-Surgical Nursing," discuss how nitrogenous waste products increase insidiously in the blood. Patients often attribute fatigue, headache and low energy to other causes, such as overwork, stress, allergies or some other illness.
Nausea and Decreased Appetite
A buildup of nitrogenous waste products in the blood is called azotemia. The general unwell feeling caused by azotemia suppresses a person's appetite. Fluid and electrolyte disturbances and altered blood glucose levels because of impaired insulin degradation cause nausea. Nausea and a loss of appetite further decrease energy levels.
Dry Itchy Skin
Azotemia can become quite severe before people become acutely ill. As waste products build up in the body, perspiration is saturated with urea and forms a uremic frost, which coats the skin. Perspiration has a urinous odor, and the skin is dry and itchy.
Edema
Scott and White Hospital reports that as kidney function continues to decline, people experience fluid retention. Edema, which is swelling, is first noted in dependent body parts, like the hands and feet. Gradually the swelling becomes generalized, and more advanced symptoms of fluid retention occur, such as shortness of breath, wet cough and congestive heart failure.
Increased Heart Rate and Blood Pressure
Renal failure effects include increased heart rate and blood pressure, which are called tachycardia and hypertension. Fluid retention and electrolyte disturbances cause vital sign changes. Two electrolyte disturbances are high potassium and low sodium blood levels, which cause muscle weakness, irregular heart rhythms and sudden death.
Confusion
Azotemia worsens as kidney function declines. Confusion is an insidious symptom of kidney failure most often noticed by friends and family before the patient is aware of any problem. If renal failure remains untreated, confusion progresses to serious central nervous system complications such as coma, seizure and death.
References
- "Medical-Surgical Nursing - Critical Thinking for Collaborative Care"; Donna D. Ignatavicius MS RN, & M. Linda Workman Ph.D; 2006
- Scott and White Hospital Patient Information: "Chronic Kidney Disease"
