What is kidney failure?

Kidney failure, also called renal failure, is when your kidneys no longer work well enough to keep you alive.

Your kidneys' main job is to clean your blood, regulate your body fluid balance and make urine (wee) to get rid of waste products. When the kidneys do not work properly, waste and fluid build up in your body.

There are 2 main types of kidney failure:

1. acute kidney failure (now called acute kidney injury)
2. chronic kidney failure

Acute kidney failure

Acute kidney injury is loss of kidney function that develops quickly — over a few hours or days. It can be mild, or severe enough to cause kidney failure.

Many people with kidney function will recover over time. This could take days, weeks or months. For some people, acute kidney injury can cause death, or it can cause permanent damage and lead to chronic kidney disease.

Chronic kidney failure

Chronic kidney disease is when your kidneys have been damaged in a way that can't be reversed. Chronic kidney disease takes months or years to develop.

If chronic kidney disease gets worse, it can lead to chronic kidney failure.

What are the symptoms of kidney failure?

Acute kidney failure

The first symptom of acute kidney failure is a decreased amount of urine (wee).

Acute renal failure has early and late stages.

Early symptoms may include:

• oedema (swelling)
• weight gain
• changes in blood test results

Late symptoms may include:

• tiredness
• trouble concentrating
• confusion
• changes in your breathing
• seizures

Once you begin to recover, you will start to make a lot of urine before returning to a normal rate.

Chronic kidney failure

You may develop symptoms of chronic kidney disease, including:

• changes in your urine — such as waking up at night to pass urine, or blood in your urine
• tiredness
• loss of appetite, nausea and vomiting
• puffiness in your ankles
• itching
• shortness of breath
• restless legs

As kidney failure develops, additional symptoms may include:

• muscle cramps
• worsening swelling, including fluid build-up in your lungs and abdomen
• confusion and problems with thinking
• seizures
• anaemia and bleeding

Eventually kidney failure may lead to coma and death.

What causes kidney failure?

The are several causes of both acute and chronic kidney failure.

Acute kidney failure

Causes of acute kidney failure include:

• some infections
• a clot or inflammation in the blood vessels of the kidney
• dehydration
• blocked ureters (the tubes that drain urine from the kidneys) — this may be from kidney stones, a tumour or an enlarged prostate
• some medicines
• heart failure

Chronic kidney failure

In Australia, the most common conditions causing chronic kidney failure are:

• diabetes
• high blood pressure
• inflammation in the kidney (glomerulonephritis)

When should I see my doctor?

See your doctor if you have symptoms or risk factors of kidney disease. You should also see your doctor if you have been diagnosed with kidney disease and your symptoms are getting worse or you feel unwell.

In chronic kidney disease, your body can cope with your kidneys not working properly for quite a while, so you may not have any symptoms. If you have any risk factors for kidney disease, it's very important to get your kidney function checked regularly. Ask your doctor how often you should be tested.

Risk factors for developing chronic kidney disease include:

• hypertension (high blood pressure)
• smoking
• diabetes
• obesity

If you have chronic kidney disease you should see your doctor at least once a year.

When to seek urgent care

It's important to see your doctor if you have symptoms of chronic kidney disease or symptoms of kidney failure. See your doctor immediately or go to your local hospital emergency department if you notice you are suddenly making less urine (wee) than usual.

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How is kidney failure diagnosed?

Your doctor will ask about your symptoms and examine you. They will also ask about your health in general and any medicines you take.

Your doctor will likely recommend tests such as:

• blood tests — including your level of urea and creatinine (waste products in the blood) and estimated glomerular filtration rate (eGFR), which is a measurement of your kidney function
• urine tests
• an ultrasound scan of your kidneys

You may need other tests, such as a CT scan or a biopsy of your kidneys.

How is kidney failure treated?

Treatment for kidney failure will depend on the type of kidney failure and the cause.

Acute kidney failure

In acute kidney failure your doctor will:

• find and treat the cause of your kidney failure
• prescribe fluids given through a tube into your vein
• prescribe or adjust medicines if needed
• monitor your urine (wee) production, blood pressure and kidney function
• recommend changes in your diet especially your proteins, sodium (salt) and fats

Some people will need dialysis treatment while their kidneys recover. This may take days, weeks or months.

Chronic kidney failure

There are 3 treatment options for chronic kidney failure:

1. Dialysis — this removes waste and extra fluid from your blood. This is done through a tube into a blood vessel in your arm (called haemodialysis) or into your abdomen (called peritoneal dialysis).
2. Kidney transplant — where you receive a healthy kidney from a donor.
3. Supportive care — this involves treating symptoms and providing support when someone is approaching the end of their life.

You should also see a dietitian for advice on what to eat and drink.

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What are the complications of kidney failure?

For some people, acute kidney failure can cause permanent damage. This can put you at a higher risk of developing chronic kidney disease.

Chronic kidney disease can cause many different problems, including:

• fluid in your lungs
• high potassium levels in your blood
• anaemia
• weak bones and fractures
• problems with concentrating, memory and thinking
• pregnancy complications
• heart-related diseases

Can kidney failure be prevented?

Here are some things you can do to help keep your kidneys healthy:

• Maintain a healthy weight.
• Do not smoke.
• Keep your blood pressure under control.
• If you have diabetes, keep your blood sugar level under control.

If you already have chronic kidney disease, making these healthy lifestyle changes can prevent it getting worse and leading to kidney failure. It's also important to:

• avoid having too much salt in your diet
• keep your cholesterol at a healthy level
• ask your doctor before you take medicines that can affect your kidneys, such as anti-inflammatory medicines (NSAIDs)
• avoid becoming dehydrated
• see your doctor for regular check-ups

Ask your doctor or pharmacist if you are unsure if a medicine is safe for you to take. You should also check with them before taking vitamins, supplements and herbal or complementary medicines.

Resources and support

Visit Kidney Health Australia for more information and resources or call their Kidney Helpline on 1800 454 363.

Take a quick online test to check your risk of chronic kidney disease.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Support for carers

If you are caring for someone with kidney failure, visit Carers Australia for support, or call Carer Gateway on 1800 422 737.

Languages other than English

Kidney Health Australia has information about kidney disease in a number of community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Kidney Health Australia also has resources for Aboriginal and/or Torres Strait Islander people.