Kidney (renal) failure

Renal failure – more commonly known as kidney failure – is a potentially fatal condition where the kidneys are no longer able to perform their vital functions. 

A man with kidney failure in hospital

Kidney failure typically results in a build-up of harmful waste and excess fluid in the body, elevated blood pressure and a decrease in red blood cell production. 

Causes of kidney failure include: 

  • A drop in blood flow to the kidneys
  • Direct damage to the kidneys
  • Damage from poison
  • Infection
  • The long-term use of certain medications
  • A blockage that stops the flow of urine from the kidneys. 

Kidney failure usually occurs in conjunction with another medical condition or event, that is, in patients who are already hospitalised for a condition requiring intensive care.

What are its symptoms?

Symptoms of renal failure include the following:

  • Little or no urine output
  • Swelling in the legs and feet due to fluid retention
  • Nausea and vomiting
  • Reduced appetite
  • Fatigue
  • Anxiety and/or confusion
  • Back pain (just below the rib cage)
  • Chest pain
  • Seizure or coma (in severe cases)

How is it diagnosed? 

Most often, renal failure is diagnosed or discovered when a patient is already in hospital, that is, in conjunction with another condition. If you’re not in hospital, but are showing the signs and symptoms of kidney failure, it’s important to seek medical attention as soon as possible. 

Blood, urine and other tests will detect how well your kidneys are functioning, and what is causing renal failure. These tests include:

  • Urine output measurement: This measures the amount of urine that is excreted daily.
  • Urine test (also called a urinalysis): This may reveal abnormalities associated with renal failure
  • Blood test: Blood samples can be tested for urea and creatinine levels – both are used to measure the degree of kidney function.
  • Imaging test: An ultrasound or CT scan will allow your doctor to examine images of your kidneys.
  • Kidney biopsy: A small sample of the kidney is taken for lab testing – this can assist in diagnosing kidney disease and its severity.

What are your treatment options?

Treatment for kidney failure will require hospitalisation. It will involve identifying what is causing the kidney failure so that appropriate treatments can commence. For example, if there is a blockage in the urinary tract that is preventing the excretion of urine, this needs to be attended to.

For kidney failure, treatment will involve preventing complications and restoring kidney function. They may include the following:

  • Balancing the amount of fluids in your blood
  • Medication to control blood potassium levels and calcium levels
  • Dialysis: This process takes over the function of your kidneys, and works to remove toxins and excess fluids from the body. A machine pumps blood out of your body through a dialyzer or artificial kidney, after which the filtered blood is returned to your body. 

The prognosis for kidney failure depends on whether any permanent damage has been caused. Some patients may continue to suffer from chronic kidney disease, and regular dialysis or a kidney transplant may be necessary. Elderly patients, or those who are very ill may succumb to the underlying condition that has caused the kidney failure. 

Can it be prevented? 

While kidney failure may be difficult to predict or prevent, there are ways to take care of your kidneys that reduce the risk. These include:

  • Pay attention to contraindications on over-the-counter medications.
  • Manage diabetes and high blood pressure (hypertension) carefully as both these conditions are risk factors for kidney failure.
  • Follow a healthy lifestyle that includes a balanced diet and moderate alcohol consumption. 

For more info

The Kidney Foundation of South Africa: (011) 447 2531 / [email protected]

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2016