Kidney Failure

Kidney failure refers to a decline in kidney function to the extent that the patient cannot live long without dialysis or a kidney transplant. Kidney failure can occur suddenly (acute renal failure) or gradually over time. Most often, kidney failure is permanent and is referred to as end-stage renal disease. Kidney failure can be the result of loss of blood flow to the kidneys or a blockage that prevents urine from exiting the kidneys. Blood or urine flow can be interrupted by severe dehydration, underlying disease conditions, certain medications, surgical complications or trauma.

Causes for Kidney Failure

There are many possible causes for kidney failure and several underlying conditions that put patients at greater risk. Patients are more likely to suffer kidney failure if they:

  • Have an autoimmune disease like diabetes, lupus or HIV/AIDS
  • Have a genetic kidney disease like polycystic kidney disease
  • Have had a serious injury to the region
  • Are taking certain prescribed medications or recreational drugs
  • Are hypertensive (have high blood pressure)

Individuals who are obese or who suffer from liver disease are also at heightened risk for kidney failure.

Symptoms of Kidney Failure

When patients go into kidney failure, the body experiences a buildup of waste products it is no longer able to remove. Since, in addition to ridding the body of waste, the kidneys also function to regulate blood pressure, electrolyte balance, and red blood cell production, kidney failure can produce the following symptoms:

  • Abnormal heart rhythm
  • Anemia
  • Confusion
  • Edema (swelling)
  • Hypertension
  • Internal bleeding
  • Infrequent or little urination
  • Nausea and vomiting
  • Shortness of breath
  • Weakness

In its early stages, kidney failure may be signaled by sudden weight loss. Left untreated, kidney failure is fatal.

Diagnosis of Kidney Failure

Once a physical examination is performed and symptoms are reviewed, the physician diagnoses kidney failure through the administration of a number of tests. Blood pressure is checked because high blood pressure can be the result of kidney malfunction. Other tests administered may include:

  • Urinalysis to detect blood or protein in the urine
  • X-rays, ultrasound or CT scan
  • Blood tests to measure levels of blood urea nitrogen (BUN)
  • Blood tests to measure creatinine level
  • Blood tests to evaluate the rate of glomerular filtration

In some cases, a kidney biopsy may be performed to check on the reason for impaired kidney function.

Treatment of Kidney Failure

The goal of treatment is to restore kidney function so waste products stop accumulating in the body. Sometimes, treating an underlying condition will allow the kidneys to function normally again. In other cases, one of the following treatment methods may be necessary:

  • Medical management
  • Peritoneal dialysis to remove waste through the abdomen
  • Hemodialysis to filter the blood through a dialysis machine
  • Kidney transplant

Medical management includes lifestyle changes, particularly dietary ones, and the administration of medications to lower blood pressure and/or cholesterol levels, and to relieve swelling. At times, antibiotics may also be prescribed if infection is present. Medical management is a temporary means of extending life and improving its qualtiy.

Dialysis preserves life for a longer time period, since waste products are being removed from the body by artificial means. Peritoneal dialysis may be performed at home once the abdominal catheter has been surgically implanted. Hemodialysis, the most frequently used treatment for kidney failure, normally takes place at a dialysis center.

A kidney transplant may provide a more long-term solution to kidney failure, but there is an extremely long waiting list for recipients.

Additional Resources