Your kidneys are a pair of organs located toward your lower back of the body, on either side of the spine. Your kidneys’ main function is to act as a filtration system for your blood and to remove toxins from your body. The kidney transfers the toxins to the bladder, where they are later removed from the body during urination.
Kidney failure occurs when the kidneys lose the ability to sufficiently filter waste from the blood. Many factors can interfere with kidney health and function, such as toxic exposure to environmental pollutants and chemical food preservatives, certain diseases and ailments, and kidney damage. If your kidneys cannot do their regular job, your body becomes overloaded with toxins. Left untreated, this can lead to kidney failure and can result in death.
People who are most at risk for kidney failure suffer from one or more of the following causes:
Loss of Blood Flow to the Kidneys
A sudden loss of blood flow to the kidneys may prompt kidney failure. Some diseases and conditions that cause loss of blood flow to the kidneys include heart attacks, heart disease, cirrhosis of the liver, dehydration, severe burns, cholesterol deposits, allergic reactions, and infections. Additionally, blood pressure and anti-inflammatory medications can limit blood flow.
Damage to the Kidneys
Some diseases and conditions that may lead to kidney failure include:
- blood clots in or around the kidneys
- an overload of toxins from heavy metals
- drugs and alcohol
- vasculitis (inflammation of blood vessels)
- lupus (an automimmune disease that can cause inflammation of many body organs)
- glomerulonephritis (inflammation of the small blood vessels of the kidneys)
- hemolytic uremic syndrome (syndrome characterized by a breakdown –hemolysis- of red blood cells following a bacterial infection, usually of the intestines)
- multiple myeloma (cancer of the plasma cells in the bone marrow
- scleroderma (an autoimmune disease that affects skin,
- thrombotic thrombocytopenic purpura (disorder of the blood clotting system that causes clots in small vessels of the body)
- chemotherapy drugs (medications that treat cancer and some immune diseases)
- dyes used in some imaging tests
- zoledronic acid used to treat elevated calcium levels
- certain antibiotics
Urine Elimination Problems
When your body cannot eliminate urine, toxins build up and overload the kidneys. Some cancers can block the urine passageways. These include prostate, colon, cervical, and bladder. Other conditions can interfere with urination, such as kidney stones, an enlarged prostate, blood clots within the urinary tract, and damage to the nerves that control the bladder.
There are five different types of kidney failure:
Acute Prerenal Kidney Failure
This is caused by insufficient blood flow to the kidneys. Without enough blood flow, the kidneys cannot filter toxins from the blood. This type is usually curable by resolving the cause of inadequate blood flow.
Acute Intrinsic Kidney Failure
This can be caused by direct trauma to the kidneys, such as physical impact, accidents, toxin overload, or ischemia (a lack of oxygen to the kidneys). Severe bleeding, shock, renal blood vessel obstruction, or glomerulonephritis (inflammation of the tiny filters in your kidneys) can all cause ischemia.
Chronic Pre-Renal Kidney Failure
When low blood flow to the kidneys is not treated and the condition remains for an extended period of time, chronic pre-renal kidney failure can occur. The kidneys begin to shrink and lose the ability to function.
Chronic Intrinsic Kidney Failure
Damage to the kidneys over an extended period due to intrinsic kidney disease can develop into chronic intrinsic kidney failure.
Chronic Post-Renal Kidney Failure
This happens when a long-term blockage of the urinary tract prevents urinary waste elimination, which causes pressure and eventual kidney damage.
Many symptoms may imply kidney failure. Sometimes no symptoms are present, but usually someone with kidney failure will see a few signs of the disease. Possible symptoms include:
- a low amount of urination
- swelling of the legs, ankles, and feet from retention of fluids caused by the failure of the kidneys to eliminate water waste
- unexplained shortness of breath, drowsiness or fatigue, nausea, confusion, pain or pressure in the chest, seizures, and sometimes a coma
There are several tests that can be used to diagnose kidney failure. These include:
A urine sample is tested for any abnormalities. Your doctor may perform a urinary sediment examination, which will measure the amount of red and white blood cells, look for high levels of bacteria, and look for high numbers of cellular casts.
Measuring urine output is one of the simplest tests to help diagnose kidney failure. For example, low urinary output may suggest that kidney disease is due to a urinary blockage, which can be caused by multiple illnesses or injuries.
Samples of your blood are taken to measure substances that are filtered by your kidney, such as urea and creatinine. A rapid rise in their levels may mean kidney failure.
Imaging tests, such as ultrasounds, MRIs, and computerized tomography (CT) scans, allow a visual of the kidneys themselves, along with the urinary tract. This allows your doctor to visually look for blockages or abnormalities in your kidneys.
Kidney Tissue Sample
Tissue samples are examined for abnormal deposits, scarring, or infectious organisms. A kidney biopsy is used to collect the tissue sample. A biopsy is a simple procedure that is performed while you are awake. A local anesthetic is used to eliminate any discomfort. The sample is collected with a biopsy needle inserted through your skin and down into the kidney. X-ray or ultrasound equipment is used to locate the kidneys and assist the physician in guiding the needle.
Dialysis performs the function of the kidneys. Depending on the type of dialysis, you may be connected to a large machine, or a portable catheter bag. A low-potassium, low-salt diet is often prescribed along with dialysis.
It is important to note that dialysis does not cure kidney failure. However, it will extend your life.
Another treatment is a kidney transplant. There is usually a long wait to receive a donor kidney that is compatible with your body. The advantages to a transplant are that the new kidney will work perfectly, and dialysis is no longer required. The disadvantage is that immunosuppressive drugs must be taken after the surgery. These drugs have their own side effects, some of which are serious. Also, there is a risk that the transplant surgery may fail, and may even result in death.
There are steps you can take to reduce your risk:
Limit Excessive Use of Toxic Substances
Follow the directions for over-the-counter medications. Too-high doses (even of common drugs like aspirin) can create high toxin levels in a short amount of time, which can overload your kidneys. Whenever possible, you should limit your exposure to chemicals, such as household cleaners, tobacco, pesticides, and other toxic products.
Manage Kidney Problems as Recommended by a Doctor
Many kidney or urinary tract conditions lead to kidney failure when not managed properly. Follow your doctor’s guidance, always take prescribed medicine as directed, and adopt healthy diet guidelines.
Written by: Rose Kivi and Matthew Solan
Published on Aug 07, 2012
Medically reviewed by Brenda B. Spriggs, MD, MPH, FACP