The kidneys filter waste and excess fluids from the blood, converting them into urine. Incontinence is the involuntary leakage of urine. Kidney failure can contribute to or worsen urinary incontinence through various mechanisms.
Fluid Overload and Bladder Strain
When kidneys fail, their ability to filter waste and fluids diminishes. This leads to excess fluid buildup, known as fluid overload. The increased fluid volume impacts the urinary system, increasing urine production and volume. This elevated volume can overwhelm the bladder’s capacity, filling it more rapidly and frequently.
A constantly full bladder increases pressure on its walls, weakening bladder muscles. This can cause urgency, a sudden need to urinate, or frequency, requiring more bathroom trips. The bladder’s inability to fully empty or its overactivity from constant stretching can lead to overflow or urge incontinence.
Neurological and Systemic Impacts
Kidney failure can affect bladder control through its systemic impact on the nervous system. The accumulation of toxins and waste products in advanced kidney failure (uremia) can lead to nerve damage. This neuropathy impairs nerves communicating between the bladder and brain, disrupting signals for bladder muscle function and fullness sensation.
Damage to these nerves can hinder the bladder’s ability to contract or relax effectively, affecting urine storage and release. Kidney failure causes electrolyte imbalances. These electrolytes are important for nerve and muscle function, including bladder control. Imbalances can compromise the coordination and strength of muscles and nerves supporting continence.
Associated Health Conditions
Underlying health conditions contributing to kidney failure can also independently cause or worsen incontinence. Diabetes, a leading cause of kidney disease, can lead to nerve damage (diabetic neuropathy) from uncontrolled blood sugar. This affects bladder function and sensation, contributing to incontinence.
High blood pressure is also a common cause of kidney failure and can indirectly affect bladder control. Some medications for high blood pressure can increase urine production and exacerbate incontinence symptoms. Neurological disorders like Parkinson’s disease or multiple sclerosis directly impair the nervous system’s bladder control, leading to incontinence.
Seeking Medical Guidance
Individuals experiencing incontinence, especially with existing kidney concerns or changes in urination, should seek medical evaluation. A healthcare provider will begin by reviewing medical history and conducting a physical examination. Diagnostic tests may include urine tests for infection or kidney problems, and blood tests to assess kidney function and electrolytes.
Further diagnostics may include a bladder diary, recording fluid intake and urination, or urodynamic studies, measuring bladder storage and emptying. Treatment depends on the underlying cause. This may include fluid management, medications to relax the bladder or improve muscle function, and lifestyle adjustments. Addressing the kidney disease itself can help manage associated incontinence.