Kidney Failure
Condition
(Renal Failure; Renal Insufficiency)
Definition
Kidney failure is when the kidneys do not work as they should. There are two main types:
- Acute kidney injury (AKI)—happens quickly
- Chronic kidney disease (CKD)—happens over a long time
Waste and excess fluids are screened out in the kidneys and passed as urine (pee). Filters in the kidneys help to control how much fluid and healthy elements like sodium leave the body. Kidney failure makes it hard for the body to keep fluids and other important elements in balance.
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Causes
Kidney failure is caused by injury to the filters and other areas of the kidneys. AKI is most often caused by trauma, infection, or a toxin that cause sudden injury. CKD is often caused by long term health problems. These problems cause wear and tear to kidneys over time. The two most common causes of CKD are:
- Diabetes—harms the tiny tubules that filter blood
- High blood pressure—harms the blood vessels
Other common causes are:
- A kidney infection— pyelonephritis
- Glomerulonephritis
- Genetic diseases such as polycystic kidney disease
- Narrowed blood vessels— bilateral renal artery stenosis
- Structural problems—some may exist at birth
- Medicines or drugs
- Dyes given for x-rays
Risk Factors
The risk of kidney failure is higher with:
- Long term health conditions
- Certain structural problems
- Autoimmune diseases such as systemic lupus erythematosus
- Cancer
- Severe trauma
- Infections such as HIV
- Long term use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
- Blood volume problems caused by burns, bleeding, or dehydration
- Blockage in the urinary tract from an enlarged prostate , kidney stones, or tumors
- Recent heart surgery
Symptoms
Symptoms of kidney failure are usually not present in early stages. Later stages may cause:
Diagnosis
The doctor will ask about symptoms and past health. Urine tests will be done to look for signs of kidney problems such as:
- Blood
- Certain proteins
- Levels of other elements normally found in the blood
Blood tests will also be done to measure levels of some elements. Images of the kidney may be taken with:
Treatment
The goal of kidney failure treatment is to slow further damage. Treatment may also be needed to balance fluids and clean waste from the blood. AKI may only need short term support. The kidneys may recover enough function once they recover from injury.
CKD may need more long term treatment.
Prevention
To lower the risk of kidney problems:
- Those with high blood pressure or diabetes need to follow their care plans.
- Do not use medicines that harm to the kidneys. The doctor will make changes as needed.
- Use NSAIDs only as advised.
- Drink only in moderation. Moderation is 2 drinks a day or less for men or 1 drink a day or less for women.
- Those at high risk for kidney problems should see their doctor as advised.
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation
CANADIAN RESOURCES:
Health Canada
The Kidney Foundation of Canada
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation
CANADIAN RESOURCES:
Health Canada
The Kidney Foundation of Canada
References
- Acute kidney injury in adults—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/acute-kidney-injury-in-adults-approach-to-the-patient.
- Charles C, Ferris AH. Chronic kidney disease. Prim Care. 2020 Dec;47(4):585-595.
- Kidney failure. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure.
- Overview of chronic kidney disease (CKD) in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/overview-of-chronic-kidney-disease-ckd-in-adults.
- Snivel CS, Gutierrez C. Chronic kidney disease: prevention and treatment of common complications. Am Fam Physician. 2004;70(10):1921-1928.
- Your kidneys and how they work. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work.
Contributors
- April Scott, NP
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