Diagnosis renal failure Be well informed

What is “renal failure” and why does it happen?

The kidneys are vital organs. They are responsible for the removal of waste products from the body, the regulation of body fluids and the production of some hormones. When kidneys can no longer perform these functions at sufficient capacity, the result is kidney disease, also called renal failure. Usually, renal failure occurs as the result of a gradual decrease in the efficiency of the kidneys over a long period (chronic renal failure). Many conditions can lead to chronic renal failure; the most frequent include diabetes, chronic kidney inflammation, high blood pressure and vascular damage. In some cases it is the consequence of sudden kidney failure (i.e. acute renal failure).

As a hemodialysis or peritoneal dialysis patient, you will have different medications prescribed for different purposes. You should always be aware of all medication you take, meaning that you should know their names, purposes and how they are administered. Whenever you have problems with your medications or any questions, do not hesitate to contact your doctor or nursing staff in your renal care center. Impaired renal function and hemodialysis can drastically alter the effects of medication. Consult your doctor before making any changes to your current medication.

The following medications are used most frequently:

Antihypertensives  

Many patients suffer from high blood pressure (hypertension). Hypertension can harm you. Therefore, blood pressure has to be regulated with appropriate medication and carefully monitored especially during treatment.

Erythropoietin (EPO)

Erythropoietin, often referred to as EPO, is a hormone produced by the kidneys that stimulates the bone marrow to produce red blood cells. Since the production of erythropoietin in chronic kidney disease patients is reduced, the number of red blood cells is also reduced. This is the main aspect leading to a condition known as renal anemia. Synthetic erythropoietin can be given intravenously or through the skin as a substitute for natural erythropoietin in order to maintain an adequate number of red blood cells. It may also be given through the bloodlines of the dialysis machine during the dialysis treatment. 

Iron

Iron is a vital building block of hemoglobin, the key protein found in normal red blood cells. Without iron, it is difficult for the body to create enough healthy red blood cells. This is why iron supplementation is mostly necessary in addition to EPO. Iron is usually supplied by an intravenous infusion at the renal care center.

Phosphate binders 

Our kidneys normally excrete the phosphate that is absorbed with food. In chronic renal failure, this no longer happens. Therefore, phosphate levels in the body increase and, in combination with other substances, cause irritation to blood vessels, bone and sometimes the skin. A major side effect of increased phosphate levels can be arteriosclerosis, i.e. calcification of the blood vessels, which leads to heart disease. Dialysis helps in this regard, but it can only eliminate some of the excess phosphate. This means that phosphate levels in the body must be lowered further by means of a low phosphate intake and appropriate medications, known as phosphate binders. These medications ‘bind’ the phosphate in the gut so that it cannot be absorbed into the bloodstream.

Vitamin D

Vitamin D is activated in the kidneys and is needed for multiple functions in the body. For example, it is needed for healthy bones. People with kidney disease are often prescribed vitamin D in a pre-activated form as their kidneys cannot activate the vitamin D anymore.