Definition

Kidney failure occurs when one or both kidneys aren't able to work normally. The kidneys remove waste in the form of urine from the body. They also balance the water and electrolyte content in the blood by filtering salt and water.

Kidney failure is divided into two categories:

    
  • Acute kidney failure —sudden loss of kidney function
  • Chronic kidney failure —slow, gradual loss of kidney function
  • Causes

    Kidney disease causes the tiny filters in the kidneys called nephrons to lose their ability to filter. Damage to the nephrons may occur suddenly after an injury or poisoning. But, many kidney diseases take years or even decades to cause damage that is noticeable.

    The two most commons causes of kidney disease are:

        
  • Diabetes —high blood sugar can damage nephrons
  • High blood pressure —severe high blood pressure can damage blood vessels in the kidneys
  • Others causes include:

        
  • Pyelonephritis
  • Glomerulonephritis
  • Polycystic kidney disease
  • Birth defects
  • Bilateral renal artery stenosis
  • Poisoning
  • Severe trauma
  • Viral infections such as hepatitis B , hepatitis C , and HIV/AIDS
  • Long-term use of medicines that contain aspirin, acetaminophen, or ibuprofen
  • Abnormal build-up of substances within the kidneys such as amyloidosis and protein build-up
  • Toxic reaction to drugs or x-ray dyes
  • Systemic diseases such as lupus, polyarteritis , and Wegeners granulomatosis
  • Conditions that severely decrease the amount of blood such as burns , pancreatitis , peritonitis , bleeding, and dehydration
  • Conditions that make it difficult to urinate such as enlarged prostate , kidney stones , and tumors
  • Renal Failure

    Kidney failure stones

    A blockage from kidney stones has caused renal failure.

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    Risk Factors

    Factors that increase your chance of developing kidney failure include:

        
  • Diabetes
  • Genetics: polycystic kidney disease and type 1 diabetes
  • Race: African American
  • High blood pressure
  • Lupus or other autoimmune diseases
  • Long-term use of pain medications containing aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) in high doses
  • Liver failure, jaundice
  • Respiratory failure
  • HIV
  • Cancer
  • Recent open heart surgery
  • Recent surgery on an abdominal aortic aneurysm
  • Condition that obstructs urine flow
  • Enlargement of the prostate gland
  • Symptoms

    Some kidney diseases begin without any symptoms. As the disease progresses, some of the following symptoms may develop:

        
  • Fluid retention
  • Swollen and numb hands and feet, itchy skin
  • Fatigue, insomnia
  • Low urine output or no urine output in severe cases, frequent urination
  • Altered consciousness
  • Loss of appetite, malnutrition
  • Sores , bad taste in the mouth
  • Nausea, vomiting
  • Muscle cramps and twitches
  • Shortness of breath
  • High blood pressure
  • Low temperature
  • Seizures , coma
  • Breath smelling like urine
  • Yellowish-brownish skin tone
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.

    Your bodily fluids and tissues may be tested. This can be done with:

        
  • Blood tests
  • Urine tests
  • Biopsy
  • Images may be taken of your kidneys, bladder, and ureters. This can be done with a renal ultrasound .

    Treatment

    Most chronic kidney diseases are not reversible. But, there are treatments that may be used to help preserve as much kidney function as possible. In the case of acute renal failure , treatment focuses on the illness or injury that caused the problem.

    General Measures

        
  • Restricting fluids
  • Doing daily weight checks
  • Eating a high-carbohydrate, low-protein diet
  • Medications

    Medications used in acute or chronic kidney failure may include:

        
  • Diuretics —to flush out the kidneys, increase urine flow, and rid the body of excess sodium
  • Blood pressure medications
  • Medicine to treat anemia
  • Sodium polystyrene sulfonate or insulin in dextrose to control high potassium levels
  • Medications to control high phosphorus levels
  • Talk to your doctor about other medications you are taking. These include prescribed and over-the-counter medications, as well as herbs and supplements. Since the kidneys are no longer working properly, waste can build up in your body.

    Dialysis

    Dialysis is a process that takes over for the kidneys and filters waste from the blood. This may be done on a short-term basis until kidney function improves or it may be done until you have a kidney transplant .

    Kidney Transplant

    This may be the right option for some patients. Having a successful transplant depends on many factors, such as what is causing the kidney damage and your overall health.

    Lifestyle Changes

    You can take the following steps to help your kidneys stay healthy longer:

        
  • Have your blood pressure checked regularly. Take medication to control high blood pressure.
  • If you have diabetes, control your blood sugar. Ask your doctor for help.
  • Avoid the chronic use of pain medications.
  • If you have chronic kidney disease, you may need to limit how much protein you eat. Talk to a dietician.
  • Limit how much cholesterol and sodium you eat.
  • If you have severe kidney disease, limit how much potassium you eat. If your kidneys are failing, get help from a dietician.
  • If you are diagnosed with kidney failure, follow your doctor's instructions .

    Prevention

    In some cases, you cannot prevent kidney failure. But, there are some steps you can take that will lower your risk:

        
  • Maintain normal blood pressure.
  • If you have diabetes, control your blood sugar.
  • Avoid long-term exposure to toxic substances, such as lead and solvents.
  • Do not abuse alcohol or over-the-counter pain medication.
  • If you have chronic kidney failure, talk to your doctor before you become pregnant.