Published: 18 Jun 2025

ICD9: 586      ICD10: N19      ICD11: GB60

Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a condition where the kidneys are unable to filter waste products and excess fluid from the blood effectively.
This buildup of waste and fluid can lead to a wide range of health problems.

Here's a breakdown of key aspects:

What the Kidneys Do (Normally):

Filter Waste: Remove waste products from the blood, such as urea and creatinine, which are byproducts of metabolism.
Regulate Fluid Balance: Control the amount of water in the body, maintaining proper fluid levels.
Regulate Electrolytes: Maintain the balance of electrolytes like sodium, potassium, calcium, and phosphate.
Produce Hormones: Produce hormones that help regulate blood pressure, make red blood cells, and maintain bone health.

What Happens in Kidney Failure:

When the kidneys fail, these functions are compromised, leading to:

Build-up of toxins: Waste products accumulate in the blood, causing various symptoms and health problems.
Fluid overload: Excess fluid can lead to swelling (edema), high blood pressure, and shortness of breath.
Electrolyte imbalances: Disrupted electrolyte levels can cause heart problems, muscle weakness, and other complications.
Anemia: Reduced production of erythropoietin, a hormone that stimulates red blood cell production, can lead to anemia.
Bone problems: The kidneys play a role in vitamin D activation, which is essential for calcium absorption and bone health. Kidney failure can disrupt this process, leading to bone weakness.
High blood pressure: Kidney failure can both be caused by and worsen high blood pressure.

Causes of Kidney Failure:

Kidney failure is often caused by other health conditions that damage the kidneys over time. Common causes include:

Diabetes: High blood sugar levels can damage the small blood vessels in the kidneys.
High Blood Pressure (Hypertension): Uncontrolled high blood pressure can damage the blood vessels in the kidneys.
Glomerulonephritis: Inflammation of the kidney's filtering units (glomeruli).
Polycystic Kidney Disease: An inherited disorder that causes cysts to form in the kidneys.
Urinary Tract Obstructions: Blockages in the urinary tract (e.g., kidney stones, enlarged prostate) can damage the kidneys.
Certain Medications and Toxins: Long-term use of some medications (e.g., NSAIDs) and exposure to certain toxins can damage the kidneys.
Infections: Severe kidney infections can lead to scarring and kidney damage.

Symptoms of Kidney Failure:

Symptoms of kidney failure can vary depending on the severity of the condition and can develop gradually over time. In the early stages, there may be no noticeable symptoms. Common symptoms include:

Decreased urine output (though sometimes urine output remains normal or even increases, especially in early stages).
Swelling in the legs, ankles, feet, face, or hands (edema).
Fatigue and weakness.
Shortness of breath.
Nausea and vomiting.
Loss of appetite.
Itching (due to waste buildup).
Muscle cramps.
Trouble sleeping.
Changes in mental state (confusion, difficulty concentrating).
High blood pressure that is difficult to control.

Diagnosis:

Kidney failure is typically diagnosed through:

Blood Tests: To measure creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR). eGFR is a measure of how well the kidneys are filtering.
Urine Tests: To check for protein, blood, and other abnormalities in the urine.
Kidney Biopsy: A small sample of kidney tissue is taken for examination under a microscope.
Imaging Tests: Ultrasound, CT scan, or MRI to visualize the kidneys and look for abnormalities.

Stages of Kidney Disease:

Chronic kidney disease (CKD) is classified into five stages based on the eGFR:

Stage 1: Kidney damage with normal or increased GFR (GFR ≥ 90 mL/min/1.73 m2)
Stage 2: Kidney damage with mildly decreased GFR (GFR 60-89 mL/min/1.73 m2)
Stage 3a: Moderately decreased GFR (GFR 45-59 mL/min/1.73 m2)
Stage 3b: Moderately decreased GFR (GFR 30-44 mL/min/1.73 m2)
Stage 4: Severely decreased GFR (GFR 15-29 mL/min/1.73 m2)
Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m2) or requiring dialysis

Treatment:

Treatment for kidney failure aims to slow the progression of the disease, manage symptoms, and prevent complications. Treatment options include:

Lifestyle Changes: Following a kidney-friendly diet (low in sodium, potassium, and phosphorus), managing fluid intake, quitting smoking, and exercising regularly.
Medications: To control blood pressure, manage diabetes, treat anemia, and control electrolyte imbalances.
Dialysis: A procedure that filters the blood when the kidneys are no longer able to do so. There are two main types: hemodialysis and peritoneal dialysis.
Kidney Transplant: A surgical procedure to replace a diseased kidney with a healthy kidney from a donor.

Prognosis:

The prognosis for kidney failure varies depending on the underlying cause, the stage of the disease, and the individual's overall health. Early diagnosis and treatment can help slow the progression of the disease and improve outcomes. Dialysis and kidney transplantation can significantly extend life expectancy for people with ESRD.

Important Considerations:

Prevention: Managing conditions like diabetes and high blood pressure can help prevent kidney failure.
Early Detection: Regular checkups and screening tests can help detect kidney disease early, when it is more treatable.
Adherence to Treatment: Following the doctor's recommendations for lifestyle changes, medications, and dialysis (if needed) is crucial for managing kidney failure and preventing complications.

This information is for general knowledge and does not substitute for professional medical advice. If you suspect you have kidney problems, consult a doctor immediately. They can provide an accurate diagnosis and recommend the best course of treatment.