17689 Kidney Failure

Overview

Kidney failure means your kidneys have stopped working well enough to keep your body healthy. Normally, your kidneys filter waste and extra water from your blood, helping control blood pressure and keeping your bones and blood healthy. When they fail, waste builds up in your body, making you feel unwell. It is a serious condition, but with the right care many people live active, full lives.

Yes, kidney failure is more common than most people think. It affects many thousands of people in the UK and around the world.

Anyone can develop kidney failure, but it is more likely as you get older. It is also more common in people with diabetes, high blood pressure, or a family history of kidney disease.

Symptoms

Common symptoms

• Feeling tired and short of energy
• Swollen ankles, feet, or hands
• Shortness of breath
• Feeling sick or losing your appetite
• Itchy skin
• Needing to urinate more often, especially at night
• Trouble concentrating or feeling 'foggy'

Symptoms in children

• Poor growth or slow weight gain
• Frequent vomiting or feeling sick
• Swelling in the face, belly, or legs
• Unusual drowsiness
• Foamy, bloody, or very dark urine

Symptoms in older adults

• Falling or feeling dizzy
• Confusion or memory trouble
• Losing interest in food
• Weakness and tiredness
• Changes in how often you pass urine

Causes

Main causes

• Diabetes, which can damage the kidney filters over time
• High blood pressure, which puts strain on the kidneys
• Inflammation of the kidney, called glomerulonephritis
• Polycystic kidney disease, an inherited condition with fluid-filled sacs
• Repeated kidney infections or blockages in the urinary tract
• Sudden loss of blood flow to the kidneys, such as from severe dehydration, infection, or heart failure

Risk factors

• Being older
• Having diabetes or high blood pressure
• Having a family history of kidney disease
• Smoking
• Carrying excess weight
• Taking certain pain relief medicines regularly for a long time without medical supervision

When to see a doctor

See a doctor urgently if:

• If you notice blood in your urine
• If you have swollen legs or face and trouble breathing
• If you feel very drowsy or confused

Book a routine appointment if:

• If you feel tired, sick, or have swelling that does not go away
• If you are urinating much more or much less than usual
• If you have diabetes or high blood pressure and are not having regular kidney checks

Diagnosis

Doctors diagnose kidney failure using blood and urine tests that show how well your kidneys are filtering waste. They may also do an ultrasound to look at the size and shape of your kidneys.

Tests that may be done

• Blood test to check your kidney function (called eGFR)
• Urine test to look for protein or blood
• Ultrasound scan of your kidneys
• Sometimes a small sample of kidney tissue, called a biopsy, to find the cause

What to expect at your appointment

If kidney failure is suspected, your doctor will usually refer you to a kidney specialist team. They may ask about your symptoms, medical history, and medicines. You may need to have your blood pressure checked and repeat tests over time.

Treatment

Treatment for kidney failure aims to manage the cause, slow down further damage, and help you feel as well as possible. It involves working closely with a healthcare team and making changes to your daily routine.

Self-care at home

• Take all medicines exactly as your doctor or pharmacist tells you
• Check your blood pressure at home if your team asks you to
• Avoid smoking and limit alcohol
• Talk to your pharmacist before taking any pain relief or herbal remedies
• Keep every appointment with your kidney specialist and general practice team

Medical treatments

Medical treatment may include medicines to control blood pressure, manage diabetes, protect your bones, and keep waste products like potassium from building up in your blood. If your kidneys can no longer clean your blood safely, dialysis may help. Dialysis is a treatment that filters your blood using a machine or through your abdomen. Some people may be suitable for a kidney transplant.

When is surgery considered?

Surgery may be needed if you have a kidney transplant or if you need a small tube placed in your abdomen for peritoneal dialysis, or an access point in your arm for haemodialysis. These are common procedures done by specialist teams.

Living with this condition

Living with kidney failure means building a routine around your health. This can include taking medicines, planning meals, staying active when you can, and making time for rest. Many people find that keeping a daily log of weight, blood pressure, or fluids helps them feel more in control.

Lifestyle tips

• Stay as active as you can, with your doctor's advice
• Aim for enough sleep and find ways to reduce stress
• Get to know your body so you can notice changes early
• Ask family and friends for help when you need it

Diet and exercise

Your kidney team may suggest changes to your diet, such as limiting foods high in salt, potassium, or phosphate. This does not mean eating nothing tasty — it means learning what works for your body. A dietitian can help you plan meals. Gentle exercise like walking or swimming can help your energy, mood, and heart health, but always check with your doctor first.

Mental health and emotional wellbeing

It is completely normal to feel anxious, low, or angry after a kidney failure diagnosis. Talk to your healthcare team about how you are feeling. Supporting your mental health is just as important as caring for your kidneys.

Prevention

You cannot always prevent kidney failure, but you can reduce your risk and slow down the damage. Keeping your blood pressure and blood sugar in a healthy range, staying active, and avoiding long-term use of pain medicines without help from your doctor are all important steps.

Vaccines

Kidney failure can make it easier to get certain infections. Keeping up to date with recommended vaccines, such as flu, COVID-19, and others advised by your healthcare team, is a good idea. Ask your pharmacist or doctor what is recommended for you.

Screening programmes

Screening is not routine for everyone, but if you have diabetes, high blood pressure, or a family history of kidney disease, your doctor may check your blood and urine regularly to catch kidney problems early.

Complications

If left untreated

• Build-up of waste and fluid in the body, causing severe tiredness and swelling
• High potassium levels, which can be dangerous for your heart
• Weakening of the bones and a higher risk of fractures
• Anaemia, which means not enough red blood cells
• Heart and blood vessel problems
• Fluid gathering in the lungs, making breathing hard

Long-term outlook

Kidney failure is a serious condition, but the outlook is more hopeful than ever. With modern treatments, good self-care, and a supportive team, many people live long and fulfilling lives. Even if dialysis or a transplant is needed, these treatments have helped millions of people around the world continue to do the things they love.

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