What Is Kidney Failure?

You can still live well with kidney failure, but you will need dialysis or a kidney transplant to take over the work of your kidneys. Here's what you should know.

Kidney failure means that your kidneys work at 15 percent or less of their normal capacity. Type 1 and type 2 diabetes, high blood pressure, or another disease has damaged your organs to the point where they can no longer filter wastes and fluid from your blood.

Your doctor might use the term end-stage kidney disease or end-stage renal disease (or ESRD) to describe the last phase of kidney disease. Though those terms might sound dire, having kidney failure doesn't mean your life is over. You can continue to live well and stay active once you're on treatment.

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How your kidneys work

Your kidneys are important to your health. The two bean-shaped organs are no bigger than your fist, yet they have big jobs. As blood passes through their millions of tiny filters, the kidneys separate out wastes and extra fluid, which are sent to your bladder to be removed as urine.

Your kidneys not only filter your blood but also help:

• Regulate blood pressure
• Maintain your balance of minerals like calcium, sodium, and potassium
• Control production of red blood cells
• Produce vitamins

Kidney failure happens for one of three reasons:

1. A disease like uncontrolled diabetes, high blood pressure, glomerulonephritis, or lupus, or an injury, damages your kidney's filters.
2. Your kidneys don't get enough blood because of a heart condition or blockage.
3. Wastes back up when a condition like kidney stones or an enlarged prostate stops urine from leaving your body.

What happens when your kidneys fail?

Kidney disease is a gradual condition. Early kidney disease may produce no symptoms. Some people may not recognize symptoms until their kidneys fail. As kidney damage progresses, you'll start to have symptoms like:

• Dry, itchy skin
• Fatigue and weakness
• Foamy urine
• Itchy skin
• Muscle cramps
• Nausea and vomiting
• Swelling in your feet and ankles
• Trouble catching your breath
• Urinating more or less than usual

Treatment for kidney failure

You will need to see a nephrologist, a specialist who treats kidney failure. This doctor will go over your treatment options with you.

Once you're in kidney failure, you'll need either dialysis or a kidney transplant to replace your damaged organs.

Dialysis uses either a machine (hemodialysis) or your belly (peritoneal dialysis) to filter waste, excess sodium and potassium, and fluid from your blood in place of your damaged kidneys.

• Hemodialysis is done in a hospital, an outpatient dialysis center, or at home about three times a week for three to four hours at a time. Your blood travels through a machine called a dialyzer, which removes fluid and wastes. The cleaned blood is then returned to your body.
• Peritoneal dialysis uses the tissue that surrounds your abdominal organs (the peritoneum) to filter your blood. Dialysate fluid enters your abdominal cavity through a tube called a catheter. You let the fluid sit for four to six hours while it draws out wastes, then drain it and replace it with clean fluid.

Kidney transplant is a longer-term treatment for kidney failure. The healthy kidney can come from a deceased or living donor. Because the average wait time is three to five years for an organ from a deceased donor, you'll get a new organ faster if you get on the transplant list before you need dialysis or find a living donor. Both you and your donor can live perfectly well with one kidney.

What you can do

While you're on dialysis or waiting for a kidney transplant, you can preserve your existing kidney function if you:

• Work with a dietitian to create a kidney-friendly diet that's rich in fruits and vegetables and very low in sodium.
• Manage your blood pressure and blood sugar levels.
• Walk, ride a bike, or do other aerobic activities for 30 minutes on most days.
• Drink enough water and other fluids to stay hydrated.
• Be cautious about using over-the-counter pain relievers and other medications that are known to damage kidneys.

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