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
- 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
The risk of kidney failure is higher with:
- Long term health conditions
- Certain structural problems
- Autoimmune diseases such as systemic lupus erythematosus
- 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 of kidney failure are usually not present in early stages. Later stages may cause:
- Swelling in the feet and ankles
- Puffiness around the face
- Itchy skin
- Muscle cramps and twitches
- Nausea or vomiting
- Loss of hunger
- Weight loss
- Urinary problems
- Trouble sleeping
- Feeling tired
- Changes in mental state
The doctor will ask about symptoms and past health. Urine tests will be done to look for signs of kidney problems such as:
- 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:
- Renal ultrasound
- CT scan
- Kidney biopsy
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.
Changes in day to day habits can ease stress on the kidneys. It may slow damage to kidneys. Steps may include:
- Managing intake of fluids
- Making nutritional changes such as limiting protein, cholesterol, salt, or potassium
- Being as active as possible
- Checking weight daily to watch fluid levels
- Checking blood pressure at home and keeping it in a healthy range
- Changing the use of pain medicine and avoiding NSAIDs
- Following a care plan for diabetes or high blood pressure
Medicines help manage:
- The balance of salt, minerals, and fluids in the body
- Blood pressure
The doctor may also change medicines if they harm a person's kidneys.
Dialysis takes over the work of the kidneys. It may be needed for a short time while a person heals. Some people need it for life. Others use it until a kidney transplant is ready.
There are 2 main types:
- Hemodialysis —Blood with wastes is taken from the body and filtered through a machine. Clean blood is returned to the body.
- Peritoneal dialysis —A cleansing fluid fills the space in the belly. Wastes are drawn from the blood into the fluid. The fluid then drains out of the body.
A transplant may work for some people. A healthy kidney comes from a donor. It’s placed next to the existing kidney during surgery. The new kidney should work well enough for the person to stop dialysis.
An effective transplant may depend on the cause of kidney damage and the person's overall health.
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.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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