What is kidney failure?
Kidney failure (also called renal failure) means one or both kidneys can no longer function well on their own. Sometimes, kidney failure is temporary and comes on quickly. Other times, it is a chronic condition that can get worse slowly over a long time.
Kidney failure may sound serious, and it is. But treatments such as dialysis and kidney transplant help many people with limited kidney function continue to live fulfilling lives.
What do the kidneys do?
The kidneys have several jobs. One of the most important is helping your body eliminate toxins. The kidneys filter your blood and send waste out of your body in urine.
The kidneys are bean-shaped organs about the size of your fist. They sit under your ribcage, toward your back. Most people have two working kidneys, but people can live well as long as at least one is working correctly.
When the kidneys don’t work effectively, waste products build up in your body. If this happens, you might feel sick. In the most serious situations, kidney failure can be life-threatening. However, many people can manage kidney failure with the right treatment.
Symptoms and Causes
What causes kidney failure?
When the kidneys lose function suddenly (within hours or days), it’s called acute kidney failure (or acute kidney injury). This type of kidney failure is often temporary. Common causes of acute kidney failure can include:
- Autoimmune kidney diseases
- Certain medications
- Severe dehydration
- A urinary tract obstruction
- Uncontrolled systemic disease like heart or liver disease
Kidney failure usually doesn’t happen overnight. Chronic kidney disease refers to a group of health conditions that affect how well your kidneys function over time. If left untreated, chronic kidney disease can lead to kidney failure.
The biggest causes of kidney failure from chronic kidney disease are:
- Diabetes: Unmanaged diabetes can lead to uncontrolled blood sugar levels. Consistently high blood sugar can damage the body’s organs, including the kidneys.
- High blood pressure: High blood pressure (hypertension) means blood travels through your body’s blood vessels with increased force. Over time, untreated high blood pressure levels can damage the kidneys’ tissue.
Other causes of chronic kidney disease include:
- Polycystic kidney disease, a hereditary condition where cysts (fluid-filled sacs) grow inside your kidneys.
- Glomerular diseases, such as glomerulonephritis, which affect how well the kidneys can filter waste.
- Lupus and other autoimmune diseases that can affect multiple body systems.
What are the symptoms of kidney failure?
In early stages of kidney disease, many people experience few or no symptoms. It’s important to note that chronic kidney disease can still cause damage even though you feel fine.
Chronic kidney disease and kidney failure can cause different symptoms for different people. If your kidneys aren’t working properly, you may notice one or more of the following signs:
- Fatigue (extreme tiredness)
- An upset stomach or vomiting
- Confusion or trouble concentrating
- Swelling, especially around your hands or ankles
- More frequent bathroom trips
- Muscle spasms (muscle cramps)
- Dry or itchy skin
- Poor appetite or metallic taste of food
Diagnosis and Tests
How is kidney failure diagnosed?
Doctors use a variety of tests to measure kidney function and diagnose kidney failure. If your doctors suspect you may be at risk for kidney failure, they may recommend:
- Blood tests, which can show how well the kidneys are removing waste from the blood.
- Advanced imaging, which can show kidney abnormalities or obstructions (blockages).
- Urine tests, which measure the amount of urine or specific substances in the urine, such as protein or blood.
Management and Treatment
How is kidney failure treated?
Kidney failure treatment is determined by the cause and extent of the problem. Treating your chronic medical condition can delay the progression of kidney disease. If your kidneys start losing their function gradually, your doctor may use one or more methods to track your health. By watching you closely, your doctor can help you maintain your kidneys’ function as long as possible.
Your doctor may gauge your kidney function with:
- Routine blood tests
- Blood pressure checks
Because the kidneys serve such an important purpose, people in kidney failure need treatment to keep them alive. The main treatments for kidney failure are:
- Dialysis: This treatment helps the body filter the blood (doing the job that the kidneys can no longer perform).
- In hemodialysis, a machine regularly cleans your blood for you. People often receive this kidney failure treatment at a hospital or dialysis clinic, 3 or 4 days each week.
- Peritoneal dialysis cleans the blood in a slightly different way using a dialysis solution and a catheter. Sometimes, people can do their treatment at home.
- Kidney transplant: In kidney transplant surgery, doctors place a healthy kidney in your body to take over the job of your damaged organs. This healthy kidney, called a donor organ, may come from a deceased donor or a living donor, who may be a friend or family member. People can live well with one healthy kidney.
Can kidney failure be prevented?
While kidney failure from chronic kidney disease can’t be reversed, you can do many things to help preserve the kidney function you have today. Healthy habits and routines may slow down how quickly kidneys lose their functional abilities.
If you have chronic kidney disease or kidney failure, you’ll want to:
- Monitor your kidney function, with your doctor’s help.
- Keep your blood sugar levels under control, if you have diabetes.
- Keep your blood pressure levels in a normal range.
- Avoid smoking.
- Make healthy diet choices, such as limiting foods high in protein and sodium.
When should I call the doctor?
A nephrologist (kidney specialist) receives special training in kidney evaluation and treatment. You may benefit from a kidney specialist’s expert opinion if:
- You have trouble keeping your blood pressure levels in a normal range, even with medication.
- Your blood sugar levels fluctuate (go up and down) widely.