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Renal failure: Decreased or absent renal function

Kidney failure is characterized by temporary or permanent damage to the kidneys that results in a loss of normal kidney function. There are two types. Acute renal failure has an abrupt onset and is potentially reversible. Chronic kidney failure progresses slowly over many years, leading to permanent kidney failure. The causes, symptoms, treatments, and outcomes of acute and chronic kidney failure are different. The treatment of chronic renal failure consists of kidney dialysis and/or a kidney transplant, while in acute renal failure the doctor treats the underlying condition or medical problem. The prospects are also variable. If the patient does not receive treatment, he will die.

  • Causes and types of kidney failure
  • Symptoms
  • Diagnosis and examinations
  • Treatment via dialysis or kidney transplant
  • Complications of reduced or absent kidney function
  • Prognosis of chronic and acute renal failure


Causes and types of kidney failure

The kidneys remove waste products and excess water from the body through urine. Kidney failure occurs when the kidneys are no longer able to support daily life. In most patients, kidney failure presents in the chronic form, where symptoms present over a longer period of time and progression is slow. Nevertheless, some patients suffer from acute renal failure with very rapid progression.

Chronic renal failure

Chronic renal failure is the final stage of chronic kidney disease in which the kidneys function at only 10% or less. This slowly progressive condition happens when the kidneys do not work enough to support the body. The most common causes of chronic kidney disease leading to kidney failure are diabetes mellitus and high blood pressure (hypertension). These conditions affect the kidneys. Kidney failure is often the result of chronic kidney disease. The kidneys then slowly stop working over a period of ten to twenty years.Patients with the following conditions are at a higher risk of chronic renal failure:

  • certain autoimmune diseases such as lupus and IgA nephropathy
  • diabetes (diabetes )
  • increased blood pressure
  • Alport syndrome (blood in the urine and increased blood pressure)
  • interstitial nephritis (kidney inflammation)
  • polycystic kidney disease
  • pyelonephritis: medical term: inflammation of the renal pelvis and kidney: This is a bacterial inflammation of the upper urinary tract; usually it is an ascending infection. A patient gets this due to a urethra that is too short, during pregnancy, after the patient has been fitted with a bladder catheter, in diabetes mellitus, etc.


Acute renal failure

This type of kidney failure occurs acutely as a result of, for example:

  • a heart attack
  • illegal drug use
  • insufficient blood flowing to the kidneys
  • urinary tract problems

 Bruises are characteristic / Source: Dezidor, Wikimedia Commons (CC BY-3.0)


Common symptoms include:

  • absent menstruation (amenorrhea)
  • tremors in hands (sometimes)
  • bruising
  • blood in the stool
  • bone pain
  • vomiting (often in the morning)
  • concentration problems and thinking problems
  • diarrhea (often in acute renal failure)
  • abnormally dark or light skin
  • a general ill feeling
  • dry skin
  • an excessive thirst
  • bad breath (halitosis)
  • a reduced libido
  • a loss of appetite
  • reduced or absent urine production
  • frequent hiccups
  • numbness in the hands, feet, or other areas
  • large amounts of urination (polyuria)
  • headache
  • impotence
  • itching (pruritus)
  • fever (often in acute renal failure)
  • nausea
  • nighttime urination (nocturia)
  • nail abnormalities
  • nosebleeds (often in acute renal failure)
  • unexplained weight loss
  • involuntary twitching of the eyebrow
  • irritability
  • back pain (often in acute renal failure)
  • sleep problems
  • drowsiness
  • muscle twitching or muscle cramps
  • fatigue
  • confusion
  • swelling of the feet and hands (edema)


Diagnosis and examinations

Physical examination

The doctor performs a physical examination and measures blood pressure, because most patients suffer from elevated blood pressure. Patients with kidney failure also produce much less urine. The doctor notes the other symptoms, but he must perform additional tests to be sure of kidney failure.

Diagnostic research

A blood test confirms the diagnosis. Anomalous results can be found for the levels of albumin, calcium, cholesterol, electrolytes, phosphorus, potassium, magnesium (hypermagnesemia: increased magnesium levels in the blood) and sodium. In addition, a urine test is required.

Treatment via dialysis or kidney transplant

In acute renal failure, the doctor treats the underlying problem, which usually leads to an improvement in symptoms.The treatment of chronic renal failure consists of dialysis or a kidney transplant. The patient often follows a special diet or else takes medications to reduce the symptoms of kidney failure.


Dialysis takes over part of the job of the kidneys when they no longer function properly. The doctor usually starts this when the kidney function is only 10 to 15% . Patients waiting for a kidney transplant also receive dialysis. This treatment technique has several important functions:

  • The production of red blood cells (erythrocytes) by the body.
  • Regulate blood pressure.
  • Removing extra salt, water and waste products from the blood so they don’t build up in the body.
  • Keep minerals and vitamins in good balance in the body.

Dialysis comes in two forms: hemodialysis and peritoneal dialysis. During hemodialysis, your own blood passes through a tube to an artificial kidney, or filter. During peritoneal dialysis, a special solution is introduced into the abdomen through a catheter. The solution remains in the abdomen for a period of time and then the doctor removes it. This technique can be done at home, at work or while traveling.

Kidney transplantation

A kidney transplant is a surgical technique in which the surgeon removes a damaged kidney from the patient and replaces it with a healthy kidney from a donor patient. The patient must meet a number of conditions for this, but he will discuss this with the doctor in the hospital.

Special diet

With chronic kidney disease it is useful to follow a special diet. The patient then limits the intake of fluid, but also of salt, potassium, phosphorus and other electrolytes. He also eats foods that contain a low protein content. Finally, he must consume enough calories if he is suffering from weight loss.

Other treatments

Other treatments depend on the symptoms but may include:

  • The treatment of anemia, such as extra iron in the diet, iron tablets or injections with the medicine “erythropoietin” and blood transfusions
  • Extra calcium and vitamin D (always to be taken in consultation with the doctor)
  • Phosphate binders (certain medications) to prevent the phosphorus content from becoming too high
  • Medicines to lower blood pressure
  • Necessary vaccinations (hepatitis A vaccine (viral hepatitis A), hepatitis B vaccine (viral hepatitis B), flu vaccine, pneumonia vaccine)


Complications of reduced or absent kidney function

Health problems that occasionally arise from kidney failure include:

  • abnormal electrolyte levels
  • anemia (deficiency of red blood cells)
  • bleeding from the stomach or intestines
  • bone pain, joint pain and muscle pain
  • dementia
  • a stroke (insufficient blood supply to the brain with mental and physical symptoms)
  • a heart attack
  • high potassium levels (hyperkalemia)
  • a miscarriage or infertility
  • an increased risk of infections
  • increased blood pressure
  • an increased risk of infections
  • epileptic attacks
  • joint pain, bone pain and muscle pain
  • heart failure (poor pumping of blood by the heart)
  • hepatitis B
  • hepatitis C
  • restless leg syndrome (annoying feelings in lower legs)
  • skin infections due to itching and dry skin
  • hyperparathyroidism (overactive parathyroid gland)
  • liver damage or liver failure
  • malnutrition
  • damage to the nerves of the legs and arms
  • changes in blood sugar (glucose) levels
  • fluid build-up around the lungs
  • weaker bones and fractures (fractures) related to high phosphorus and low calcium levels
  • swelling and edema


Prognosis of chronic and acute renal failure

Chronic renal failure

The prognosis of chronic renal failure is poor if the patient does not receive treatment; he then dies. The prospects are better with treatment via dialysis and/or a kidney transplant. However, both dialysis and kidney transplants carry risks. The results are therefore different.

Acute renal failure

Acute kidney failure is not always permanent. The patient usually responds well to treatment of the underlying condition or problem, resulting in (almost) complete recovery of kidney function.

read more

  • Chronic kidney disease: Progressive damage to kidney function
  • Renal cell carcinoma (kidney cancer): Tumor in kidney with pain in side
  • Kidney Health: Tips for Healthy Kidneys & Good Kidney Function
  • Renal hypertension: High blood pressure through the artery(s) of the kidneys
  • Eye problems in chronic kidney disease

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