Kidney failure: symptoms, causes, and treatments
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Every minute, the kidneys filter about 1 liter of blood, or one-fifth of the amount pumped by the heart.

Chronic kidney failure is a serious disease that causes a gradual and irreversible deterioration in the ability of the kidneys to filter blood and excrete certain hormones.

As a result, the products of metabolism and excess water pass less and less in the urine and accumulate in the body.

How do the kidneys work?

The kidneys have the primary function of removing excess fluid and metabolic waste from the blood. The kidneys receive blood through the renal arteries which carry oxygenated blood from the heart. 

As it enters the kidneys, the blood circulates in smaller and smaller vessels which each end in a nephron, a kind of miniature kidney.

A nephron is formed by a glomerulus that filters water, mineral salts, calcium, amino acids, and waste products and a tubule which transports water and all collected materials. 

The blood then reabsorbs the materials the body can use again, and the rest is collected in the renal pelvis, a kind of funnel connected to the ureter which carries urine to the bladder.

The causes of kidney failure

Causes of Chronic Kidney Disease

Chronic kidney failure results from complications of diabetes, hypertension, or other illnesses.

Causes of Acute Kidney Failure

Acute kidney failure, on the other hand, occurs suddenly.

It often occurs as a result of a reversible decrease in renal blood flow. The causes are multiple, such as dehydration, severe infections, an obstruction such as an enlarged prostate, or exposure to substances that are toxic to the kidneys such as contrast products used in radiology.

Too much uric acid is also a symptom of kidney failure.

When to consult for kidney failure?

If you have diabetes or another condition that can cause kidney failure, your doctor will monitor your kidney health on a regular basis through blood and urine tests.

If symptoms occur between two visits, do not hesitate to contact your doctor.

Even if you are not at risk for kidney failure, contact your doctor immediately if your urine volume changes significantly or if your urine contains traces of blood.

The progression of chronic kidney disease is so slow that symptoms are often unnoticeable for the first few years as the kidneys adapt and compensate for their loss of function.

Nevertheless, some signs can alert you.

Symptoms of Kidney Failure

Many patients only become aware of their health problems when their kidneys are operating at less than 25% of their normal capacity.

Some nonspecific symptoms, such as fatigue, maybe the only manifestation of the disease for a long time.

In people at risk, follow-up by blood and urine tests is therefore essential in order to detect warning signs of renal failure.

Once the disease is well established, the following symptoms may appear:

  • swelling of the feet, ankles, legs, or eyelids;
  • pain in urination and decrease in urine volume;
  • more frequent urination;
  • foamy, cloudy, or dark-colored urine;
  • high blood pressure;
  • more marked fatigue and weakness;
  • nausea and vomiting;
  • loss of appetite and bad taste in the mouth;
  • unexplained weight loss;
  • drowsiness, psychomotor retardation;
  • headache ;
  • sleeping troubles ;
  • pain in the middle, lower back, or sides of the pelvis;
  • involuntary contractions of muscles and cramps;
  • persistent itching.

There are several risk factors for chronic kidney disease.

By discovering them below, you can be more vigilant to prevent the appearance of this pathology.

Risk factors for chronic kidney disease

The most common cause of chronic kidney disease is diabetes, whether type 1 or type 2.

This is because diabetes damages small blood vessels, including those inside the kidneys.

In general, diseases that cause cardiovascular problems are also risk factors for kidney disease: advanced age, high blood pressure, obesity, diabetes, smoking, and low HDL cholesterol (“good cholesterol”).

Other risk factors can cause chronic kidney disease, including the following:

  • pyelonephritis (kidney infection);
  • polycystic kidney disease;
  • autoimmune diseases, such as acute systemic lupus erythematosus;
  • urinary tract obstruction (as in enlarged prostate);
  • use of drugs metabolized by the kidneys, such as certain cancer chemotherapy agents.

In some cases, the disease is impossible to prevent.

The two main causes are diabetes (type 1 and 2) as well as arterial hypertension, it is important to know that good control of these diseases greatly reduces the risk of progression to kidney failure.

However, healthy lifestyle habits can also help reduce risk.

How to prevent chronic or acute kidney failure?

Some lifestyle habits can help you prevent kidney failure and reduce the risk of disease:

  • faithfully follow the treatments recommended by your doctor if you suffer from a chronic disease such as diabetes, lupus, or hypertension;
  • have your blood pressure taken or take yourself on a regular basis;
  • avoiding the abuse of alcohol, drugs, and medications, including those sold without a prescription, such as aspirin, acetaminophen, or ibuprofen;
  • get treated right away if you have a urinary tract infection or any other urinary tract condition.

Without being able to cure chronic renal failure, treatment can slow or even stop its progression.

In acute renal failure, the process is often reversible. Priority is given to the disease that is causing kidney failures, such as diabetes or hypertension.

Renal failure itself is treated in parallel.

The different treatments for kidney failure

Changing your diet to treat kidney failure

The first measure proposed to patients is often the modification of the diet. The doctor may recommend a reduction in protein intake to slow the buildup of waste products in the blood and limit nausea and vomiting. The risk of having to resort to dialysis is reduced and mortality is reduced.

Sodium intake (contained in salt), as well as lipids (fat), should be limited. Everything must be adjusted to the severity of the kidney failure and the advice of a nutritionist will prove very useful in these circumstances.

The doctor may also prescribe a reduction in the consumption of liquids: water, ice cubes, coffee, tea, soft drinks, juices, soups, milk, cream, ice cream, and sorbets. It could for example limit this consumption to 1.5 liters per day.

To control thirst, patients are offered to regularly rinse their mouths with water, without swallowing it. Sucking on candy or chewing gum can also help moisten the inside of your mouth with saliva. A mouth spray like Biotène can help.

Medicines to treat kidney failure

When diet is no longer sufficient to control water and electrolyte imbalances (calcium, phosphorus, potassium, etc.), the introduction of medications in addition to good eating habits will help achieve this goal:

  • vitamin D, sevelamer (Rénagel) to control phosphorus;
  • sodium polystyrene sulfonate (Kayexalate) to control potassium;
  • calcium and calcimimetics cinacalcet (Sensipar) to regulate calcium.

Treatment will be proposed if necessary to maintain the red blood cells at a certain level: darbopoietin (Aranesp) and erythropoietin (Eprex).

Tight control of high blood pressure decreases the progression of kidney damage and medication will almost certainly be needed to achieve the desired pressure values. The target is less than 140/90, or even 130/80 in the case of diabetes or proteinuria.

In addition, we will try if necessary to urinate “excess water” present in the body with diuretics: furosemide (Lasix), and hydrochlorothiazide (Hydrodiuril).

In diabetics, blood sugar must be maintained at an acceptable level, by the use of oral medications or insulin if the diet is no longer sufficient. See the fact sheet on diabetes.

Treat kidney failure medically with dialysis

Dialysis uses a membrane that acts as a filter and is used to remove toxins and excess fluid from the blood.

There are two types of dialysis:

  • peritoneal dialysis;
  • hemodialysis.

The choice of one method rather than the other is based on the patient’s age, his ability to manage his treatment (peritoneal dialysis requires a minimum of dexterity and autonomy), the presence of other diseases, and the preference of the patient.

In peritoneal dialysis, the peritoneum is used to act as a filter. The peritoneum is the double membrane that lines the wall of the abdomen (belly) and the abdominal organs (intestinal, stomach, etc.).

These two membranes are separated by a tiny space in which a catheter (a flexible tube, of very small size) is installed permanently. Thanks to this tube, the peritoneum is filled with a solution called dialysate, left for a few hours in this cavity. 

The blood circulating in the vessels combing the peritoneum is then filtered: toxins and excess water pass to the side of the dialysate. Once the operation is complete, the dialysate is removed and replaced with another, virgin one.

Peritoneal dialysis is usually done at home, by the patient or a family member. Continuous ambulatory peritoneal dialysis is usually repeated every 6 hours. Automated peritoneal dialysis is done once a day, overnight, using a programmed device.

Hemodialysis must be performed in a hospital or a specialized clinic. A machine called a “dialyzer” is used to filter blood.

The blood is first pumped into the dialyzer. Inside the machine, it remains on one side of a membrane that serves as a filter. Waste and excess fluid pass through the membrane and pass to the other side, where the dialysate is. The filtered blood is returned to the body. In general, the procedure requires 4 hours. It should be repeated about 3 times a week.

Kidney transplant

For some patients, a kidney transplant is required.

Applications are evaluated by very strict criteria to avoid any form of discrimination. A detailed evaluation by a nephrologist specializing in renal transplantation is necessary to establish whether this treatment option is adequate for a given patient.

The kidney can come from a living donor, often a relative, or from a donor who has just died.

With a successful transplant, the recipient is able to lead an active, healthy life.

Kidney failure cannot be cured.

However, with complementary approaches to medical treatment, it is possible to slow or even stop the progression of the disease.

Complementary treatments for kidney failure

fish oils

IgA nephropathy, also called Berger’s disease, affects the kidneys and can progress to fatal kidney failure. In some clinical trials, a slowing of the progression of kidney failure has been observed in subjects on long-term treatment with fish oils.

A review concluded that fish oils were useful in slowing the progression of this disease5, which was confirmed by other subsequent research which, however, specified for which forms of the disease they were effective6.


A Cochrane systematic review of 9 studies showed that one can possibly improve kidney function as measured by creatinine levels, and possibly decrease the progression to end-stage renal disease. The published research, however, suffers from methodological flaws and is not of the highest quality.

Coenzyme Q10

Two studies have shown that the use of dialysis can be reduced with coenzyme Q10, at the rate of two 30 mg capsules three times a day.

Research with 97 patients, 45 of whom were already on dialysis, showed that the patients needed fewer dialysis sessions than those who took the placebo. At the end of 12 weeks of treatment, almost half as many patients still needed dialysis.

In another study of 21 patients with impaired kidney function, 36% of patients on coenzyme Q10 needed dialysis compared to 90% of patients taking a placebo. We did not find any study showing the outcome of these patients in the long term.

Caution: Since the diet of people with kidney failure must be strictly controlled, be sure to speak with your doctor before taking any supplement.

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