Kidney failure: why do kidneys fail?

In Nephrology, we call renal failure to the inability of our kidneys to perform their functions of toxin clearance and volume control properly. If this inability appears in a short period of time, it is called acute renal failure, and if it is established over a longer period of time (months/years) it is called chronic renal failure. Kidney failure is classified in different stages from 1 to 5 according to the severity of the disease.

At what point and for what reasons can the kidneys fail? What causes kidney failure?

In the case of acute renal failure, the causes can be multiple, the most frequent being dehydration, especially in the elderly, or obstructive causes of the renal excretory tract such as prostatic hyperplasia in the case of men. Other less frequent causes may be drugs or substances that cause toxicity at the renal level or microscopic kidney diseases called glomerulonephritis that can appear at any stage of life.

In the case of chronic renal insufficiency, the most frequent causes are diabetes and/or arterial hypertension, which over the years cause damage at the level of the small vessels that make up different organs, including the kidneys. Glomerulonephritis is also a cause of chronic renal failure when it develops over a long period of time.

What are the symptoms of kidney failure?

Renal insufficiency is often a silent disease, as there are hardly any symptoms until the advanced stages of the disease.

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Some of the symptoms of renal failure are also not very specific, such as nausea, vomiting, gait instability, generalized weakness, cramps in the lower limbs…and in the most severe cases, those in which renal failure is very severe, symptoms such as cardiac arrhythmias, edema or swelling in the lower limbs, respiratory failure or even pulmonary edema appear.

Can kidney failure be treated?

Acute renal failure can be treated in most cases, because the cause is often punctual, and knowing the reason for the renal damage, treatment can be instituted with good response in most cases. Depending on the cause, the treatment can range from simply providing adequate hydration in the case of patients with dehydration, treatment with corticosteroids or immunosuppressants in the case of some glomerulonephritis or urological assessment and/or treatment in the case of obstructive causes.

In the case of chronic renal failure in many occasions, when the diagnosis is made, the established renal damage cannot be recovered, in that case the treatment is directed to prevent or to slow down the progression of the disease and to watch with periodic analytical controls how is the situation of the disease.

In the case of some glomerulonephritis, treatments that reverse or change the course of the disease, such as corticosteroids or immunosuppressants, may be necessary.

Is it possible to have an adequate quality of life with renal failure?

Yes, patients with kidney failure have a good quality of life until the final stages of the disease. The most extreme case is that in which a patient needs external help to compensate for the function that their kidneys cannot perform. This type of therapy known as dialysis can limit or vary to some extent the quality of life of patients, but nowadays the techniques used allow these patients to lead a practically normal life.

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For more information on kidney failure, contact a specialist in Nephrology.