Chronic renal failure, or
chronic kidney disease (CKD), is a slow and progressive decline of kidney function. It's usually a result of a complication from another serious medical condition. Unlike acute renal failure, which happens quickly and suddenly, chronic renal failure happens gradually - over a period of weeks, months, or years - as the kidneys slowly stop working, leading to end-stage renal disease (ESRD).
Its causes are numerous. Generally it occurs because of damage to the kidney tissue caused by decreased renal blood flow (renal ischemia) from any cause (e.g. low blood pressure), exposure to substances harmful to the kidney, an inflammatory process in the kidney, or an obstruction of the urinary tract which impedes the flow of urine. AKI is diagnosed on the basis of characteristic laboratory findings, such as elevated blood urea nitrogen and creatinine, or inability of the kidneys to produce sufficient amounts of urine.
Urine color is directly linked to hydration status because the yellow tint is a measure of how many solid particles, such as sodium, chloride, nitrogen and potassium, are excreted. The color’s intensity depends on how much water the kidneys mix with the solids. Less water equals darker urine. More water equals lighter urine. Dark or rank-smelling urine are signs your body may need more water. But light-to-medium yellow urine is fine. Very clear urine may actually be a signal that your
kidneys are taxed by the amount of fluid moving through them and the minerals in your body are being too diluted.
Also note that some vitamins, such as riboflavin, or B2, can turn urine bright yellow, so don’t be alarmed if your urine is a funny color after either swallowing a multivitamin or eating certain foods, like nutritional yeast, which is high in B vitamins.
The body retains water in response to biochemical and hormonal imbalances, toxicity, poor cardiovascular and cellular health — and, interestingly, dehydration. “If you’re not drinking enough liquid, your body may actually retain water to compensate,” says Vasey, adding that a general lack of energy is the most common symptom of this type of water retention. “Paradoxically, you can sometimes eliminate fluid retention by drinking more water, not less, because if you ingest enough water, the kidneys do not try and retain water by cutting back on elimination,” he explains.
Under normal conditions, the body flushes the water it doesn’t need. But it is possible — generally under extreme conditions when you are drinking more than 12 liters in 24 hours or exercising heavily — to disrupt the body’s osmotic balance by diluting and flushing too much sodium, an electrolyte that helps balance the pressure of fluids inside and outside of cells. That means cells bloat from the influx and may even burst.
While the condition, called hyponatremia, is rare, it happens. Long-distance runners are at highest risk for acute hyponatremia (meaning the imbalance happens in less than 48 hours), but anyone can get in trouble if they drink water to excess without replacing essential electrolytes and minerals. Extreme overconsumption of water can also strain the kidneys and, if drunk with meals, interfere with proper digestion.
Chronic hyponatremia, meaning sodium levels gradually taper off over days or weeks, is less dangerous because the brain can gradually adjust to the deficit, but the condition should still be treated by a doctor. Chronic hyponatremia is often seen in adults with illnesses that leach sodium from the body, such as
kidney disease and congestive heart failure. But even a bad case of diarrhea, especially in children, can set the stage for hyponatremia. Be on the lookout for symptoms such as headache, confusion, lethargy and appetite loss.
That said, there is no scientific evidence to back up the very specific and well-worn advice that you need to drink eight, 8-ounce glasses of water a day (a.k.a. the 8 x 8 rule). In 2002, Heinz Valtin, MD, a retired physiology professor from Dartmouth Medical School and author of two textbooks on kidney function, published the definitive paper on the subject in the American Journal of Physiology. He spent 10 months searching medical literature for scientific evidence of the 8 x 8 rule only to come up empty-handed.
Artificially sweetened drinks add to the body’s toxic burden. Sugar and coffee also create an acidic environment in the body, impeding enzyme function and taxing the kidneys, which must rid the body of excess acid.
Moreover, says Vasey, caffeine found in coffee, black tea and soft drinks adversely affects your body’s water stores because it is a diuretic that elevates blood pressure, increasing the rate of both the production and elimination of urine. “The water in these drinks travels through the body too quickly,” says Vasey. “Hardly has the water entered the bloodstream than the kidneys remove a portion of the liquid and eliminate it, before the water has time to make its way into the intracellular environment.”
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