Chronic Kidney Failure

What is chronic kidney failure?

Chronic kidney (renal) failure is a long-lasting shutdown of your kidneys. This problem is also called chronic renal failure or chronic renal insufficiency.

Your kidneys are located on each side of your spine above your waist. They make urine by filtering waste products from your blood, control the balance of salt and water in your body, and help regulate your blood pressure. As long as you have at least one kidney that is working, your body can get by.

When you have kidney failure, the kidneys are no longer able to make urine, rid your body of wastes, or keep a healthy balance of minerals such as sodium and potassium. Chronic kidney failure usually occurs in middle-aged and older people.

How does it occur?

Chronic kidney failure (also called chronic renal insufficiency) is caused by continuous damage to the kidneys over the years by diseases such as:

• high blood pressure (hypertension)
• cysts in the kidney
• diabetes
• heart or lung disease.

Acute kidney failure, which is a sudden shutdown of your kidneys, may develop into chronic kidney failure. Prolonged use of painkillers can also cause chronic kidney failure.

What are the symptoms?

Symptoms include:

• a need to pass urine often
• pale and dilute-looking urine
• tiredness, weakness, headaches, loss of appetite, nausea, vomiting
• coated tongue, bad breath, itchy skin
• muscle cramps
• collapse, coma, death.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine you. You will have urine and blood tests to see how well your kidneys are working.

You may also have special x-rays and ultrasound scans of your kidneys. In some cases you may need to have a biopsy, a test in which tissue or cell samples are taken from the kidney and examined.

Your provider will look for disease that may be causing damage to your kidneys, such as high blood pressure; diabetes; heart, lung or arterial disease; or cancer.

How is it treated?

Your health care provider will probably prescribe medicine to:

• Treat the disease that is causing the kidney failure.
• Keep your blood pressure normal.
• Keep the balance of liquids in your body normal.
• Keep the balance of minerals in your body normal.

You may need to change your diet. Follow your health care provider's guidelines for the amount of salt in your diet. Also, the amounts of liquids you drink must be balanced against how much you urinate. You may need to have less protein to prevent further damage to your kidneys. You may also need to limit the potassium in your diet because it may be hard for your body to get rid of extra potassium. With the right diet, you can reduce the work your kidneys must do.

If these treatments are not enough, you may need kidney dialysis.

Whether dialysis is used depends on:

• why your kidneys stopped working
• your other health conditions
• your overall health.

For many people, dialysis can extend life, and improve quality of life. For others whose condition is extreme, dialysis may seem a burden that only prolongs suffering. Discuss this with your health care provider.

Dialysis is a mechanical way to do the work your kidneys normally do. It removes waste products and extra water from the blood and can be life-saving. Dialysis can be done in a medical center, but many people can operate the necessary equipment themselves in their own homes and are able to live a normal life. Kidney transplants from a donor can also be very successful.

How long will the effects last?

Chronic kidney failure develops slowly, and you have it for the rest of your life unless you have a kidney transplant. Without treatment, kidney failure is fatal.

How can I take care of myself?

• Carefully follow your health care provider's instructions for treating your kidney failure.
• Take medicines exactly as you are directed by your provider.
• Follow your provider's instructions for balancing your fluids through the day.
• Make changes in your diet as recommended by your health care provider. It may help to ask your provider for written diet instructions.