Nierfalen

Nierfalen, or kidney failure, is a medical condition in which the kidneys lose the ability to filter waste products and excess fluids from the blood effectively. It can be acute or chronic. In its most advanced form, chronic kidney disease progresses to end-stage renal disease (ESRD), where renal replacement therapy is typically required for survival.

Acute kidney injury (AKI) develops suddenly, often over days. It may be reversible with prompt treatment if the underlying cause is addressed. Chronic kidney disease (CKD) describes a gradual decline in kidney function over months or years, potentially leading to ESRD. Common causes include diabetes mellitus, hypertension, glomerulonephritis, and inherited conditions such as polycystic kidney disease. Other factors include prolonged dehydration, severe infections, urinary tract obstructions, and exposure to certain nephrotoxic drugs or toxins.

Symptoms of nierfalen may include reduced urine output, swelling in the legs and ankles, shortness of breath, fatigue, nausea, confusion, and high blood pressure. However, early CKD often has few symptoms and is detected through laboratory tests.

Diagnosis relies on measuring kidney function, primarily estimated glomerular filtration rate (eGFR) and serum creatinine, along with urine tests, electrolyte levels, and imaging studies. Proteinuria or abnormal urine sediment can indicate kidney damage.

Treatment focuses on the underlying cause and preserving remaining kidney function. AKI management emphasizes fluid balance and hemodynamic support. CKD and ESRD may require dietary modifications, blood pressure and glucose control, anemia management, and, in advanced cases, dialysis (hemodialysis or peritoneal dialysis) or kidney transplantation. Prevention centers on risk factor management, such as controlling diabetes and hypertension and avoiding nephrotoxins.