Causes and symptoms of acute tubular necrosis

Damage or destruction to tube-like structures known as tubules in the kidneys can bring about the development of acute tubular necrosis (ATN) and subsequently, acute kidney failure.

What causes acute tubular necrosis (ATN)?

A lack of supply of oxygen to the cells in the kidney is the most common cause of this condition. The reason as to why oxygen may not reach the cells and tissues of this organ could be restriction or blockage of the pathways. When this happens, the kidneys get damaged. Dehydration is the most important cause of ATN which may be because of loose motions, vomitings, heat stroke etc.

Health conditions such as diabetes, heart attack, and stroke can bring about a decrease in blood flow to the organs resulting in ATN and death of cells. Similarly, the presence of toxic substances in the blood can also lead to tubules damage and change the way the cells function in the tubules.

Other causes that may lead you to develop ATN may be medications, radiology dyes, anesthetics and chemicals that cause your body to react adversely.

In addition to these causes, a number of factors can put you at risk of ATN and there are:

- An injury to the body, more specifically your kidneys can cause clotting of the blood vessels
- An adverse response to blood transfusion
- Instances of septic shock can slow down blood flow to the organs
- A major surgery that can interrupt blood supply to the organs

What are the symptoms of the condition?

The symptoms associated with the condition can vary depending on the severity of the problem.

You may experience:

- Troubles in waking up
- Drowsy feeling even during daytime
- Feelings of lethargy
- Feelings of excessive thirstiness
- Problems with urination
- Fluid retention problems
- Instances of confusion
- Feelings of nausea



Can Acute Tubular Necrosis Cause Kidney Failure?

Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.

In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.

Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.

Need for dialysis

A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.

When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.

Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:

Hemodialysis
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.

Peritoneal Dialysis
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.

Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.

A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling. 

Dialysis May Save Your Life!

Severe disorders in one or more kidneys can be debilitating since the quality of life is severely affected. If you suffer from such a condition, you may already be undergoing dialysis. But, have you considered kidney transplant yet? 

Here is a look at some benefits of kidney transplant over dialysis.

1.Increased life expectancy

You may not know this, but dialysis restricts your life expectancy. For instance, a person undergoing dialysis at 30 will have a life expectancy of 15 more years. However, with a transplant, you can go on to lead a full life. The same 30-year old person will have a life expectancy of 30 additional years in case of a transplant from a brain-dead donor. If the donor is a healthy individual, life expectancy may extend to 40 years as well.
Therefore, if you want to live longer, you need to seek a kidney transplant.
2. Enhanced quality of life
Not only does severe kidney disorder mean relying on dialysis, but it also imposes other major restrictions in regards to diet and lifestyle. However, the kidney transplant is a more permanent solution to the problem. Once the transplant is completed and you recover from the surgery, you can resume a normal life. Additionally, some of the dietary restrictions are also lifted in such a case. 

Why dialysis is more common?
Dialysis is more common for the following reasons-
    The kidney to be transplanted may not be readily available. You would be placed on a list and it may take a while for a suitable kidney to arrive. During this period, you would need to undergo dialysis.
    Since dialysis is a minimally invasive procedure, it is often preferred by patients. However, kidney transplantation is better in the long-term.



Why Should You Opt For Kidney Transplant Instead Of Dialysis?

A kidney transplant is a procedure that employs an operation to transplant properly functioning kidney in the body. The main job of the kidneys is to remove the excess waste from a person s body with the help of a filtration process. When the kidneys stop filtering the toxins properly, they become diseased as harmful waste products and toxins begin to accumulate in the body. Following this, the patient has to go through treatment measures like dialysis or kidney transplant.

Read on to know the five things you should keep in mind about a kidney transplant.

Treatment: Transplant is one of the best ways to treat chronic kidney disease stage-V, until unless it is contraindicated. Life becomes near normal after transplant, though there is a possibility of rejection of transplant kidney. Patient has to take immunosuppressive medication life long. 
Medication: Medications are mainly for:
To prevent rejection: Patient takes immunosuppressive medications life long. 
Prevention of infection: Patient has to take care all the measures to prevent infections as they are more prone to infections. 
Other medication: To control diabetes, HTN etc. 
Family Only: The donors are from family or emotionally related or cadavers (after brain death). HLA-matched donors are better because of less chances of rejections and first reduction of immunosuppressive. 
Doing Your Part: Once transplant is done - patient becomes normal and he/she lives a normal life. However, they have to take regular medications and to protect themselves from various infection. 
End Stage Renal Diseases: These diseases includes diabetes mellitus, HTN, polycystic kidney disease, chronic glomerulonephritis or interstitial nephritis etc.
Consult your Nephrologist before going for renal transplant for detailed check up or line of action.

Kidney Transplant - 5 Things About it !

If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.

Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption.

Peritoneal Dialysis - Procedure to be Followed!

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