Types of Kidney failure
Types list: The list of types of Kidney failure mentioned in various sources includes:
The Course of Kidney DiseaseThe deterioration that characterizes kidney disease of diabetes takes place in and around the glomeruli, the blood-filtering units of the kidneys. Early in the disease, the filtering efficiency diminishes, and important proteins in the blood are lost in the urine. Medical professionals gauge the presence and extent of early kidney disease by measuring protein in the urine. Later in the disease, the kidneys lose their ability to remove waste products, such as creatinine and urea, from the blood. Measuring these waste products in the blood gives an indication of how far kidney disease has progressed.
Symptoms related to kidney failure usually occur only in late stages of the disease, when kidney function has diminished to less than 10 to 25 percent of normal capacity. For many years before that point, kidney disease of diabetes is a silent process.
Scientists have described five stages in the progression to kidney failure in people with diabetes.
Stage I. The flow of blood through the kidneys, and therefore through the glomeruli, increases--this is called hyperfiltration--and the kidneys are larger than normal. Some people remain in stage I indefinitely; others advance to stage II after many years.
Stage II. The rate of filtration remains elevated or at near-normal levels, and the glomeruli begin to show damage. Small amounts of a blood protein known as albumin leak into the urine--a condition known as microalbuminuria. In its earliest stages, microalbuminuria may not be detected on each evaluation. But as the rate of albumin loss increases from 20 to 200 micrograms per minute, the finding of microalbuminuria becomes more constant. (Normal losses of albumin are less than 5 micrograms per minute.) A special test is required to detect microalbuminuria. People with type 1 and type 2 diabetes may remain in stage II for many years, especially if they have good control of their blood pressure and blood glucose levels.
Stage III. The loss of albumin and other proteins in the urine exceeds 200 micrograms per minute. It now can be detected during routine urine tests. Because such tests often involve dipping indicator strips into the urine, they are referred to as "dipstick methods." Stage III sometimes is referred to as "dipstick-positive proteinuria" (or "clinical albuminuria" or "overt diabetic nephropathy"). Some patients develop high blood pressure. The glomeruli suffer increased damage. The kidneys progressively lose the ability to filter waste, and blood levels of creatinine and urea-nitrogen rise. People with type 1 and type 2 diabetes may remain at stage III for many years.
Stage IV. This is referred to as "advanced clinical nephropathy." The glomerular filtration rate decreases to less than 75 milliliters per minute, large amounts of protein pass into the urine, and high blood pressure almost always occurs. Levels of creatinine and urea-nitrogen in the blood rise further.
Stage V. The final stage is kidney failure. The glomerular filtration rate drops to less than 10 milliliters per minute. Symptoms of kidney failure become apparent.
These stages describe the progression of kidney disease for most people with type 1 diabetes who develop kidney failure. For people with type 1, the average length of time required to progress from onset of kidney disease to stage IV is 17 years. The average length of time to progress to kidney failure is 23 years. Progression to kidney failure may occur more rapidly (5-10 years) in people with untreated high blood pressure. If proteinuria does not develop within 25 years, the risk of developing advanced kidney disease begins to decrease. Type 1 diabetes accounts for only 5 to 10 percent of all diagnosed cases of diabetes, but type 1 accounts for 30 percent of the cases of kidney failure caused by diabetes. 1
Renal (kidney) failure results when the kidneys are not able to
regulate water and chemicals in the body or remove waste products from
your blood. Acute renal failure (ARF) is the sudden onset of kidney
failure. This can be caused by an accident that injures the kidneys, loss
of a lot of blood, or some drugs or poisons. ARF may lead to permanent
loss of kidney function. But if the kidneys are not seriously damaged,
they may recover. Chronic renal failure (CRF) is the gradual
reduction of kidney function that may lead to permanent kidney failure, or
end-stage renal disease (ESRD). You may go several years without knowing
you have CRF.
1. excerpt from Kidney Disease of Diabetes: NIDDK
2. excerpt from Your Urinary System and How It Works: NIDDK
Last revision: May 30, 2003
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