If you learn you have kidney failure, it means your kidneys aren’t able to filter wastes from blood as well as they should. There are different stages of kidney failure. End-stage kidney disease (also known as end-stage renal disease or ESRD) is the most severe. 

When you have end-stage kidney disease, it means your kidneys are only working at 15% of what they should. This condition is life-threatening. You need dialysis (a treatment that takes over for your kidneys) or a kidney transplant. Close to 786,000 Americans are living with kidney failure.

From the community: “I am 70 years old with diabetes type 2, cirrhosis of the liver and just got out of the hospital with acute on chronic kidney failure, acute kidney injury superimposed on CKD as well as some heart issues. I have had chronic kidney disease, stage 3, for some time but my GFR went down to 13 during my kidney failure and creatinine of 3.3. I was told this would happen again and again until my kidneys shut down. Is there anyone who is going through this that could give me some perspective on how this may go? I will see a nephrologist in a couple of weeks but would like some information before that. Thanking you in advance.” – Inspire member

What happens when your kidneys fail?

Kidney failure doesn’t happen overnight. A condition called chronic kidney disease (CKD) precedes it. Approximately 37 million Americans have chronic kidney disease, which leads to a gradual loss of kidney function. When detected early, treatments can slow or stop the progression of the disease and keep your kidneys functioning longer. 

What causes kidney failure?

Two out of three people who develop chronic kidney disease have either high blood pressure (hypertension), diabetes, or both. Other conditions that increase your risk for chronic kidney disease and kidney failure include:

• autoimmune diseases like lupus and lupus nephritis

• changes to the kidneys or urinary tract that are present at birth (congenital)

• enlarged prostate (benign prostatic hyperplasia or BPH)

• excessive alcohol consumption and smoking

• glomerular diseases like glomerulonephritis, a group of conditions that damage filters in the kidneys

• hereditary kidney diseases like autosomal dominant polycystic kidney disease (ADPKD), a type of polycystic kidney disease

• kidney cancer, including renal cell carcinoma

• kidney stones and kidney cysts

• repeated urinary tract infections (UTIs)

• sudden onset of kidney injury usually during hospitalization (acute kidney injury)

From the community: “hi friends, fresh out of bed and on my way to the bathroom about 3 months ago i collapsed and an mri indicated the beginning stages of kidney failure. i had been on a new med, Latuda, for bipolar disorder to replace the Lithium i had taken for 20+ years because i had read that Lithium was suspect for triggering Psoriasis. the mri showed that i had to be taken off the Lithium that day with no tritrating down which is the way Lithium is supposed to be stopped. i thot i was going to lose my mind! but i persisted and the Latuda was increased. today, i am not doing so badly on the Latuda and Cymbalta for my bipolar disorder and as for my kidneys my GP said "we caught it just in time!" Thank God because i already have auto-immune disorders and i dont need more to add to my list. this past week i have been feeling generally weak and i am being tested again next week to see how my kidney is doing.” – Inspire member

What are the 5 stages of kidney disease?

Kidney damage from chronic kidney disease gets worse over time. Nephrologists (medical doctors who specialize in kidney diseases) use urine tests, imaging scans, and blood tests (called estimated glomerular filtration rate or eGFR) to measure the stage, or level, of kidney damage.

There are five stages of chronic kidney disease:

• Stage 1: Your kidneys work at better than 90% of capacity

• Stage 2: You have mild kidney damage with 60% to 89% kidney function.

• Stage 3: You have mild to moderate kidney damage (45% to 59% kidney function), which means your kidneys aren’t working as well as they should.

• Stage 4: You have severe kidney damage, and your kidneys are barely functioning (15% to 29% kidney function).

• Stage 5: You have less than 15% kidney function and have end-stage kidney disease, requiring dialysis or a kidney transplant. 

What are the signs of kidney failure?

During the early stages of kidney failure, you may be unaware that anything is wrong. The disease may not cause symptoms until an excess amount of waste and toxins build up in your blood. As your kidneys lose more of their ability to remove waste, you may experience kidney failure symptoms like:

• foamy or frothy-looking urine

• itchy skin

• lack of energy, difficulty sleeping, and fatigue

• leg cramps and muscle cramps

• loss of appetite

• nausea and vomiting

• shortness of breath

• swollen legs, feet, or ankles

• urinating more, or less, than usual

From the community: “My father has been able to eat and drink less and less each year. He has frequent diarrhea, and if he eats too much, nausea and vomiting. At the same time his kidney function has been plummeting. We don't know which problem causes the other. Is it possible that the kidney failure could cause the inability to eat? (He has had scopes and scans and the doctors just say they don't know what's causing the digestion problems but he has lost down to 125 pounds and is very weak. His last BUN was 59, his creatinine 3.3. He also shows low RBC, Hemoglobin, and hematocrit. He is at home but very dizzy and weak, unable to stay hydrated.” – Inspire member

How do doctors treat kidney failure?

When you have end-stage kidney failure, you need another way to filter wastes from your blood. Without treatment, the condition can be fatal. Treatments for end-stage kidney disease (kidney failure) include: 

• dialysis

• kidney transplant

Dialysis

Dialysis removes wastes and excess fluids from your blood. Nearly 3 out of 4 people with end-stage kidney disease use dialysis to treat the condition. There are two dialysis methods:

• Hemodialysis uses a machine and a dialyzer filter (sometimes called an artificial kidney). The machine takes blood from your body, filters out wastes, and then returns the purified blood back to your body. Hemodialysis can take place at a dialysis center, hospital, or your home.

• Peritoneal dialysis cleanses blood while it’s inside your body. You use a catheter inserted into a small surgical opening to fill the lining of your abdomen (peritoneum) with a cleansing solution. Tiny blood vessels inside the peritoneum use the cleansing solution to filter out impurities. You use a different catheter to drain the used cleansing solution. You must repeat these steps several times today, or you may choose to use a machine called a cycler to pump the fluid in and out of your body while you sleep.

Kidney transplant

A kidney transplant does away with the need for dialysis. You may get a healthy kidney from a living donor (often someone you know) or a deceased organ donor. Close to 1 in 3 people with end-stage kidney disease get kidney transplants. Your body only needs one kidney to function. 

You may need to use dialysis while waiting to find the best match for your kidney transplant, a process that may take as long as four years. After a kidney transplant, you’ll take immunosuppressants for life. These medications keep your body from treating the donor kidney as a foreign matter and rejecting it. 

What’s the outlook for someone with kidney failure?

Treatments can help you live longer with kidney failure. Your prognosis depends on many factors like your age, overall health, and other health conditions. People can live 5 to 10 years on only dialysis. A kidney transplant can give you 10 to 20 additional years. 

Kidneys from living donors tend to last longer (15 to 20 years) than those from deceased donors (10 to 15 years) because the kidneys often come from a healthy donor. It also helps that the transplant procedure is planned to take place when both you and your donor are at your healthiest. If you have to wait for an organ from a deceased donor, your health may deteriorate. And the surgery is an emergency procedure. 

Sources

• Kidney failure, end-stage kidney disease (ESKD), or end-stage renal disease (ESRD). American Kidney Fund. November 2021.

• Stages of kidney disease. American Kidney Fund. November 2021.

• Chronic kidney disease symptoms and causes. National Kidney Foundation. 

• Kidney failure. National Kidney Foundation.

• Kidney disease statistics for the United States. National Institute of Diabetes and Digestive and Kidney Diseases. September 2021.

• What is kidney failure? National Institute of Diabetes and Digestive and Kidney Diseases. January 2018.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.