Learn about kidney failure, a serious condition in which the kidneys lose their ability to filter waste and excess fluid from the blood. Explore its types, causes, symptoms, and treatment options.
Kidney failure, also known as renal failure, is a serious condition where the kidneys lose their ability to filter waste and excess fluids from the blood. Kidney failure can develop from either acute or chronic cause discussed below. This guide provides an overview of the types, causes, diagnosis, symptoms, treatment options available for managing kidney failure effectively and prevention
Kidney failure, also known as renal failure, occurs when the kidneys can no longer function effectively. This condition impairs the kidneys' ability to filter waste, excess fluids, and toxins from the bloodstream, leading to a dangerous buildup of these substances in the body. Individuals diagnosed with kidney failure have lost approximately 85% to 90% of their kidney function, severely affecting overall health.
Kidney failure can arise from either acute (sudden) or chronic causes. When considering chronic kidney failure, it is essential to note that it represents the final stage of chronic kidney disease. This condition Is medically referred to as advanced stage as end stage renal disease (ESRD) or end stage kidney disease (ESKD).
When blood flows to the kidneys, specialized kidney cells act as sensors to regulate how much water is excreted as urine, along with the concentration of electrolytes. This process ensures fluid balance in the body. If a person is dehydrated due to exercise or illness, the kidneys conserve water, making the urine more concentrated. Conversely, when there is an adequate water supply, the kidneys excrete more diluted urine. This function is controlled by renin, a hormone produced in the kidneys that plays a crucial role in fluid balance and blood pressure regulation
In addition to fluid regulation, the kidneys produce erythropoietin, a hormone responsible for stimulating the bone marrow to produce red blood cells. Specialized kidney cells monitor oxygen levels in the blood; if oxygen levels drop, erythropoietin production increases, prompting the body to generate more red blood cells.
Once urine is produced by the kidneys, it flows through the ureters (tubes connecting the kidneys to the bladder). The bladder stores urine until it is expelled through the urethra during urination. This continuous filtration and regulation process keeps the body’s internal environment stable and healthy.
Healthy kidneys are essential for cleaning the blood by removing excess fluids, minerals, and waste from the bloodstream. They also produce hormones that help maintain strong bones and support red blood cell production. When the kidneys are damaged, they fail to perform these functions effectively, leading to fluid retention, waste accumulation, high blood pressure, and insufficient RBC production (anemia) leading to kidney failure
Kidney failure can arise from various causes, categorized into acute kidney failure (AKF) and chronic kidney disease (CKD). Each type has distinct causes and risk factors.
Acute kidney failure occurs suddenly and can result from conditions that impair kidney function. Common causes include:
Chronic kidney disease develops gradually over time, typically due to long-term conditions that impair kidney function. The most common causes include:
Other conditions and factors that may contribute to kidney failure include:
There are two primary types of kidney failure: acute and chronic. Each type has distinct characteristics and implications for treatment.
Acute kidney failure (AKF), also known as acute kidney injury or acute renal failure, occurs suddenly, typically within a few hours or days. This condition can result from various factors, including infections, trauma to the kidney, or decreased blood flow. Additionally, blockages such as kidney stones or very high blood pressure can lead to acute kidney failure.
While AKF is potentially reversible with timely medical intervention, it can be life-threatening if left untreated. Studies indicate that approximately 12% to 15% of AKF patients may require long-term dialysis.
The severity of acute kidney failure is determined by the estimated glomerular filtration rate (eGFR), which measures kidney function. The stages are as follows:
Stage I: GFR 90 or higher (up to 100). Normal kidney function with mild damage
Stage II: GFR 89 to 60. Mild kidney function loss with adequate performance
Stage IIIa: GFR 59 to 45. Mild to moderate loss of kidney function
Stage IIIb: GFR 44 to 30. Moderate to severe loss of kidney function
Stage IV: GFR 29 to 15. Severe loss of kidney function
Stage V: GFR lower than 15. Kidneys are close to or at complete failure
Chronic kidney disease (CKD), also known as chronic renal failure or chronic renal disease, develops gradually over time and results in progressive kidney damage. Common contributing factors include diabetes, hypertension, and cardiovascular disease. In some cases, genetic predisposition also plays a role
CKD is diagnosed when kidney damage or an eGFR of less than 60 mL/min/1.73 m² persists for at least three months, regardless of the underlying cause. This progressive condition ultimately leads to the need for renal replacement therapy, such as dialysis or kidney transplantation. Understanding the differences between acute and chronic kidney failure is essential for effective management and improving patient outcomes. Early detection and intervention are critical in both cases to prevent complications and preserve kidney function
Chronic kidney disease is classified into five stages ranging from very mild to complete loss of kidney function (kidney failure). Distinct symptoms and complications increase as the stages progress. Estimated glomerular filtration rate (eGFR) helps determine the stage of CKD as the condition progresses. The stages are as follows;
| Stage | Category | eGFR (milliliters per min) | Symptoms |
|---|---|---|---|
| 1 | Normal | Greater than 90 | Swelling, Back pain, Changes in urination frequency, But usually no symptoms. |
| 2 | Mild | 60 to 89 | Kidney issues such as protein in urine and physical damage to the kidneys |
| 3 | Moderate | 30 to 59 | Symptoms include swelling, back pain and changes in urination frequency |
| 4 | Severe | 15 to 29 | Bone disease, anemia, and high blood pressure are possible complications |
| 5 | Kidney failure | Less than 15 | Symptoms such as vomiting and nausea, trouble breathing, and itchy skin Dialysis or kidney transplant is the required treatment |
Kidney failure symptoms vary in severity and onset depending on whether it is acute kidney failure (AKF) or chronic kidney disease (CKD). AKF symptoms appear suddenly, while CKD symptoms develop gradually over time as kidney function declines.
General symptoms include;
Several tests to diagnose kidney failure. Common tests include:
The treatment for kidney failure depends on the cause and stage of the condition, with prevention being the primary goal, especially for chronic diseases like hypertension and diabetes
Once kidney failure is present, the goal is to prevent further decline in renal function. Addressing and aggressively treating underlying illnesses can help preserve kidney function, though improvement is not always possible
Various classes of medications may be used to manage issues associated with kidney failure:
Once kidneys fail, treatment options are limited to dialysis or kidney transplantation
Dialysis filters and purifies the blood using a machine to perform the kidneys' function. Depending on the type of dialysis, patients may connect to a large machine or use a portable catheter bag. Patients may also need to follow a low potassium and low salt diet. While dialysis does not cure kidney failure, regular treatments can extend life. There are two main types of dialysis:
A kidney transplant can restore kidney function, eliminating the need for dialysis. However, there is often a long wait for a compatible donor kidney. If a living donor is available, the process may be expedited
Transplant surgery may not be suitable for everyone and is not always successful. Post-surgery, patients must take immunosuppressant drugs to prevent rejection of the new kidney, which can have serious side effects
Dietary modifications can help prevent the progression of kidney failure. Recommendations often vary based on the stage of kidney disease and overall health:
Alcohol intake should be limited, especially in people with CKD and other chronic conditions. Alcoholic beverages like beer and wine contain high levels of phosphorus, which can be dangerous if kidneys cannot properly filter it out. In severe cases, alcohol consumption may contribute to heart issues and complications. Eliminating alcohol may be the best option for individuals with kidney failure or late-stage kidney disease
When the kidneys fail to function or do not function properly, it affects the functions of other organs in the body as well. As kidney failure progresses, it results in several complications such as
Secondary complications such as
Certain measures may help decrease risk of developing kidney failure and include;
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