Chronic renal failure is kidney damage that lasts at least 3 months. The main factors that cause it are structural or functional abnormalities of the kidney with or without decreased glomerular filtration rate, manifested by: pathological abnormalities or markers of kidney damage, including alterations in blood or urine composition and/or alterations in imaging tests.
One of the most important values for defining chronic renal failure is the glomerular filtration rate. Below 60 ml/min/1.73m2 for at least 3 months with or without apparent renal damage we define this entity.
Causes of chronic renal failure
The most frequent causes of chronic renal failure are Diabetes Mellitus type 2 and vascular diseases (arterial hypertension and arteriosclerosis). There are also other important causes, although less frequent, such as glomerular diseases and renal diseases secondary to infections.
One of the important characteristics of chronic renal failure is progression, regardless of the cause that originated it. With early diagnosis and control of cardiovascular and metabolic risk factors (arterial hypertension, diabetes, hypercholesterolemia, obesity, etc.) we are able to slow down and in some cases stop the progression to advanced renal failure.
As a guideline, if glomerular filtration rates are below 10 ml/min/1.73m2 or 15 ml/min/1.73m2 for diabetic patients, it is necessary to start renal replacement therapy. At this moment the possibilities are: renal transplantation, hemodialysis and peritoneal dialysis.
Treatment for chronic renal failure
The treatment of choice is usually renal transplantation, but most often the patient spends a period undergoing hemodialysis or peritoneal dialysis until the diagnosis is complete in order to be included in the waiting list for renal transplantation, provided there are no contraindications.
Dialysis and hemodialysis in the treatment for chronic renal failure
Hemodialysis is a treatment that purifies the blood through a catheter or an arteriovenous fistula (an intervention to join an artery and vein in the arm) by using a dialyzer that allows us to exchange substances in the blood with a liquid whose composition is of interest and known to us. It is usually performed in a center, but it is possible for the patient to have it done at home after learning how to do it.
Peritoneal dialysis is a therapy performed by the patient himself at home after placement of a peritoneal catheter in the abdomen to infuse and drain a liquid that, in contact with the peritoneal membrane, provides an exchange of waste substances with the blood.
For more information consult your nephrologist.