One more attack

In its early stages, acute kidney attack is both treatable and entirely reversible.

Everyone has heard of heart attack. They know it is a serious condition that requires immediate medical attention. But has anyone heard of ‘kidney attack’? This term basically refers to acute kidney failure and is an attempt to get people to recognise the seriousness of the condition.

Acute kidney attack refers to sudden worsening of kidney function. While it is a dangerous situation, it is also reversible. Complete recovery of kidney function is possible if the problem is identified early. If damage to the kidneys is severe or if appropriate treatment has been delayed, damage will be permanent and can result in chronic kidney disease, which leads to end-stage kidney disease.

Why is the kidney vulnerable to acute damage and sudden loss of function? The kidneys receive 20 per cent of all the blood pumped by the heart and maintain the fluid balance in our body. Water constitutes nearly 70 per cent of our body. The kidneys are also the chief excretory organs, eliminating not only the by-products from our food but also drugs.

Acute kidney attack can occur either due to conditions that do not directly injure the kidneys but disturb its function or an injury directly affecting the kidneys or conditions that prevent the outflow of urine from the kidneys. Some other causes include blocks in the blood vessel supplying the kidney (emboli, renal artery stenosis), acute nephritis infections, stone (any age), stricture (middle age) and enlarged prostate (elderly men). It must be noted that there is an urban-rural divide in the causes. In rural areas diarrhoeal disease combined with dehydration, infectious diseases like dengue and malaria are still common causes for acute kidney attacks.

Animal venoms — snakes, bees, spiders, caterpillars — and septic abortions are preventable causes once again common in rural areas. Certain groups, like children, elderly people, diabetics, patients afflicted by heart and liver diseases are more likely to suffer from acute kidney attacks.

As acute kidney attack means sudden reduction in kidney function, the signs and symptoms are related to various functions of the kidney. Blood tests will reveal increased urea and creatinine acids that accumulate to cause a life-threatening condition called metabolic acidosis. Blood pressure can also be very low if there has been increased fluid loss.

Ultrasonograms can reveal the kidney size and the reason for reduced flow of urine: stones, enlarged prostate, stricture urethra.

Once the diagnosis is made, the patient should see a nephrologist. In the early stages the kidney will recover if the cause is identified and corrective measures undertaken. If kidney failure is severe, the nephrologist will consider dialysis to give the sick kidneys a break. This helps the kidneys recover faster and even regain normal function in two to four weeks’ time. If the damage is severe, and if the attack is combined with damage to other organs, the attack can even be fatal.

Is there cause for concern once a patient has recovered completely and his kidneys have resumed their normal function? Yes. It is important to have regular check-ups even after recovery. Research shows that 30 per cent of patients who have apparently recovered develop chronic kidney diseases and around nine per cent end up with end stage kidney disease and require dialysis and transplant.

What you can do

Seek early treatment for vomiting, diarrhoea and replacement of lost fluids.

Avoid self-medication. NSAIDs, commonly used for pain relief, lead to acute kidney attack.

Do not repeat prescriptions because symptoms resemble earlier illness when a drug gave relief.

Consult your family physician immediately at the onset of illness and follow his/her advice.

When dialysis is advised, do not hesitate to agree.

Keep your neighbourhood clean and prevent vector-borne diseases like dengue, malaria, leptospirosis.

Warning signs

Sudden decrease in urine output or no urine output.

Swelling of the face and the body.

Breathing difficulty.

Vomiting and poor appetite.

Alteration in level of consciousness, fits (advanced stage)

Source : the Hindu