Kidney Failure Disease: A Comprehensive Guide

Kidney Failure Disease affects millions of people worldwide and can occur at any age. The kidneys are vital organs responsible for filtering waste, balancing electrolytes, regulating blood pressure, and producing essential hormones.

When kidney function declines, toxins accumulate in the blood, leading to complications that can affect every organ system. Chronic kidney disease (CKD) is now recognized as a major public health issue, contributing to millions of premature deaths annually.

Read more about How to Maintain Healthy Kidneys: Protecting the Natural Urinary Gateway

Table of contents

• What is Kidney Failure Disease?
• Functions of the Kidneys
• Common Causes and Risk Factors
• Signs and Symptoms
• Diagnosis and Tests
• Stages of Kidney Failure Disease
• Treatment and Management
• Nutrition and Lifestyle
• Prevention and Early Screening
• When to See a Doctor

What is Kidney Failure Disease?

Kidney failure disease refers to any condition that impairs the structure or function of the kidneys. It can be Acute Kidney Injury (AKI) - a sudden loss of kidney function, often reversible if treated early; or Chronic Kidney Disease (CKD): Long-term, progressive damage to the kidneys lasting more than 3 months.

Other types include genetic (e.g., Polycystic Kidney Disease (PKD)), autoimmune (e.g., lupus nephritis), or drug-induced kidney damage.

Functions of the Kidneys

Healthy kidneys perform several life-sustaining functions:

• Filtration: Remove waste and excess fluid via urine.
• Blood pressure regulation: Via the renin-angiotensin-aldosterone system.
• Acid-base balance: Keep the blood’s pH within normal range.

Electrolyte regulation and Hormone production: maintain sodium, potassium, calcium, and phosphorus balance; Stimulate red blood cell formation (erythropoietin) and activate vitamin D. When these functions decline, multiple organs are affected, highlighting why early kidney health screening is critical.

Common Causes and Risk Factors

Kidney failure disease often develops silently but is influenced by well-known causes and risks:

Major Causes Include

• Diabetes mellitus - the leading global cause of CKD.
• Hypertension (high blood pressure) - damages kidney blood vessels over time.
• Autoimmune diseases - e.g., lupus nephritis.
• Genetic disorders - e.g., Polycystic Kidney Disease (PKD).
• Glomerulonephritis - inflammation of kidney filtering units.

Additional Risk Factors

• Long-term use of NSAIDs or nephrotoxic drugs.
• Smoking, obesity, aging, and family history of kidney disease.
• Frequent urinary tract infections (UTIs) or kidney stones.

The National Kidney Foundation (NKF) identifies these as major targets for early prevention and intervention.

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Signs and Symptoms

Kidney disease is often called a “silent disease” because early stages show few symptoms. As it progresses, you may experience:

• Swelling in the legs, ankles, or around the eyes (edema).
• Fatigue, weakness, or difficulty concentrating.
• Changes in urine output (too little or too much).
• Foamy urine due to protein loss.
• High blood pressure or difficult-to-control hypertension.
• Loss of appetite, nausea, vomiting, or muscle cramps.
• Shortness of breath (from fluid overload).

If you experience these symptoms, consult a nephrologist immediately for evaluation.

Diagnosis and Tests

Early diagnosis saves kidney function. Doctors use a combination of blood, urine, and imaging tests to evaluate renal health:

Laboratory Tests

The tests include urine albumin-to-creatinine ratio (ACR) that detects early kidney damage (albuminuria). BUN (blood urea nitrogen) that indicates waste accumulation and Serum creatinine & eGFR (estimated glomerular filtration rate) to measure kidney filtering efficiency.

Imaging

Ultrasound or CT scan shows kidney size, cysts, or obstructions.

Biopsy

Biopsy may be needed in glomerular or autoimmune kidney diseases for definitive diagnosis.

KDIGO 2024 Clinical Practice Guideline recommends combining eGFR and ACR for accurate staging and risk prediction.

Stages of Kidney Failure Disease

According to KDIGO:

The lower the eGFR, the more advanced the kidney impairment.

Treatment and Management

Treatment focuses on slowing progression, managing symptoms, and preventing complications.

Medical Management

Controlling blood pressure is crucial, use ACE inhibitors or ARBs to reduce proteinuria and protect kidneys. Newer medications include SGLT2 inhibitors, which have been shown to protect kidneys in both diabetic and non-diabetic patients.

• Control blood sugar: For diabetic patients, maintain HbA1c < 7%.
  
• Treat anemia: Use erythropoiesis-stimulating agents and iron supplements.

Renal Replacement Therapy

When kidneys fail, renal replacement therapy (RRT) is required. Dialysis: Hemodialysis or Peritoneal dialysis remove waste and fluid; Kidney transplantation offers longer survival and better quality of life but requires lifelong immunosuppression.

Nutrition and Lifestyle

A kidney-friendly lifestyle can help slow disease progression. According to Mayo Clinic, these actions are recommended:

• Stay hydrated (unless fluid restriction prescribed).
• Reduce sodium (salt): < 2,000 mg/day.
• Moderate protein intake: avoid excessive red meat;
• Choose plant-based proteins.
• Control potassium and phosphorus in advanced stages.
• Quit smoking and limit alcohol.
• Maintain a healthy weight and exercise regularly.
• Work with a renal dietitian for personalized plans

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Prevention and Early Screening

Most kidney diseases are preventable through early detection and risk management:

• Use simple tests eGFR and ACR annually.
• Avoid unnecessary NSAIDs or nephrotoxic drugs.
• Treat urinary tract infections and kidney stones promptly.
• Participate in public health kidney screening programs.

It is also suggested to screen high-risk individuals such as diabetics, hypertensive patients, older adults, family history of kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) provides free educational resources for patients and healthcare providers.

When to See a Doctor

Seek urgent medical care if you experience:

• Very little or no urine output.
• Swelling of legs, face, or abdomen.
• Shortness of breath or chest pain.
• Persistent nausea, vomiting, confusion, or fatigue.
• Blood in urine or foamy urine.
• Abnormal lab tests (elevated creatinine, low eGFR, or positive albuminuria).

Early intervention can prevent irreversible kidney failure.

Conclusion and suggested daily habits

Kidney failure disease is often silent until advanced stages, but early detection, lifestyle modification, and medical management can prevent or delay kidney failure. Maintain blood pressure and blood sugar within normal limits, avoid unnecessary medications, and have regular checkups.

Protecting your kidneys is an investment in your long-term health, small actions today can prevent major complications tomorrow.

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