Recognize Kidney Failure Symptoms: Key Warning Signs

Understanding Kidney Failure Symptoms

Kidney failure, also called end-stage kidney disease or renal failure, is when the kidneys are not able to properly remove toxins and waste products from the body or control fluid and salt levels in the body. Kidney failure can develop gradually or suddenly. People with kidney failure need to undergo dialysis or a kidney transplant to survive.

Healthcare providers use a blood test called the estimated glomerular filtration rate (eGFR), which measures kidney function, to find out if you have kidney disease. Depending on the eGFR, your doctor will then classify your case of kidney disease as mild, moderate, or severe. This test can also tell if you have severe kidney damage and kidney failure.

The eGFR is calculated based on the results of a blood test called serum creatinine, your age, gender, height, weight, and ethnicity. A normal eGFR is 90 or higher. An eGFR of 15 or lower is called kidney failure or renal failure.

Acute Kidney Failure (Acute Kidney Injury) vs Chronic Kidney Failure

Damage to your kidneys that results in a short-term loss of kidney function is called acute kidney failure. An acute kidney injury develops quickly over a period of a few hours to days. Acute kidney failure can occur due to illnesses (infections, severe dehydration) or exposure to certain nephrotoxic drugs and poisons.

When kidney damage occurs over a period of many months to years, it is called chronic kidney disease (CKD). CKD results in permanent kidney damage. Sometimes, acute kidney failure can cause permanent kidney damage and chronic kidney disease.

Importance of Recognizing Symptoms Early

Recognizing the symptoms and signs of kidney disease early is important because it can prevent further kidney damage, kidney failure, and other health problems.

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 7 adults in the U.S. has chronic kidney disease (CKD) and 750,000 people are living with kidney failure. However, experts estimate that 90% of people with CKD do not have kidney disease symptoms and are unaware they have kidney problems.

CKD is, therefore, a “silent” disease. It causes no symptoms or nonspecific symptoms that can be due to many other medical conditions. Generally, severe symptoms do not develop until they have progressed to advanced kidney disease when kidney function is very low, and kidney failure has already developed.

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Signs of Kidney Failure

Signs and Symptoms of Acute Kidney Injury

Acute kidney injury (AKI) is now the preferred term to describe “acute kidney failure” or “acute renal failure.” AKI symptoms may vary depending on the severity, the cause, and an individual’s overall health status. Common symptoms of acute kidney injury may include:

Making a lot less urine than usual or no urine
Swelling in legs, feet, and ankles
Fatigue or weakness
Shortness of breath
Poor appetite
Nausea, vomiting
High blood pressure
Muscle cramps
Flank pain (back pain in between your ribs and hips)
Confusion, mood changes
Chest pain or tightness
Coma or seizures in severe cases

Signs and Symptoms of Chronic Kidney Disease

Many people with early-stage chronic kidney disease (CKD) don’t have any significant symptoms until later. However, if the kidneys are not working properly, chronic kidney disease symptoms may include:

Fatigue and weakness
Nausea and vomiting
Loss of appetite
Metallic taste in the mouth
Trouble sleeping
Changes in urination (peeing too much or too little)
Blood in urine or foamy urine
Muscle cramps, numbness in the arms or legs
Puffiness around the eyes
Swelling of the ankles or feet
Dry and itchy skin
Difficult to control hypertension (high blood pressure)
Chest pain
Shortness of breath
Confusion
Trouble concentrating
Decreased mental sharpness
Unintentional weight loss

What Happens To Your Body When Your Kidneys Start Shutting Down?

Healthy kidneys remove waste and excess fluid and maintain an acid-base balance in the body. As a result, reduced kidney function and kidney failure can have a significant impact on overall health due to the buildup of waste and extra fluid in the body. People with complete kidney failure need dialysis or a kidney transplant to stay alive. Possible health complications of advanced kidney disease and renal failure include:

Fluid retention leading to edema (swelling in the arms and legs) or shortness of breath (pulmonary edema or fluid in the lungs).
Hypertension (high blood pressure).
Hyperkalemia (high blood potassium levels), which can cause potentially life-threatening abnormal heart rhythm.
Heart disease.
Anemia (decreased number of red blood cells).
Osteoporosis (weak bones) and an increased risk of fractures.
Damage to the central nervous system resulting in cognitive changes, personality changes, or convulsions.
Problems with immune system function with an increased risk of infections.
Pericarditis (inflammation of the membrane that covers the heart).
Sexual problems including fertility problems, decreased libido (sex drive), and erectile dysfunction.
Complications during pregnancy with increased risks for mother and baby.
Irreversible kidney damage and end-stage kidney disease (kidney failure), requiring dialysis or kidney transplant to make up for the loss of kidney function.

What Happens When One Kidney Starts To Fail?

When one kidney starts shutting down or fails or is surgically removed, the remaining healthy kidney can usually compensate. Most people with one kidney can live healthy lives. However, there is a slightly higher risk of developing complications such as fluid retention, high blood pressure, and protein in urine.

Causes and Risk Factors

Common Causes of Acute Kidney Failure

Severe dehydration.
An obstruction in the urinary tract.
Autoimmune diseases affecting the kidneys, such as lupus nephritis and glomerulonephritis.
Untreated heart disease or liver disease.
Certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), some antidepressants, anti-anxiety medicines, and mood stabilizers, certain antihistamines, some antibiotics and antiviral drugs, chemotherapy drugs, contrast dye used during imaging studies, certain herbs, and many more.

Common Causes of Chronic Kidney Disease

Untreated type 1 or type 2 diabetes (high blood sugar).
Hypertension (high blood pressure).
Polycystic kidney disease (an inherited condition in which multiple fluid-filled sacs develop in the kidneys).
Glomerular diseases that affect the ability of the kidneys to filter waste.
Inflammatory conditions such as glomerulonephritis or interstitial nephritis.
Vesicoureteral reflux (backflow of urine into the kidneys).
Recurrent kidney infections (pyelonephritis).
Prolonged urinary tract obstruction due to kidney stones, enlarged prostate, or certain cancers.
Systemic lupus erythematosus (SLE or lupus), an autoimmune disease that can cause organ damage, including kidney damage.

Common Risk Factors for Developing Kidney Disease

Older age above 60.
African-American, Native American, or Asian-American ethnicity.
A family history of kidney disease
Structural abnormalities in the kidneys.
Frequent or prolonged use of nephrotoxic drugs (medicines that can damage the kidneys).

Are you at risk for kidney disease? Check out our blog “Am I At Risk For Kidney Disease? Early Signs Of Kidney Problems” to learn more.

Lifestyle Factors Contributing To Kidney Failure

Obesity.
Smoking.
Excessive alcohol intake.
High-salt diet.
Unhealthy diet (excessive intake of processed foods, meat, sugar).
Lack of proper hydration.

How to Prevent Kidney Disease?

To lower your risk of developing kidney disease:

Take over-the-counter (nonprescription) pain relievers according to the instructions on the package.
Maintain a healthy weight.
Stop smoking, if you smoke.
Follow your doctor’s advice to manage health conditions that are risk factors for kidney disease, such as diabetes and high blood pressure.

Diagnosis and Testing: How is Kidney Failure Diagnosed?

Regular Medical Check-Ups and Screenings

As mentioned above, in the early stages, chronic kidney disease does not usually cause any symptoms. Undergoing regular medical check-ups and screening for kidney disease is therefore the only way to find out if your kidneys are working properly. The sooner kidney disease is diagnosed, the sooner you can have kidney disease treated and protect yourself from developing kidney failure.

If you have diabetes, you should get tested for kidney disease every year. If you have high blood pressure, heart disease, or a family history of kidney failure, your healthcare provider will advise you about how often you should undergo screening based on your risk factors.

Doctors can screen for chronic kidney disease with a kidney health check consisting of:

Serum creatinine for estimated glomerular filtration rate (eGFR).
Spot urine albumin-to-creatinine ratio (ACR) to detect protein in urine.

Diagnostic Tests

Your healthcare provider can make a diagnosis of kidney disease or kidney failure based on your symptoms, medical history, medication history, family history, physical exam, and tests, including:

Blood tests (kidney function tests) to measure creatinine and urea (waste products) in blood.
Urine tests to check for abnormalities that might indicate CKD or kidney failure and the cause of CKD.
Imaging tests such as an ultrasound of the kidneys.
Kidney biopsy to take a small sample of kidney tissue and examine it under a microscope in the laboratory. This procedure is done under local anesthesia using a long, thin needle inserted through the skin.

How To Check Kidney Health At Home?

You can check kidney health at home with:

A home kidney test kit that requires a finger-prick blood sample. You send the kit back to the company. The lab processes it and sends you results within a week. Examples: LetsGetChecked Kidney Test and Verisana Kidney Function Test.
A home kidney test kit that requires a urine sample. You place the dipstick that comes with the kit in a sample of your urine. You then take a photo of the dipstick with your smartphone and submit it through an app. The app compares your results against a color chart. Example: Healthy.io Minuteful Kidney.
A combination blood and urine test to check kidney health at home. The kit has to be purchased online and picked up at the nearest location. You then have to collect the samples at home and drop the kit back at the lab. You can view results online. Example: LabCorp On Demand Kidney Health Test Package.

Note: It is important to consult a healthcare professional to understand the results of your home test for kidney health.

How is Kidney Failure Treated?

Can A Person Recover From Kidney Failure?

A person can recover from acute kidney injury with prompt treatment. Chronic kidney failure causes permanent damage to the kidneys and cannot be cured. However, there are ways to slow the progression of CKD by treating the underlying cause.

Treatment Options: Dialysis and Kidney Transplant

People with end-stage kidney disease or kidney failure require dialysis or kidney transplantation to stay alive.

Dialysis: Dialysis, also called renal replacement therapy, is a procedure in which a machine takes over the function of the kidneys to remove waste products and extra fluid from the body. It can be used to tide over a person until they can receive a kidney transplant.
- In hemodialysis, your blood is drawn into the dialysis machine through tubes and clean blood is returned to your body. Hemodialysis usually needs to be done in a hospital or dialysis center.
- In peritoneal dialysis, your abdomen is filled with a dialysis solution that absorbs waste and extra fluid. The solution is then removed from your body. Continuous ambulatory peritoneal dialysis is a type of peritoneal dialysis that can be done while you’re awake and going about your routine activities.
Kidney transplantation: During a kidney transplant, a healthy kidney from a living or deceased donor is placed surgically into your body. Afterward, you need to take immunosuppressant (anti-rejection) medications lifelong to prevent your body from rejecting the new kidney. However, you don’t need to be on dialysis after the transplant surgery.

Some people choose not to treat kidney failure with dialysis or kidney transplantation. They receive conservative medical care from their healthcare team, consisting of symptom management, palliative care, and advance planning.

Lifestyle Changes to Manage Symptoms

In addition to prescribed treatment for chronic kidney disease or kidney failure, your nephrologist (kidney specialist) may recommend lifestyle changes and a kidney-friendly diet to place less strain on your kidneys. They may ask you to:

Avoid a high-salt diet. Certain foods, such as canned soups, frozen dinners, fast foods, salty snacks, cheeses, and processed meats have large amounts of added salt.
Avoid high-potassium foods. Examples include bananas, oranges, tomatoes, spinach, and potatoes. Low-potassium foods include carrots, green beans, cabbage, apples, strawberries, and grapes.
Avoid salt substitutes because they often contain potassium.
Limit protein intake. High-protein foods include lean meats, eggs, dairy, and beans. Low-protein foods include fruits, vegetables, cereals, and breads. Your healthcare provider or registered dietitian can tell you how many grams of protein to eat per day.

Living With Kidney Failure

Coping Strategies for Patients and Families

Join support groups. Connect with other people living with kidney disease and kidney failure. This will help you learn from their experiences, pick up tips on coping, and feel less isolated.
Maintain a normal routine: As much as possible, continue working and doing the things you enjoy. This can help prevent sadness and depression related to a chronic illness.
Stay active: Get moving on most days of the week with at least 30 minutes of moderate physical activity. This will help you cope with stress and improve your overall health.
Share your thoughts and concerns: Talk to a trusted friend, family member, faith leader, social worker, or counselor.