Chronic Renal Failure
(Kidney Failure · Chronic Kidney Disease)
In this condition factsheet:
The Facts on Chronic Renal Failure
Chronic renal failure, or chronic kidney disease (CKD), is a slow and progressive decline of kidney function. It's usually a result of a complication from another serious medical condition such as diabetes, high blood pressure or cardiovascular disease. Unlike acute renal failure, which happens quickly and suddenly, chronic renal failure happens gradually – over a period of weeks, months, or years – as the kidneys slowly stop working, leading to end-stage renal disease (ESRD).
The progression is so slow that symptoms usually don't appear until major damage is done. Approximately 7 in every 100 Canadians have chronic kidney disease.
The kidneys play 3 major roles:
- removing waste products from the body, keeping toxins from building up in the bloodstream
- producing hormones that control other body functions, such as regulating blood pressure and producing red blood cells
- regulating the levels of minerals or electrolytes (e.g., sodium, calcium, and potassium) and fluid in the body
Most people have 2 functioning kidneys. It's entirely possible to live a full, healthy life with only 1 kidney – 1 fully functioning kidney usually can do the work of 2 – but it's essential to watch for signs of any problems with the remaining kidney.
When kidneys get to the point where they can't function at all, kidney dialysis or a transplant is the only way to remove the body's waste products.
Causes of Chronic Renal Failure
The most common causes of chronic renal failure in North America are diabetes mellitus (type 1 or type 2 diabetes) and high blood pressure.
One of the complications resulting from diabetes or high blood pressure is the damage to the small blood vessels in the body. The blood vessels in the kidneys also become damaged, resulting in CKD.
Other common causes of chronic renal failure include:
- recurring pyelonephritis (kidney infection)
- polycystic kidney disease (multiple cysts in the kidneys)
- autoimmune disorders such as systemic lupus erythematosus
- hardening of the arteries, which can damage blood vessels in the kidney
- urinary tract blockages and reflux, due to frequent infections, stones, or an anatomical abnormality that happened at birth
- excessive use of medications that are metabolized through the kidneys
Symptoms and Complications of Chronic Renal Failure
Chronic renal failure can be present for many years before you notice any symptoms. When you first start losing kidney function, the healthy tissues in the kidney will help to compensate for the loss by working harder. If your doctor suspects that you may be likely to develop renal failure, they will probably catch it early by conducting regular blood and urine tests. If regular monitoring isn't done, the symptoms may not be detected until the kidneys have already been damaged. Some of the symptoms – such as fatigue – may have been present for some time, but can come on so gradually that they aren't noticed or attributed to kidney failure.
Some signs of chronic renal failure are more obvious than others. These are:
- increased urination, especially at night
- foamy or bubbly urine (indicates proteins are present in the urine)
- urine that is cloudy or tea-coloured
Other symptoms aren't as obvious, but are a direct result of the kidneys' inability to eliminate waste and excess fluid from the body:
- puffy eyes, hands, and feet (called edema)
- high blood pressure
- fatigue
- shortness of breath
- loss of appetite
- nausea and vomiting (this is a common symptom)
- thirst
- bad taste in the mouth or bad breath
- weight loss
- generalized, persistent itchy skin
- muscle twitching or cramping
As the kidney failure gets worse and the toxins continue to build up in the body, seizures and mental confusion can result.
Being diagnosed with chronic renal failure can be very frightening. The future of the condition, however, depends on the medical problem that caused the kidney failure, how much kidney damage has occurred, and what, if any, complications are present.
Some of these complications may include:
- anemia
- erectile dysfunction
- high blood pressure (hypertension)
- increased risk of infection
- fluid overload (called edema)
- decreased interest in sexual activity
- dehydration
- electrolyte abnormalities (e.g., hyperkalemia, high blood potassium levels)
- mineral abnormalities (e.g., hypercalcemia [high blood calcium levels] or hyperphosphatemia [high blood phosphorus levels])
- brittle bones
- malnutrition
- reduced fertility
- seizures
