What is Renal Failure?
Renal failure happens when kidney disease progresses to a stage when only 15 percent function remains in the kidneys. It is referred to as end stage renal failure (ESRD).
The consequence of this means survival depends on kidney dialysis or transplant.
Whilst this is a serious condition, treatments are available which can either prolong or improve quality of life. Current statistics indicate, around 63 percent of patients received dialysis treatment and just under 30 percent had a successful kidney transplant. (1, 2)
End stage renal failure is the outcome of chronic kidney disease and is the final and most severe stage of this disease.
Usually other health problems will have contributed to the damage of your kidneys over time. Kidney disease tends to start slowly, then gradually does more harm meaning your kidneys are less able to function.
Knowing how the kidneys work can better help us explain the causes for kidney disease and renal failure.
The kidneys’ primary function is to filter extra water and waste products from the blood to produce urine. They also balance salts and minerals which circulate in the blood and are essential to keep the body healthy.
Other functions include: production of hormones to control blood pressure, making red blood cells and helping our bones stay strong. (3)
There are several health conditions and diseases which affect kidney function, including:
Diabetes is the number one cause of renal failure. This disease affects the way our body uses or makes insulin, a hormone that helps turn sugar into glucose to provide energy. When insulin is not used efficiently sugar levels in the blood are elevated.
The blood vessels in the kidneys which clean the blood can be damaged by high blood sugar levels, therefore diabetic kidney disease develops. Diabetic kidney disease happens over a long period, sometimes many years and you will not know it is happening unless it is tested.
This damage cannot be corrected and when left untreated leads to renal failure. (4)
High Blood Pressure (Hypertension)
High blood pressure is a condition where your heart works overtime to pump your blood. Pressure or tension builds in the arteries, veins and capillaries which carry blood throughout the body. When this pressure is high the workload of the heart increases and friction damages the inside of the arteries.
This in-turn allows a build up of a fatty substance called plaque which narrows the arteries. Blood flow is impaired and the heart has to work even harder.
The high force created can damage many parts of the body including the kidneys. Again, the blood vessels which clean the blood in the kidneys suffer, and the result can be renal failure. (5)
Autoimmune diseases forces the immune system, which usually protects the body to turn on itself and attack cells and organs.
Systemic lupus erythematosus (SLE or lupus) is a disorder classed as an autoimmune disease.
One of the most common health issues arising from lupus is kidney disease. This can affect as many as five out of ten adults and eight out of ten children with lupus.
Furthermore up to thirty percent of lupus sufferers will develop renal failure. (6)
Other autoimmune diseases which are not so common and affect the kidneys include Goodpasture syndrome, amyloidosis and wegener’s granulomatosis. (7)
There are many conditions we are born with can which affect kidney function. (8)
One of the more common is polycystic kidney disease, this causes the growth of cysts inside the kidneys. Consequently the kidneys become enlarged and tissue within them is damaged. The result can be chronic kidney disease leading to end stage renal failure. (9)
This refers to a group of symptoms which indicate your kidneys are not working efficiently. They include: excess protein in urine, too little protein in blood, high cholesterol or triglyceride levels and swelling in the lower limbs.
Proteins are essential for fighting infections, building bones, muscles and other bodily functions. Inefficient kidneys don’t filter a protein called albumin which causes a fluid build up resulting in lower limb swelling.
High cholesterol can contribute to heart attacks or stroke which can damage kidney function.
Triglycerides, a type of fat found in blood, are stored to make energy. When triglyceride levels are high heart disease can result. This can then lead to renal failure. (10)
Urinary Tract Issues
Urinary tract infections can lead to sepsis, this might in turn cause damage to the kidneys and renal failure. This is however not common, providing the infections are treated. (11)
Other conditions affecting the urinary tract like enlarged prostate or kidney stones can also cause damage to the kidneys if they are not treated. (12)
Acute Kidney Injury
Certain things can make the kidneys stop working very rapidly and result in renal failure. These include heart attack, lack of blood flow to the kidneys and illegal use of drugs or drug abuse. (13)
The deterioration of chronic kidney disease is usually slow and your kidneys could be badly damaged before any symptoms appear. When renal failure approaches, symptoms as a result of extra waste fluid retention starts to manifest.
Your lower limbs (ankles, legs and feet) might swell and you might feel an itching sensation all over your body. You may start producing excess amounts of urine or might find that you produce very little.
Joints can become stiff and painful and muscles might be numb, weak or start cramping. Headaches are also not uncommon, as is a shortness of breath.
You may experience loss of appetite and food can also lose its taste. Nausea and vomiting as well as a weight loss are other symptoms of this condition.
You might be tired all the time and feel confused. Focusing on even the simplest tasks might be beyond your capabilities and your memory might start slipping.
Sleep could elude you leaving you feeling fatigued during the day.
If renal failure is sudden, other symptoms could be noticed. These include pain in the back or abdomen, fever, rash, diarrhea, nosebleeds and vomiting. (14, 15)
Often kidney disease doesn’t display any symptoms in the early stages and unless you have a blood or urine test you might not even know you have it.
Certain conditions can predispose you to kidney disease. If you have diabetes, heart disease, high blood pressure or a family history of kidney failure you should get tested.
If you have any concerns about your kidney function you should see a medical professional. They will take a full personal and family medical history. Blood and urine tests will then be done to see how well your kidneys are functioning.
The blood tests produce what is called a glomerular filtration rate (GFR) to indicate how effectively your kidneys filter blood.
A GFR of 60 or less indicates kidney disease while a GFR of 15 or below is classified as renal failure.
The urine tests check for the amount of the protein albumin in the urine. Healthy kidneys do not allow this to pass from the blood.
Both these tests are the standards for healthcare professionals to manage and treat kidney disease and renal failure. (16)
What is renal failure? Renal failure happens when kidney disease progresses to a stage when only 15 percent function remains in the kidneys. It is referred to as end stage renal failure (ESRD) and is life threatening.
What causes renal failure? Renal failure is the end stage of kidney disease. There are many factors that can lead to kidney disease including diabetes, high blood pressure, autoimmune diseases and genetic makeup.
How do doctors test for renal failure? Blood and urine tests indicate the presence of renal failure and kidney disease.
When should you go to the doctor with renal failure? Changes in your pattern of urination, too much or too little, will likely be the first indication of kidney issues. If you have any concerns, especially if you are diabetic, have hypertension or heart conditions, see a doctor.
Can you prevent renal failure? Early diagnosis of kidney disease allows it to be treated and might help prevent renal failure.
What treatments are there for renal failure? To survive kidney failure you will either need a kidney transplant or have ongoing dialysis. Kidney dialysis involves the blood being diverted to a machine which filters waste and excess fluid from the blood. Your healthcare provider will discuss the best options for you and help you adjust to this major change in your life. Kidney transplants surgically replace your damaged kidney with a healthy one from a donor. (17)
What can relieve kidney failure? There are things that might help you feel better when dealing with renal failure. Sticking to your treatment schedule is a must and take any medications you are prescribed. A dietician can advise you and develop a healthy eating plan that you will enjoy. It is also important to stay physically and socially active. (18)
Are there other complications of renal failure? Renal failure can cause high blood pressure, heart disease, bone disorders, anemia and malnutrition. It is important to work with your health team to recognize and deal with any complications. (19)
Renal failure is a life threatening condition that happens when kidney function is severely impaired. Survival depends on treatment with dialysis or kidney transplant.
It is important to recognize and get tested for kidney diseases as early as possible to prevent renal failure.
Whilst there is no cure for renal failure, undergoing dialysis or after having a kidney transplant can prolong life.