Kidney Failure

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KEY POINTS

• Kidney failure is a shutdown of your kidneys. Acute kidney failure happens suddenly. Chronic kidney disease can cause damage to the kidneys slowly over time and may cause kidney failure.
• The treatment of kidney failure depends on the cause. Treatment may include medicines, dialysis, which uses a machine to do the work of your kidneys, or a kidney transplant.
• Follow the full course of treatment prescribed by your healthcare provider. Take all medicines exactly as directed by your provider. Ask your provider what medicines you need to avoid because they could hurt your kidneys.

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What is kidney failure?

Kidney failure is a shutdown of your kidneys. Acute kidney failure happens suddenly. Chronic kidney disease can cause damage to the kidneys slowly over time and may cause kidney failure.

The kidneys are inside your belly, on either side of your spine just above your waist. They make urine by removing waste products, extra salt and other minerals, and water from the blood. As long as you have at least one kidney that is working, your body can filter enough blood and make enough urine to keep you healthy.

When you have kidney failure:

• Your body cannot get rid of wastes.
• Your body cannot keep a healthy balance of water and minerals.
• Your kidneys may make less urine, or no urine.

If not treated, severe kidney failure will cause death within a few days or weeks.

What is the cause?

Acute kidney failure can happen when your kidneys don’t get enough blood flow to work properly or if they are damaged in some other way. Problems that can cause sudden failure include:

• Heart disease and heart failure
• Liver failure
• Shock from low blood pressure because of:
  • Loss of a lot of fluid from vomiting, diarrhea, or heat illness
  • Severe burn or injury
  • Loss of a lot of blood from an injury or bleeding problem
  • Infection in the kidneys or blood
  • Poisons or an allergic reaction to a medicine

Sometimes blockage of urine flow causes or contributes to acute kidney failure. This can happen, for example, when a man’s prostate gland is enlarged, or from kidney stones blocking both kidneys.

Kidney failure caused by chronic kidney disease is more common in middle-aged and older people. It is caused by damage to the kidneys over the years by diseases such as:

• High blood pressure
• Diabetes
• Heart or lung disease
• Autoimmune disease, which is a disease that causes your body to mistakenly attack your own tissue such as with lupus
• Injury to the kidneys, kidney infection, and other kidney problems

Using nonprescription painkillers, such as acetaminophen, aspirin, or ibuprofen, for a long time can also cause chronic kidney failure. A family history of chronic kidney disease is also a risk factor.

What are the symptoms?

Symptoms may come on suddenly with acute kidney failure or over several months with chronic kidney disease. You may have no symptoms until the kidney disease is serious. Some of the common symptoms of kidney failure include:

• Changes in urine, such as urinating more often, less often, or not at all
• Swelling, especially in your legs, feet, or ankles
• Muscle cramps or weakness
• Bruising or bleeding
• Unusual pain in one or both sides of the back
• Skin that is yellow or a darker color than is usual for you
• Nausea and vomiting
• Shortness of breath
• Confusion or seizures
• Itching
• Tiredness
• Loss of appetite

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood and urine tests
• Ultrasound scan, which uses sound waves to show pictures of the kidneys
• CT scan, which uses X-rays and a computer to show detailed pictures of the kidneys
• Needle biopsy, which is the removal of a small piece of tissue from your kidney with a needle

A catheter (tube) may be placed in your bladder to measure how much urine your body makes.

How is it treated?

The treatment of kidney failure depends on the cause. Acute kidney failure is treated in a hospital. Your kidneys usually start working normally when the cause of the kidney failure is treated. For example:

• You may be treated for an infection.
• You may be given diuretics, often called water pills, to help your kidneys make urine.
• You may be limited on how much fluid you can drink.
• You may be given medicine through an IV to treat imbalances of water and minerals.

If your kidneys don’t start working again or if you have chronic kidney disease, you will need dialysis. Dialysis uses a machine to do the work of your kidneys. It removes waste products and extra water from your blood and can be life saving. Dialysis usually needs to be done several times a week and can be life-saving if your kidneys have failed completely. Dialysis can be done in a hospital, a dialysis center, or at home for some people with chronic kidney disease.

Dialysis can be done by filtering the blood or with a tube that filters fluid from the abdomen.

If you have acute kidney failure, you may need dialysis for a few days or weeks. There is a risk your kidneys could be permanently damaged.

If you have chronic kidney disease, the kidney failure cannot be cured. You will be on dialysis the rest of your life unless you have a kidney transplant. If you cannot use dialysis, you can be comfortable with other care sometimes provided by hospice at home or in a healthcare setting.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Take all medicines exactly as directed by your provider. Ask your provider what medicines you need to avoid because they could hurt your kidneys.

A healthy life style can keep your kidney disease stable for many years.

• Eat a healthy diet. You may need a diet that avoids salt and too much meat, and eating more fruits and vegetables. Ask your provider and dietitian what you need to eat, and what you should avoid.
• Try to keep a healthy weight. If you are overweight, lose weight.
• Stay fit with the right kind of exercise for you.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.

Try to get at least 7 to 9 hours of sleep each night.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

You can get more information from:

• The National Kidney Foundation
  800-622-9010
  https://www.kidney.org/