Overview
Kidney failure, also known as renal failure, occurs when the kidneys lose their ability to filter waste products from the blood effectively. This condition can lead to the accumulation of harmful substances in the body, disrupting various bodily functions. Kidney failure can be acute (sudden onset) or chronic (developing over time).
How common is kidney failure?
Kidney failure affects over 750,000 people in the United States each year. It affects around 2 million people worldwide.
What Happens When Kidney Failure Starts?
Kidney failure progresses through various stages based on your estimated glomerular filtration rate (eGFR), which measures how well your kidneys filter substances. A normal eGFR is around 100, and the lowest eGFR is 0, indicating no remaining kidney function.
Stages of Kidney Disease:
- Stage I: Your eGFR is higher than 90 but below 100. At this stage, your kidneys have mild damage but still function normally.
- Stage II: Your eGFR ranges from 60 to 89. There is more damage than in Stage I, but the kidneys still function well.
- Stage III: Your eGFR ranges from 30 to 59. There is a moderate to severe loss of kidney function.
- Stage IV: Your eGFR ranges from 15 to 29. There is a severe loss of kidney function.
- Stage V: Your eGFR is below 15. This indicates that your kidneys are nearing or at complete failure.
Signs and Symptoms
The signs and symptoms of kidney failure can vary depending on the severity and whether the condition is acute or chronic. Common symptoms include:
- Fatigue and weakness
- Swelling in the legs, ankles, and feet
- Shortness of breath
- Persistent nausea and vomiting
- Loss of appetite
- Confusion or difficulty concentrating
- Decreased urine output
- Fluid retention, causing swelling in the body
- Muscle cramps
- Itchy skin
- High blood pressure (hypertension)
What Are the Most Common Causes of Kidney Failure?
Kidney failure can result from a variety of conditions. Common causes include:
- Chronic Kidney Disease and Kidney Failure:
- Diabetes: Unmanaged diabetes can lead to high blood sugar levels (hyperglycemia). Consistently high blood sugar can damage the kidneys as well as other organs.
- High Blood Pressure: High blood pressure forces blood to travel through the body's blood vessels with greater force. Over time, and without treatment, this extra force can damage kidney tissue.
- Other Causes of Chronic Kidney Disease:
- Polycystic Kidney Disease (PKD): An inherited condition where fluid-filled sacs (cysts) grow inside the kidneys.
- Glomerular Diseases: Conditions that affect the kidneys' ability to filter waste.
- Lupus: An autoimmune disease that can cause organ damage, joint pain, fever, and skin rashes.
- Acute Kidney Failure:
- Kidney failure can also develop quickly due to unexpected causes, known as acute kidney failure or acute kidney injury. This condition can develop within hours or days and is often temporary. Common causes include:
- Autoimmune Kidney Diseases
- Certain Medications
- Severe Dehydration
- Urinary Tract Obstruction
- Untreated Systemic Diseases: Such as heart disease or liver disease.
Types
Kidney failure can be classified into two main types:
- Acute Kidney Injury (AKI): Sudden loss of kidney function, often reversible with prompt treatment. Causes can include severe dehydration, infection, or obstruction.
- Chronic Kidney Disease (CKD): Gradual loss of kidney function over months or years. CKD is often irreversible and progresses to end-stage renal disease (ESRD) without treatment. Common causes include diabetes, hypertension, and chronic glomerulonephritis.
Diagnosis
Diagnosis of kidney failure typically involves a combination of medical history, physical examination, and various tests, including:
- Blood Tests: Measuring creatinine and blood urea nitrogen (BUN) levels to assess kidney function.
- Urine Tests: Checking for abnormal levels of protein, blood, or other substances in the urine.
- Imaging Tests: Ultrasound, CT scan, or MRI to visualize the kidneys and identify any structural abnormalities.
- Kidney Biopsy: A small sample of kidney tissue is examined under a microscope to determine the cause of kidney failure.
Treatment
Treatment for kidney failure focuses on managing symptoms, slowing the progression of the disease, and addressing the underlying cause. Common treatments include:
- Medications:
- Blood pressure medications to control hypertension.
- Diuretics to reduce fluid retention.
- Medications to manage blood sugar levels in diabetic patients.
- Dialysis: A procedure to artificially remove waste products and excess fluid from the blood when the kidneys are no longer able to do so. There are two main types of dialysis: hemodialysis and peritoneal dialysis.
- Kidney Transplant: Surgical procedure to replace a failed kidney with a healthy one from a donor.
- Lifestyle Changes:
- Dietary modifications to reduce the intake of sodium, potassium, and phosphorus.
- Maintaining a healthy weight through regular exercise and a balanced diet.
- Quitting smoking and limiting alcohol consumption.
FAQ
- What causes kidney failure? Kidney failure can be caused by various factors, including chronic diseases such as diabetes and hypertension, severe dehydration, infections, and prolonged use of certain medications.
- How is kidney failure diagnosed? Diagnosis involves blood tests, urine tests, imaging studies, and sometimes a kidney biopsy to determine the cause and extent of kidney damage.
- What are the treatment options for kidney failure? Treatment options include medications, lifestyle changes, dialysis, and kidney transplantation, depending on the underlying cause and severity of the condition.
- Can kidney failure be prevented? While not all cases can be prevented, managing risk factors like diabetes and hypertension, staying hydrated, avoiding excessive use of medications that can harm the kidneys, and maintaining a healthy lifestyle can reduce the risk.
- Is dialysis a permanent treatment for kidney failure? Dialysis is often used as a long-term treatment for chronic kidney failure or as a temporary measure for acute kidney injury until kidney function improves or a transplant is available.
- What is the role of diet in managing kidney failure? A kidney-friendly diet is crucial in managing kidney failure. It typically involves limiting intake of sodium, potassium, and phosphorus, while ensuring adequate protein and calorie intake. Consulting a dietitian can help tailor a diet plan to individual needs.
- How does kidney transplantation work? Kidney transplantation involves surgically placing a healthy kidney from a donor into a person with kidney failure. The new kidney takes over the function of filtering waste from the blood, eliminating the need for dialysis.
- Can meditation help with kidney failure? While meditation cannot directly treat kidney failure, it can help manage stress and improve overall well-being, which may positively impact other aspects of health.
Conclusion
Kidney failure is a serious condition that requires comprehensive management to improve quality of life and prevent complications. By understanding the symptoms, types, and treatment options, patients can work closely with their nephrologist to help manage their condition effectively.