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What Is Kidney Failure?
Kidney failure — also called end-stage renal disease — is a life-threatening condition that occurs when your kidneys don’t work well enough to filter waste from your blood. When less than 15% of your kidney is working normally, you may be diagnosed with kidney failure.
What happens when kidneys fail?
When your kidneys fail, they don’t work well enough to filter waste products from your blood. That means toxins and excess fluid can build up in your body, causing life-threatening complications.
What are the types of kidney failure?
There are two types of kidney failure:
- Acute kidney failure can occur suddenly.
- Chronic kidney failure happens over time.
What causes kidney failure?
A variety of conditions can cause kidney failure. The most common causes of kidney failure are high blood pressure and diabetes.
What causes poor kidney function?
Other causes of poor kidney function and kidney failure include:
- Autoimmune conditions — Possible causes include lupus or scleroderma.
- Health conditions — Possible causes include chronic kidney disease, blood clots, vasculitis, glomerulonephritis, hemolytic uremic syndrome, multiple myeloma, thrombotic thrombocytopenic purpura, or uncontrolled diabetes.
- Loss of blood flow to your kidneys — Possible causes include high blood pressure, medications, heart disease or heart attack, liver disease, dehydration, severe burns, infection, or allergic reactions.
- Medications — Possible causes include chemotherapy drugs, antibiotics, or contrast dyes used in imaging tests.
- Substances — Possible causes include recreational drugs, alcohol, or heavy metal poisoning.
- Urinary tract blockages — Possible causes include prostate, colon, cervical, or bladder cancer, kidney stones, benign prostatic hyperplasia (BPH) or enlarged prostate, blood clots, or damage to nerves that control bladder function.
What are kidney failure risk factors and complications?
Kidney failure risk factors
As you age, your risk of kidney failure increases. However, kidney failure can affect people of any age. You may also be at increased risk of kidney failure if you have a family history of kidney disease.
Certain health conditions may increase your risk of kidney failure — especially if you have had them for a long time or they are not well-controlled. Conditions that increase your risk of kidney failure include:
Complications of kidney failure
Complications of kidney failure include:
- Anemia.
- Depression.
- Fluid in your lungs.
- Gout.
- Heart disease.
- Hyperkalemia (high potassium levels).
- Liver failure.
- Metabolic acidosis (too much acid in your blood).
- Nerve damage.
- Skin infections.
- Swelling caused by fluid retention.
- Weak bones.
How can I prevent kidney failure?
Depending on the cause, you may not be able to prevent kidney failure. However, you can slow kidney disease progression and reduce kidney failure risk.
Your doctor may recommend that you:
- Control chronic conditions — See a doctor for regular care if you have diabetes or high blood pressure.
- Drink water — Drink plenty of plain water and avoid caffeine.
- Eat healthy — Maintain a healthy diet with lots of fruits and vegetables. Limiting salt from shakers and processed foods can help reduce your blood pressure.
- Exercise — Aim for at least 30 minutes of moderate-intensity physical activity most days of the week.
- Keep track of medications — Inform your doctor if you routinely take over-the-counter drugs or herbal supplements and avoid or limit the use of NSAID medications (e.g., ibuprofen, naproxen).
- Manage stress — Take steps to manage stress and get at least seven to eight hours of sleep each night.
- Reduce alcohol intake — Limit alcohol to one drink a day for women and two drinks per day for men or less.
- Stop smoking — Quit smoking if you smoke cigarettes or marijuana.
- Track your numbers — Routinely check your blood pressure and blood glucose (sugar).
- Treat kidney conditions — If you develop kidney stones or a kidney, bladder, or urinary tract infection, get treatment immediately.
How common is kidney failure?
The U.S. Centers for Disease Control and Prevention (CDC) estimates that more than one in seven adults in the U.S. have chronic kidney disease — a significant risk factor for kidney failure.
The National Institute of Diabetes and Digestive and Kidney Diseases estimates that one in 500 Americans has stage five kidney disease, which happens when kidneys fail.
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What Are the Signs and Symptoms of Kidney Failure?
Kidney failure may not cause symptoms until it is advanced. The CDC estimates that one out of three adults with severe chronic kidney disease doesn’t know they have it.
What are the first signs of kidney failure?
Early signs of kidney failure may include urinating less than usual, swelling in your feet and ankles, or breathlessness.
As kidney failure gets worse, it may cause symptoms including:
- Blood in your urine, which turns it pink or red.
- Chest pain or pressure.
- Coma.
- Confusion.
- Difficulty sleeping.
- Fatigue and sleepiness.
- Foamy or bubbly urine due to excess protein.
- Muscle cramps, especially at night.
- Nausea that doesn’t go away.
- Seizures.
When should I see a doctor about my kidney failure symptoms?
If you have kidney failure symptoms, you should schedule an appointment with your doctor immediately. Early treatment may slow the progression of kidney disease.
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How Do You Diagnose Kidney Failure?
Your doctor will perform a physical exam, talk to you about your health history, and order blood and urine tests to diagnose kidney failure.
What to expect during your visit
During your visit, your doctor will:
- Ask about any medications you’re taking.
- Ask about recent activities, such as travel, injuries, or recreational drug use.
- Perform a physical exam.
- Order blood or urine tests.
- Review your health history.
Tests to diagnose kidney failure
Your doctor may order blood or urine tests to diagnose kidney failure. Blood tests include:
- Blood urea nitrogen (BUN) — Shows how well your kidneys are filtering urea nitrogen, a waste product, from your blood.
- Electrolyte and other tests — Checks for imbalances in electrolyte and mineral levels in your body, such as sodium, potassium, and bicarbonate.
- Estimated glomerular filtration rate (eGFR) — This shows how efficiently your kidneys function based on age, creatinine level, and sex.
- Serum (blood) creatinine — Shows how well your kidneys are filtering creatinine, a waste product, from your blood.
Urine tests include:
- Urinalysis — Looks for abnormalities in your urine, such as a protein called albumin that shows up when your kidneys aren’t working well.
- Urine output — Tracks how much urine your body produces each day.
Other tests include:
- CT scan — A test that creates images of the organs, bones, and tissues in your body.
- Kidney biopsy — A procedure that involves taking small pieces of kidney tissue for examination under a microscope to check for signs of disease.
- Ultrasound — Uses sound waves to create images of your organs to check for problems.
Kidney failure prognosis
Your prognosis after a kidney failure diagnosis will depend on your age, overall health, stage of kidney disease at diagnosis, the cause of your condition, and how well it is managed.
How long can you survive with kidney failure?
Although you will need dialysis or a kidney transplant, many people can live for years after a kidney failure diagnosis.
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How Do You Treat Kidney Failure?
Kidney failure is a life-threatening condition that requires treatment with dialysis or a kidney transplant. Kidney failure treatment aims to keep you alive, manage symptoms, and preserve your quality of life.
Treatment options may include:
Lifestyle changes
Lifestyle changes alone are not enough to treat kidney failure. Although you will need dialysis or a kidney transplant, your care team may also provide detailed guidance to help you change your diet and lifestyle.
Your doctor may recommend:
- Improving your diet and exercise routines to help you achieve a healthier weight, reduce your blood pressure, and lower your blood sugar. A low-sodium diet is essential.
- Quit smoking, limit alcohol use, and reduce stress.
- Restrict certain nutrients in your diet, such as protein, phosphorus, or potassium. Your kidneys may not filter excess amounts of these nutrients from your blood, and they can build up to dangerous levels in your body without proper filtering.
Your doctor may refer you to other medical specialists, such as a registered dietitian, endocrinologist, or cardiologist, to help you manage your health.
Dialysis to treat kidney failure
End-stage kidney disease — also known as kidney failure — is defined as having less than 15% of your normal kidney function. It causes toxic waste to build up in your body. You may need to have dialysis, also called renal replacement therapy, to filter and clean your blood.
What happens during dialysis?
During dialysis, a machine cleans waste from your blood and helps control your blood pressure.
There are two common types of dialysis:
- Hemodialysis — Performed using a machine at a dialysis clinic or home three times a week for about three hours.
- Peritoneal dialysis — Performed through a catheter in your abdomen at home.
How effective is dialysis for kidney failure?
If you have end-stage kidney disease, dialysis is a lifesaving, short-term treatment option. Without it, toxins and fluid would build up in your body and cause death within days or weeks.
Many people with kidney failure may qualify for kidney transplantation.
Kidney transplant to treat kidney failure
If you have kidney failure, a kidney transplant may be the key to getting you back to your healthy life. We partner with UPMC kidney transplant experts to provide care before, during, and after transplant.
Supportive care without dialysis
Although dialysis treatments are lifesaving for many people, they can be hard and sometimes painful for others.
For people with advanced kidney disease who want to avoid dialysis treatment, renal supportive care can offer hope and comfort.
Supportive care aims to:
- Treat the symptoms of kidney disease.
- Enhance your quality of life.
- Provide short-term treatment as you get ready for kidney transplant.
Why choose UPMC for kidney failure care?
When you choose UPMC for kidney failure care, you will receive:
- Access to world-class nephrology expertise — Our world-renowned experts treat the full spectrum of kidney diseases using the latest diagnostic and treatment techniques.
- A full range of treatment options — We'll work with you to develop a treatment plan that slows the progression of your disease as much as possible and improves your quality of life.
- Multidisciplinary care — We partner with special dialysis clinics, experts in supportive care, and kidney transplant surgeons to ensure you receive complete care.
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By UPMC Editorial Staff. Last reviewed on 2025-04-24 by Alexandra Bursic, MD.
