Diseases: Renal Failure

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Renal failure occurs when the kidneys suffer from decreased blood flow which subsequentially impairs renal function (Linton, 2012). Kidney injury can be acute or chronic. End-stage renal disease (ESRD) is irreversible damage caused to the kidneys that requires long-term treatment. It is characterized by increased nitrogenous wastes in the blood. The kidneys are impaired to an extent where fluid and electrolyte balance cannot be maintained. This occurs due to nephron injury. Nephrons are microscopic filtering units responsible for excreting metabolic wastes. In ESRD, the nephrons are replaced with scar tissue that is unable to perform operations needed and “all sense of homeostasis is lost”(Story, 2012).
There are several causes of end-stage renal disease including diabetes mellitus, hypertension, and atherosclerosis. Hypertension is a medical diagnosis that often coincides with kidney impairment. Hypertension causes vasoconstriction of the arteries which not only limits cardiac output to the kidneys, but other vital organs as well. When blood flow is limited to the kidneys, the kidneys are stimulated to release renin. Renin converts to angiotensin; the adrenal cortex is stimulated to secrete aldosterone. Aldosterone is a hormone that causes sodium and water retention (Linton, 2012). The kidneys are not able to excrete fluid, ending in waste accumulation. Diabetes mellitus is the leading cause of kidney failure. The pathophysiology is similar to that of hypertension and atherosclerosis. However, patients with diabetes mellitus suffer from kidney failure related to the hardening of glucose in the arterial walls. The vessels become thickened when glucose levels are not managed over a long period of time (Story, 2012).
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...t types of peritoneal dialysis that the patient can do at home. Continuous ambulatory peritoneal dialysis (CAPD) allows the patient to move freely without being stuck to a machine. Automated peritoneal dialysis is done at night by a “cycler” to perform fluid exchanges during the night. This is less disruptive to the patient’s activities of daily living although it does need to be done roughly five to seven times a week (DaVita, 2013).
End-stage renal disease is a grueling disease process that requires long-term treatment. However, there are options for those suffering from the disease. Kidney transplant seems more ideal, but not everyone is a candidate for transplantation. Kidneys are also not a commodity that can be easily attained. Dialysis may be the only option for some individuals. These patients do have a choice on which dialysis treatment is right for them.

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