The kidneys are working throughout the day and night to filter the blood of excess water and certain nutrients, electrolytes, wastes and toxins. It plays a crucial role in maintaining the inner balance necesarry for health (homeostasis).
Although the kidneys are not working at its maximum capacity at most times under normal circumstances, any disease that hampers kidney function can lead to an accumulation of wastes and toxins in the system. This can be dangerous and even life-threatening at times.
How To Spot Kidney Failure
The term kidney failure simply means that the kidneys cannot excrete sufficient wastes and toxins in the body leading to an accumulation of these substances. It can be acute or chronic. Acute kidney failure is a temporary state and if the underlying cause is removed the kidneys may recover. Nevertheless, it can be life-threatening. Chronic kidney failure is usually progressive and therefore irreversible.
Acute kidney failure may present with signs and symptoms suddenly which can be relatively easy to identify. Spotting chronic kidney failure on the other hand can be difficult, especially in the early stages where there are few signs and symptoms, if any. It is only when there is significant impairment of kidney function in chronic kidney failure that the symptoms become obvious. Ideally blood and urine tests should be done to assess kidney function.
Read more on strained kidneys.
Why do the kidneys fail?
A host of different conditions can cause kidney failure. This includes both acute and chronic conditions such as infections, trauma, autoimmune diseases,diabetes, high blood pressure and various other disorders. Substances like drugs and metals can also lead to kidney failure. These conditions either damage the tiny functional units of the kidney known as the nephrons, impair blood flow to the kidney or lead to obstructions of urine outflow from the kidney.
How serious is kidney failure?
Due to the intensity of symptoms in acute kidney disease, this condition is often diagnosed and treated promptly. It may be reversible. Therefore acute kidney disease may not pose any further problem after the treatment period but delayed treatment and severe acute cases can be life-threatening.
However, chronic kidney disease may be missed in the early stages. It is also irreversible and chronic kidney failure can only be managed with procedures like dialysis in severe cases until a transplant can be done. Without the appropriate medical intervention, chronic kidney failure ultimately leads to death.
Chronic kidney disease (CKD) affects about 1 in 10 Americans although not all are symptomatic or aware of the condition. End stage renal disease is more commonly seen in people older than 65 years of age. Kidney disease is currently the ninth leading cause of death in the United States.
Read more on acute kidney failure.
Reduced Urine Output
The kidneys filter the blood to remove substances and fluid that are not needed by the body. This is expelled in the form of urine. When the kidneys fail, urine production is diminished. This is evident as low urine output (oliguria) and sometimes even no urine output (anuria). Reduced urine output is more noticeable with acute kidney failure since it arises suddenly but also occurs gradually over time with chronic kidney failure.
Swelling of Feet and Hands
Swelling is one of the characteristic signs of kidney failure as a result of fluid retention. It is also seen with other diseases that do not involve the kidney directly. The swelling is most obvious in the peripheral parts of the body, such as the legs and feet as well as in the hands. However, swelling can occur anywhere an over time it may also lead to fluid accumulation in the abdomen (ascites) and even throughout the body (anasarca).
Shortness of Breath
Depending on the severity of fluid retention, the excess fluid may seep into the lungs. This fluid affects the exchange of gases in the lung which is necessary for oxygenation of the blood. As a result a person may experience shortness of breath. Some people may only experience this when lying flat. It is dependent on the degree of fluid accumulation in the lungs (pulmonary edema) and there may also be abnormal breathing sounds in more severe cases.
Nausea and Vomiting
Nausea is another common symptom seen in both acute and chronic kidney failure. It is due to the buildup of wastes and toxins in the body. This accumulation of wastes and toxins stimulate certain centers in the brain which are responsible for eliciting the sensation of nausea. Depending on the severity, it can lead to vomiting as is seen in acute kidney failure in particular.
Itching throughout the Body
Another consquence of the accumulation of wastes and toxins due to kidney failure is that these substances can cause itching. It is felt throughout the body (generalized pruritus). There is usually no rash although scratching can irritate and injure the skin, and even increase the risk of infections. Along with some of the other symptoms, the itching can affect sleep patterns.
Fatigue is another sign of kidney failure. However, it is non-specific meaning that it occurs with a host of different medical conditions and not only with kidney problems. A person may sometimes report uncharacteristic tiredness even before other symptoms become apparent. This tiredness does not correlate with the level of physical activity and may sometimes be seen as the constant need to sleep or unwillingness to move around.
High Blood Pressure
The kidneys play a crucial role in regulating blood pressure through several mechanisms. One of the most important mechanisms is regulating the fluid level in the body. When the kidneys fail and fluid levels increase beyond normal, there is usually a rise in blood pressure. Often this high blood pressure is difficult to control with drugs and can reach dangerously high levels over time.
Chest pain may also be a sign of kidney failure. It occurs as fluid fills around the heart in the peritoneal cavity and may also be reported as pressure in the chest. Furthermore the heart undergoes significant strain due to the disturbances caused by kidney failure. Depending on underlying cardiac conditions, chest pain may also indicate that the heart is experiencing difficulty in coping with the level of activity required of it.
Other Signs and Symptoms
A host of other signs and symptoms may also be present with kidney failure. As with the above features, it depends on the severity of the condition. This includes:
- Muscle cramps and twitches
- Loss of appetite