nýrnaskemmdum

nýrnaskemmdum refers to damage to the kidneys that impairs their ability to filter waste, balance fluids and electrolytes, and regulate blood pressure. The term is used in Icelandic medical literature to describe a spectrum from temporary impairment to end‑stage kidney disease.

Causes include prerenal factors (reduced renal blood flow such as dehydration or heart failure), intrinsic renal disorders (glomerular, tubular, or interstitial disease often due to disease or toxins), and postrenal factors (urinary tract obstruction). Diabetes and hypertension are major risk factors for chronic injury, while nephrotoxins such as certain medications or contrast agents can trigger acute injury.

Pathophysiology involves a decline in glomerular filtration rate, leading to the accumulation of waste products (creatinine, urea), electrolyte disturbances, and fluid imbalance. Symptoms vary: acute kidney injury may present with reduced urine output, swelling, shortness of breath, or confusion; chronic kidney disease may be asymptomatic for years and later cause fatigue, anemia, or bone problems.

Diagnosis relies on laboratory tests (serum creatinine and estimated GFR), urinalysis for protein or blood, and imaging such as renal ultrasound. In some cases a kidney biopsy is performed to identify the underlying pathology.

Management aims to treat the underlying cause, maintain adequate kidney perfusion, prevent further injury, and manage complications. This includes fluids or diuretics as appropriate, control of blood pressure and blood sugar, avoidance of nephrotoxic agents, and, in advanced disease, renal replacement therapy such as dialysis or kidney transplantation. Prevention focuses on controlling diabetes and hypertension, avoiding nephrotoxins, staying hydrated, and early recognition of dysfunction.