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Kidney failure

Medically reviewed by Drugs.com. Last updated on Jul 24, 2023.

What is Kidney failure?

Harvard Health Publishing

In kidney failure, the kidneys lose their ability to filter enough waste products from the blood and to regulate the body's balance of salt and water. Eventually, the kidneys slow their production of urine, or stop producing it completely. Waste products and water accumulate in the body.

This can lead to potentially life-threatening complications. Excess fluid can accumulate in the lungs and extreme changes in blood chemistry can affect the function of the heart and brain. There are three general categories of kidney failure (also called renal failure). They are:

Symptoms

Symptoms vary depending on the type of renal injury or failure.

If left untreated, acute kidney injury may progress to renal failure, which can cause extra fluid to back up behind the heart into the lungs, cardiac rhythm abnormalities, confusion and behavioral changes.

Diagnosis

If you have an illness or medical condition that increases the risk of acute kidney injury, your doctor will watch for symptoms and signs of kidney failure. He or she may give you blood and urine tests and measure the amount of urine you produce. If you have a chronic (long-term) medical condition that increases the risk of long-term kidney damage, your doctor will check your blood pressure and look for symptoms and signs of chronic renal failure during regularly scheduled office visits.

To confirm the diagnosis of acute kidney injury, your doctor will order tests of your urine and blood tests to check for chemical abnormalities. Levels of these chemicals are elevated in people with poor kidney function. Other tests may include:

If you have symptoms or a chronic medical condition that is known to potentially cause kidney failure, your doctor will periodically order blood tests to check on kidney function. Because chronic renal failure typically develops gradually, a physical examination may be normal. To confirm the diagnosis of chronic renal failure, the same evaluation may be recommended as for acute kidney injury, including tests of blood and urine, ultrasound of kidneys and in some cases, a kidney biopsy.

Doctors diagnose end-stage renal disease when symptoms become pronounced and certain blood chemicals reach very high levels in the blood, indicating that kidney function has been severely affected.

Expected duration

Acute kidney injury may go away within a few days simply by stopping a medication or reversing whatever caused the situation. Exactly how long the illness lasts varies considerably from person to person, depending on the cause of the kidney problem. In rare cases, acute kidney injury progresses to end-stage renal disease.

Chronic renal failure is a lifelong problem that can worsen over time to become end-stage renal disease. End-stage renal disease is a permanent condition that can be treated only with dialysis or a kidney transplant.

Prevention

Many forms of kidney injury or failure cannot be prevented. People who have diabetes, high blood pressure or coronary artery disease should try to control the illness with appropriate diet, medication and lifestyle changes. Before a computed tomography (CT) scan or angiogram procedure that uses contrast dye, your doctor will want to be sure that your kidneys can handle the dye load. Also your doctor will want you to be well hydrated with either oral or intravenous fluids.

If you already have chronic kidney failure, treating medical problems such as diabetes and high blood pressure and avoiding medications and other treatments that can further damage the kidneys may prevent worsening of kidney function. If you have chronic kidney failure, you should tell any physician who treats you.

Treatment

Treatment depends on the type of kidney injury or renal failure.

Kidney failure

Treatment options

The following list of medications are related to or used in the treatment of this condition.

View more treatment options

When to call a professional

Many people with acute kidney injury that progresses to acute renal failure are already hospitalized for their other medical conditions. Other people should call a health care professional whenever the amount of urine they produce either increases or decreases markedly. In people with decreased urine output, swelling of the face and ankles is another danger sign, especially if there is also shortness of breath. For people with chronic renal failure, it is a good idea to check with your health care professional whenever a new medication is prescribed.

Prognosis

Most children with acute kidney injury have a good outlook for recovering their kidney function, although in rare cases, end-stage renal disease can develop. Among adults, the chances of recovery depend primarily on the underlying reason for acute kidney injury.

People with chronic renal failure may have a continuing decrease in kidney function, but not everyone develops end-stage renal disease. For those who do, the time it takes for end-stage renal disease to develop varies from person to person.

Additional info

National Institute of Diabetes and Digestive and Kidney Disorders
https://www.niddk.nih.gov/

National Kidney Foundation
https://www.kidney.org/


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Further information

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