Kidney failure also known as renal failure occurs when both of the kidneys are unable to filter and clean blood. This can result in dangerous levels of waste products pilling up and if left untreated it can be life-threatening.

Kidneys are the two organs which take up the shape of a bean but are the size of a fist. They are located at the back of the stomach on either side of the spine. The work of kidneys is to clean waste products from blood by making urine. They also work by balancing the amount of various elements in the blood such as potassium, sodium and calcium and make hormones which control red blood cells and blood pressure.

Kidney or renal failure is when the kidneys do not work as they should. However, the term ‘kidney failure’ covers a lot of conditions and it can result when:

• The kidneys fail to get enough blood to filter
• The kidney is hurt by a disease such as:
• Diabetes (high blood sugar)
• High blood pressure
• Glomerulonephritis which is damage to the kidney’s filters
• Polycystic kidney disease
• The kidney is blocked by scar tissue or kidney stones

Symptoms of Kidney Failure

The symptoms of renal failure usually differ depending on how worse the problem is, how it is escalating and the cause of it.

There are 2 main types of renal failure:

1. Acute (sudden)
2. Chronic (over time)

Acute Renal Failure (ARF)

This happens when the kidneys suddenly stop the filtering of waste products from the blood.

The symptoms of acute renal failure (ARF) include:

• Internal bleeding
• Oedema, which is swelling of the face, hands and feet
• Seizures
• Confusion
• High blood pressure
• Abnormal urine and blood tests
• Coma

Chronic Renal Failure (CRF)

Chronic renal failure has very few symptoms in its early stages and tends to build slowly.

Usually a CRF patient may not have any signs of the condition until the kidney function declines to about 20% or sometimes less. That is when symptoms such as these appear:

• High blood pressure
• Abnormal urine and blood tests
• Unexplainable weight loss
• Anaemia (low red blood cell count)
• Nausea
• Vomiting
• Loss of appetite
• Metal taste in the mouth
• Chest pains
• Shortness of breath
• Tingling and numbness sensation
• Oedema (swelling of the face, hands and feet)
• Easy bruising
• Muscle cramps and twitching
• Weak bones which easily break
• Change of skin colour
• Confusion
• Seizures
• Headaches
• Fatigue
• Itching
• Trouble sleeping
• Coma

Causes of Kidney Failure

Acute renal failure can be caused by:

• Swelling of the kidney due to a reaction to an infection or drug
• Low blood flow caused by an accident or after a complicated surgery
• Sudden blockage which can be caused by a kidney stone
• Very high blood pressure

With acute renal failure, once the cause is treated, the kidney can return to its normal or near normal function.

Chronic renal failure is the total loss of kidney function and some of the causes include:

• Kidney damage (chronic glomerulonephritis)
• High blood pressure
• Diabetes (high blood sugar)
• Kidney infection
• Polycystic kidney disease
• Blocked urinary tract

Diagnosis of Kidney Failure

Kidney failure can be detected through a blood test known as creatinine level. Creatinine is a molecule that is made by the muscles. Kidneys normally remove extra creatinine from the blood and gets rid of it in urine. However, if the creatinine levels in the blood are higher than usual, it shows that the kidneys are not cleaning the blood as they should. This test is good at spotting if something is wrong with the kidneys before a patient who has kidney failure feels sick.

Other ways of diagnosing kidney failure include:

• Urine volume measurements: This is one of the simplest tests that is used to diagnose kidney failure. If a patient is experiencing low urinary output, it can suggest that kidney disease may be due to a urinary blockage which can be caused by injuries or multiple illnesses.
• Urinalysis: This involves taking a urine sample and testing it for any abnormalities such as abnormal sugar or protein that spills into the urine.
• Imaging: Images of the kidneys and the urinary tract can be seen via imaging tests such as CT scans, MRIs and ultrasounds thus allowing your physician to look for abnormalities and blockages in your kidneys.

Treatment for Kidney Failure

Treating acute renal failure involves treating the cause which can be high blood sugar, kidney stone or high/low blood pressure.

With chronic renal failure, treating the cause which can be high blood sugar and/or high blood pressure can slow down the disease. CRF may lead to end stage kidney disease.

Dialysis or a kidney transplant is often needed if the kidney function falls below 10% of normal. This is more so if you are having symptoms of uraemia which is the build-up of waste in the blood such as itching and nausea.

Dialysis

Dialysis involves pumping the blood through a machine to filter out the waste and then return the blood to your body. There are two types of dialysis: Haemodialysis and Peritoneal dialysis.

• Haemodialysis: This involves a catheter or tube being stuck in one of the neck veins or an arm or leg. Haemodialysis can be done 3 times a week with each session lasting 3 to 4 hours at a time.
• Peritoneal dialysis: This type of dialysis is done through a tube that is permanently set in the belly.

Most adult patients undergo dialysis in an outpatient haemodialysis centre while children can have peritoneal dialysis done at home.

Kidney Transplant

A kidney transplant involves a surgeon putting a healthy kidney from a donor (another person) into your body. This is usually the best way to treat end stage kidney failure in many patients.

Kidneys for transplant are donated by healthy individuals who are called living donors or from individuals who agree to donate their kidneys when they die (deceased donors). Living donors are most likely family members of the patient. The waiting time for a kidney transplant from a living donor is usually shorter than that from a deceased donor. This due to the fact that there is usually a waiting list for kidneys from deceased donors and the patients are usually more than the donors.

Kidney Clinic at King’s

Nephrology (kidney disease) specialists at King’s College Hospital London in Dubai, are kidney physicians who provide a complete range of consultation, diagnosis, and treatment for patients with kidney diseases. The scope of care encompasses all stages of kidney disease, from the earliest detectable changes in kidney function through dialysis and transplantation.