Kidney failure can be classified into several levels of severity, or stages. What are the symptoms and treatment in the early stages? Let's discuss this further.
The kidneys play a crucial role in the body because they perform numerous functions, helping to maintain proper metabolism. One type of kidney disease that causes a significant decline in kidney function is kidney failure.
Kidney failure can be broadly divided into two large groups based on the course of the disease, namely acute kidney failure or acute kidney injury (AKI) and chronic kidney failure or chronic kidney disease (CKD).
Stadium acute kidney injury
Classification of AKI conditions can be classified into RIFLE criteria to classify the level of severity.
Risk
There is an increase in serum creatinine of ≥ 1.5 times and a decrease in the glomerular filtration rate (GFR) of ≥ 25%. In addition, there is a decrease in urine output of < 0.5 ml/kg/hour for more than 6 hours.
Injury
There is a ≥ 2-fold increase in serum creatinine and a ≥ 50% decrease in GFR. Furthermore, there is a decrease in urine output of < 0.5 ml/kg/hour for more than 12 hours.
Failure
There is a ≥ 3-fold increase in serum creatinine and a ≥ 75% decrease in GFR. Furthermore, there is a decrease in urine output of < 0.3 ml/kg/hour for 24 hours or anuria for 12 hours.
Loss
There is persistent loss of kidney function for more than 4 weeks.
End-stage
There is persistent loss of kidney function for more than 3 months.
Stadium chronic kidney disease
Not only does AKI have a classification of its severity levels, but chronic kidney failure also has a classification that can categorize the severity of the course of the kidney failure disease experienced.
Stadium 1
GFR ≥ 90 ml/minute/1.73 m². In this phase, kidney function remains normal, but screening, such as a urine test, may reveal proteinuria or damage to the kidney structure.
Stadium 2
GFR is between 60-89 ml/minute/1.73 m². At this stage, signs of kidney damage begin to appear.
Stadium 3
GFR is between 30-59 ml/minute/1.73 m². At this stage, there are already signs of significant kidney damage.
Stadium 4
GFR between 15-29 ml/minute/1.73 m². In this phase, there is already severe interference with kidney function. At this stage, dialysis or hemodialysis can also be carried out routinely.
Stadium 5
GFR is <15 ml/minute/1.73 m². This stage is considered end-stage renal failure. Hemodialysis will require more frequent treatment, and if hemodialysis is no longer amenable to treatment, a kidney transplant may be considered by the treating physician.
What are the symptoms of end-stage renal failure?
Unlike early-stage kidney failure, which tends to be asymptomatic, end-stage kidney failure tends to have distinctive symptoms. The most easily recognized symptom is a drastic decrease in urine production. This is largely influenced by kidney function, or GFR, which progressively declines as the disease progresses.
Additionally, swelling may occur in the feet, hands, and face. This is caused by fluid retention and decreased kidney function in removing fluid from the body. This condition can also trigger shortness of breath due to fluid buildup in the lungs.
Patients may also complain of nausea, vomiting, weakness, fatigue, muscle cramps, and itching all over the body. Furthermore, because the body struggles to eliminate toxins due to decreased kidney function, it can lead to decreased consciousness and shortness of breath.
In end-stage kidney failure, doctors will recommend regular dialysis or hemodialysis. If the condition persists with these methods, doctors may consider a kidney transplant.
Written by Dr. Valda Garcia Reviewed by Dr. Ernest Eugene
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