Kidney failure
What is kidney failure?
The kidney stops working properly when it is damaged. The diagnosis of kidney failure (or 'renal failure') is made when the kidney fails to filter the blood properly and adequately capture the substances it should. As a result, valuable substances (such as proteins) are lost from the blood to the urine. In some cases, the blood vessels leading to the kidney are so narrowed that not enough blood is filtered. That results in excessive levels of waste substances in the blood. Kidney failure is when levels of waste substances in the blood are too high, or when urine is no longer produced.
What are the complaints associated with kidney failure?
There are usually no complaints in the early stages of kidney damage. Complaints emerge only when levels of damage become severe. It is possible to detect kidney damage much earlier by testing urine and blood. Complaints – such as swelling of the ankles and lower legs, or tightness of the chest – will be seen only when kidney damage affects about 70% of the kidneys. This indicates that the body is retaining fluid. People may fall ill as the condition progresses.
How common is kidney failure in the general population?
The prevalence of chronic kidney damage in the Netherlands is 5.2% for stages 1 and 2 (the initial stages), 5.3% for stage 3 and 0.04% and less than 0.04% respectively for stages 4 and 5 (the final stages of kidney failure).
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How common is kidney failure in people with intellectual disabilities?
There have been studies of chronic kidney disease in older people with intellectual disabilities in the Netherlands: 15.3% of 635 participants in the GOUD study had chronic kidney disease. This is the same as in the same group in the general population. Older people, people with Down syndrome, obesity, hypercholesterolaemia and hypothyroidism were found to have a higher risk of chronic kidney disease.
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A Taiwanese study found that 4% of adolescents with intellectual disabilities had chronic kidney disease, which was more than their peers in the general population.
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In addition to Down syndrome, there are also rarer syndromes, such as Bardet Biedl syndrome, that are associated with higher rates of kidney disease/kidney failure.
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5.20% General population
15.3% Older people with intellectual disabilities
Not known for people with intellectual disabilities
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337De Grauw WJC, Kaasjager HAH, Bilo HJG, Faber EF, Flikweert S, Gaillard CAJM, Labots-Vogelesang SM, Verduijn MM, Verstappen WHJM, Vleming LJ, Walma EP, Van Balen JAM. Landelijke Transmurale Afspraak Chronische nierschade. Huisarts Wet 52(12):586-97.
De Grauw WJC, Kaasjager HAH, Bilo HJG, Faber EF, Flikweert S, Gaillard CAJM, Labots-Vogelesang SM, Verduijn MM, Verstappen WHJM, Vleming LJ, Walma EP, Van Balen JAM. Landelijke Transmurale Afspraak Chronische nierschade. Huisarts Wet 52(12):586-97.
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573De Winter CF, Echteld MA, Evenhuis HM. Chronic kidney disease in older people with intellectual disability: results of the HA-ID study. Res Dev Disabil. 2014 Mar;35(3):726-32.
De Winter CF, Echteld MA, Evenhuis HM. Chronic kidney disease in older people with intellectual disability: results of the HA-ID study. Res Dev Disabil. 2014 Mar;35(3):726-32.
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574Lin JD, Lin LP, Hsieh M & Lin PY. (2010). Preliminary findings of serum creatinine and estimated glomerular filtration rate (eGFR) in adolescents with intellectual disabilities. Research in Developmental Disabilities, 31(6), 1390–1397.
Lin JD, Lin LP, Hsieh M & Lin PY. (2010). Preliminary findings of serum creatinine and estimated glomerular filtration rate (eGFR) in adolescents with intellectual disabilities. Research in Developmental Disabilities, 31(6), 1390–1397.
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338Anadoliiska A, Roussinov D. Clinical aspects of renal involvement in Bardet-Biedl syndrome. Int Urol Nephrol. 1993;25(5):509-14.
Anadoliiska A, Roussinov D. Clinical aspects of renal involvement in Bardet-Biedl syndrome. Int Urol Nephrol. 1993;25(5):509-14.
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339Uçar B, Yakut A, Kural N, Büyükasik F, Vardareli E.Renal involvement in the Laurence-Moon- Bardet-Biedl syndrome: report of five cases.Pediatr Nephrol. 1997 Feb;11(1):31-5
Uçar B, Yakut A, Kural N, Büyükasik F, Vardareli E.Renal involvement in the Laurence-Moon- Bardet-Biedl syndrome: report of five cases.Pediatr Nephrol. 1997 Feb;11(1):31-5