Kidney failure

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Kidney failure
Synonyms	Renal failure, end-stage renal disease (ESRD)
Pronounce	N/A
Specialty	Nephrology
Symptoms	Decreased urine output, swelling, fatigue, nausea, shortness of breath
Complications	Heart disease, anemia, bone disease, hyperkalemia
Onset	Gradual or sudden
Duration	Long-term (chronic) or short-term (acute)
Types	N/A
Causes	Diabetes, high blood pressure, glomerulonephritis, polycystic kidney disease
Risks	Diabetes, hypertension, family history, age
Diagnosis	Blood tests, urine tests, imaging studies, kidney biopsy
Differential diagnosis	N/A
Prevention	N/A
Treatment	Dialysis, kidney transplant, medications
Medication	N/A
Prognosis	Variable; depends on cause and treatment
Frequency	Common, especially in older adults
Deaths	N/A

Kidney disease can get worse over time and may lead to kidney failure. If less than 15 percent of your kidney is working normally, that’s considered kidney failure. You may have symptoms from the buildup of waste products and extra water in your body.

Other names

Kidney failure, also called renal failure.

Types of kidney failure

Kidney failure can come on suddenly (acute kidney failure), or after years of kidney disease (chronic kidney failure). When your kidneys fail, dialysis or kidney transplant is necessary for survival.

What is kidney failure?

A sudden drop in kidney function is called acute kidney failure. This develops quickly over a few hours or days, and mostly happens in people who are already critically ill.

Chronic kidney disease and kidney failure

More commonly, kidney failure happens as the final stage of chronic kidney disease. Called ‘end stage kidney disease,’ this is when about 90% of kidney function has been lost.

What causes kidney failure?

Acute kidney failure most commonly affects people who are already hospitalised because they are very ill. It can be caused by:

• slow blood flow to the kidneys (for example, due to an accident, burns or dehydration)
• damaged kidneys (for example, due to disease or toxins)
• blocked kidney drainage tubes (ureters) (for example, from kidney stones or tumours)
• Some medicines can also bring on acute kidney failure ‚Äî these include antibiotics, chemotherapy, imaging dyes, and medicines for blood pressure and osteoporosis.

The most common diseases causing chronic kidney failure are diabetes, high blood pressure or inflammation in the kidney (glomerulonephritis).

Signs and symptoms of kidney failure

Symptoms of acute kidney failure can include decreased amount of urine, fluid retention, confusion, nausea and chest pain. Symptoms of chronic kidney failure may include tiredness, weakness, nausea, vomiting, itching, restless legs, breathlessness, high blood pressure that can’t be controlled and night-time urination. If you notice any such symptoms, see your doctor.

Kidney failure treatment

There are three options for the treatment of kidney failure:

• kidney transplant, in which a diseased kidney is replaced by a healthy one from a donor
• dialysis, which uses a machine (haemodialysis) or other parts of the body (abdominal dialysis) to remove waste and extra fluid from your blood
• supportive care, which means providing all health care and support possible, but not attempting to cure the kidney failure. In this case the person with kidney failure will eventually die.

Preventing kidney failure

You can help keep your kidneys as healthy as possible by maintaining a healthy weight, eating well, not smoking, keeping a check on your blood pressure, keeping within your glucose targets if you have diabetes, and exercising regularly.

• A haemodialysis uses a machine to remove waste and extra fluid from your blood.
• Illustration showing how a peritoneal dialysis works.
• A dialysis using the abdomen to remove waste and extra fluid from your body.

If you have chronic kidney disease, medical treatments and lifestyle changes can delay or prevent its progression to kidney failure, and also help control symptoms.

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