Q1. What is kidney failure?

Ans: Kidney failure, also known as ESRD (end-stage renal disease), occurs when the kidneys lose their ability to filter excess fluids and waste from the blood. It is considered permanent kidney damage, with kidney function falling below 15%.

Q2. What are the main causes of kidney failure?

Ans: Common causes include diabetes, high blood pressure (hypertension), and chronic glomerulonephritis. Other causes may include genetic disorders such as polycystic kidney disease and recurrent kidney stones.

Q3. What is the difference between acute and chronic kidney failure?

Ans: Acute kidney failure develops suddenly over hours or days and may be reversible if the underlying cause is treated. Chronic kidney failure develops gradually over months or years and is usually associated with permanent kidney damage.

Q4. Is it possible to reverse kidney failure?

Ans: Damaged kidney tissue generally cannot be repaired. However, early diagnosis and proper medical management may help slow disease progression and preserve remaining kidney function.

Q5. What are some early signs of kidney failure?

Ans: Early-stage kidney failure often has no noticeable symptoms. As the condition progresses, symptoms may include swelling in the legs or ankles, fatigue, changes in urination patterns, and high blood pressure.

Q6. What are some symptoms when the kidneys are not functioning properly?

Ans: Advanced symptoms may include severe nausea, vomiting, shortness of breath, loss of appetite, muscle cramps, sleep disturbances, and intensely itchy skin.

Q7. Who should get screened for kidney diseases in India?

Ans: People with diabetes or hypertension should undergo kidney disease screening at least once a year. This typically includes a blood test for serum creatinine (eGFR) and a urine test to check for protein or albumin.

Q8. What does my creatinine level show?

Ans: Creatinine is a waste product filtered by the kidneys. Elevated creatinine levels in the blood may indicate reduced kidney function and suggest that the kidneys are not filtering waste efficiently.

Q9. When do I need dialysis?

Ans: Dialysis is typically required when kidney function falls below 15% (Stage 5 CKD). It may also be recommended earlier if symptoms such as fluid overload, uncontrolled potassium levels, or malnutrition develop.

Q10. What are the types of dialysis that are available?

Ans: The two main types are Hemodialysis, where a machine filters blood outside the body, and Peritoneal Dialysis, where the lining of the abdomen is used as a natural filter and treatment can often be performed at home.

Q11. Can anyone donate a kidney in India?

Ans: Under the Transplantation of Human Organs Act (THOA), kidney donations generally come from living related donors such as parents, siblings, or spouses. Donations may also come from emotionally related donors or deceased (cadaver) donors under specific regulations.

Q12. Is a kidney transplant better than dialysis?

Ans: In most cases, a kidney transplant is considered the preferred treatment for ESRD because it offers better long-term survival rates and quality of life compared to lifelong dialysis.

Q13. How long do transplanted kidneys usually last?

Ans: A kidney from a living donor may function for approximately 15â20 years, while a kidney from a deceased donor may last around 8â12 years. Outcomes vary depending on individual health factors.

Q14. What dietary changes do kidney failure patients need?

Ans: Patients are often advised to limit sodium, phosphorus, potassium, and sometimes protein intake. Because nutritional needs vary, a personalized meal plan should be developed with the guidance of a healthcare provider and dietitian.

Q15. Can I travel and work while on dialysis?

Ans: Yes, many people on dialysis continue to work and travel. Hemodialysis requires a regular treatment schedule, but travel is often possible by arranging dialysis sessions in advance at centers near the destination.

Kidney Failure: Causes, Symptoms & Treatment Guide

What is Kidney Failure?

Kidney failure is basically when both of your kidneys are not functioning any longer. It is temporary at times, while developing swiftly (acute kidney failure). In other scenarios, it may be a result of long-term and chronic CKD (chronic kidney disease). It may not have symptoms in the early stages, while slowly getting worse and progressing to chronic kidney failures.

Another name for this is ESKD (end-stage kidney disease). Some healthcare providers may also call it renal failure. Chronic kidney failure can be fatal without proper treatment. Those who have this condition may only live for a few days or weeks in such scenarios. Yet, with proper treatment, one can live with kidney failure for a long duration.

How Common Is Kidney Failure?

According to a study in the Lancet (2020), more than 17% of the adult population in India displays signs of chronic kidney disease, i.e. 1 in 6 adults. Added research from the Indian Journal of Nephrology also indicates that less than 10% of these people are aware of having the same. In regions like Delhi, Uttar Pradesh, Haryana, and Punjab, the prevalence is even more owing to lifestyle aspects like hypertension, diabetes and other lifestyle factors. Based on data from the Indian Society of Nephrology, about 2.2 lakh new patients in the country reach their end-stage kidney disease, needing transplants or dialysis every year.

Another Lancet study led by the University of Glasgow also mentions how India had the world's second-highest number of CKD patients in 2023, with about 138 million adults impacted by the condition. CKD also reportedly affects about 13.24% of adults in India as per other reports.

What are the Symptoms of Kidney Failure?

Some of the major symptoms of kidney failure include:

Extreme fatigue/tiredness.
Vomiting.
Nausea.
Swelling (ankles, face, or hands).
Confusion.
Less than normal/no urine.
Itchy or dry skin.
Muscle spasms or cramps.
No appetite/metallic taste.

What are the Causes of Kidney Failure?

Some of the key causes of kidney failure include:

Diabetes and high blood pressure.
Unmanaged diabetes which leads to high blood sugar levels (may damage the blood vessels in the kidneys and other organs).
PKD (polycystic kidney disease).
Glomerular diseases, inclusive of IgA nephropathy.
Genetic kidney ailments.
Autoimmune kidney diseases, such as lupus.

Some of the common reasons behind acute kidney failure (sudden stoppage of functioning that develops within days or hours) include:

Extreme dehydration.
Urinary system blockages.
Specific medications.
Ailments affecting the entire body, i.e. heart diseases, sepsis, and liver diseases.

Risk Factors for Kidney Failure

Some of the main risk factors for kidney failure include:

High blood pressure.
Heart disease.
Diabetes.
Congenital urological abnormalities impacting the kidney structure.
Biological family history of chronic kidney disease (CKD).
If you are more than 60 years of age.
Have an extended history of taking pain relievers, inclusive of over-the-counter (OTC) products like NSAIDs (nonsteroidal anti-inflammatory drugs)

What are the Complications of Kidney Failure?

Some of the main risk factors for kidney failure include:

Low red blood cells (anemia).
High blood pressure.
Fluid around the legs or lungs.
Bone disease.
Electrolyte imbalances, including high blood acid and potassium levels.

When Should I See My Healthcare Provider?

You may get an annual kidney function test with your primary healthcare provider. Also, you may see your provider in case of the following scenarios.

You’ve suffered from kidney problems earlier.
You regularly take NSAIDs.
A biological family member suffers from kidney disease.

Here are some of the questions you should ask your healthcare provider:

What is the cause of kidney failure?
Is dialysis required and what kind is recommended?
Am I the right candidate for a kidney transplant?
What medications are recommended for treatment?
Should there be any lifestyle/dietary changes?
What should be the treatment frequency?

Remember that your life expectancy depends on the treatment you get, your age, overall health conditions, and the cause of kidney failure. Most people on dialysis usually live for several years. Your healthcare provider will let you understand what to expect based on your specific situation.

How is Kidney Failure Diagnosed?

Your healthcare provider may use various kinds of kidney function tests to check the condition of your kidneys and diagnose kidney failure. In case your provider ascertains any risk of the same, then the following may be recommended:

Blood Tests To check how well the kidneys remove waste from the blood
Urine Tests To check whether you have blood or protein in your urine.
Imaging Tests Kidney ultrasound and other tests are used to examine the kidneys and the surrounding areas.

What are the Stages of Chronic Kidney Disease?

There are five stages of CKD (chronic kidney disease), based on your eGFR (estimated glomerular filtration rate). It is a calculation of how well the kidneys work, with a normal figure being above 60. However, even with a normal figure, the provider may still diagnose CKD based on additional tests. The lowest eGFR is 0, meaning that the kidney does not work at all. The stages include:

Stage I The eGFR is more than 90. In this stage, the kidneys work normally and your provider will only diagnose the same in case there are changes in additional kidney tests. In case you do not have any other CKD symptoms, an eGFR more than 90 is normal and it does not mean that you have any kidney disease.
Stage II Your eGFR may be as high as 89 or even as low as 60 in this stage. The kidneys still work well and the provider may only diagnose the same in case there are additional kidney test changes. If you do not have any other CKD signs, the eGFR is normal and you do not have kidney disease.
Stage III The eGFR may be as high as 59 or as low as 30. This means that you may have mild-to-moderate loss of your kidney functions.
Stage IV Your eGFR may be as high as 29 or as low as 15. There may be severe loss of your kidney functions in this case. This stage may see some symptoms, but it does not always happen. In case there are any symptoms, they are mostly mild in nature.
Stage V The eGFR is less than 15 at this stage, with the kidneys at/nearing total failure. Usually, this is when the symptoms start.

Can Kidney Failure be Prevented?

Scheduling regular appointments with your healthcare providers and periodic testing can help you identify kidney disease signs early (that may otherwise lead to kidney failure). Keeping your kidneys healthy also involves the following:

Consuming a well-balanced diet.
Eliminating smoking and tobacco products.
Staying active for a minimum of 30 days (5 days a week).
Maintaining a healthy weight level.
Only taking NSAIDs as per your healthcare provider’s directives.
Restricting the consumption of alcohol.
Managing any underlying conditions, such as high blood pressure or diabetes.

In case you already suffer from kidney failure or CKD, it is always a good idea to:

Monitor your kidney functions.
Maintain a normal range for your blood sugar levels.
Keep your blood pressure levels within the normal range.
Bypass foods with abundant sodium or potassium.
Schedule appointments regularly with your doctor/healthcare provider.

How to Manage Kidney Failure?

Living well with kidney failure is quite challenging. You may feel better in case you:

Stick to your schedule for treatment.
Review the medicines with your healthcare provider/doctor at every visit, while taking your medicines as you have been prescribed.
Work with a professional nutritionist to create the right meal plan.
Stay more active with walking or engaging in other physical activity.
Staying in touch with your loved ones for a better quality of life.
Get proper treatment with regular dialysis (if needed).

Does Health Insurance Cover Kidney Failure?

Yes, health insurance in India usually covers kidney failure. In this case, coverage is usually provided in the form of comprehensive health insurance (covers day-care treatments like kidney transplants and dialysis, along with hospitalization) and critical illness plans (lump-sum payout upon being diagnosed with end-stage renal failure).

With dialysis not needing 24-hour hospital stays, you should ensure coverage for day-care procedures in your policy. Insurers may have variable amounts payable per dialysis session or even for room rent. Review the policy terms carefully.

FAQs

Q1. What is kidney failure?

Ans: Kidney failure, also known as ESRD (end-stage renal disease), occurs when the kidneys lose their ability to filter excess fluids and waste from the blood. It is considered permanent kidney damage, with kidney function falling below 15%.
Q2. What are the main causes of kidney failure?

Ans: Common causes include diabetes, high blood pressure (hypertension), and chronic glomerulonephritis. Other causes may include genetic disorders such as polycystic kidney disease and recurrent kidney stones.
Q3. What is the difference between acute and chronic kidney failure?

Ans: Acute kidney failure develops suddenly over hours or days and may be reversible if the underlying cause is treated. Chronic kidney failure develops gradually over months or years and is usually associated with permanent kidney damage.
Q4. Is it possible to reverse kidney failure?

Ans: Damaged kidney tissue generally cannot be repaired. However, early diagnosis and proper medical management may help slow disease progression and preserve remaining kidney function.
Q5. What are some early signs of kidney failure?

Ans: Early-stage kidney failure often has no noticeable symptoms. As the condition progresses, symptoms may include swelling in the legs or ankles, fatigue, changes in urination patterns, and high blood pressure.
Q6. What are some symptoms when the kidneys are not functioning properly?

Ans: Advanced symptoms may include severe nausea, vomiting, shortness of breath, loss of appetite, muscle cramps, sleep disturbances, and intensely itchy skin.
Q7. Who should get screened for kidney diseases in India?

Ans: People with diabetes or hypertension should undergo kidney disease screening at least once a year. This typically includes a blood test for serum creatinine (eGFR) and a urine test to check for protein or albumin.
Q8. What does my creatinine level show?

Ans: Creatinine is a waste product filtered by the kidneys. Elevated creatinine levels in the blood may indicate reduced kidney function and suggest that the kidneys are not filtering waste efficiently.
Q9. When do I need dialysis?

Ans: Dialysis is typically required when kidney function falls below 15% (Stage 5 CKD). It may also be recommended earlier if symptoms such as fluid overload, uncontrolled potassium levels, or malnutrition develop.
Q10. What are the types of dialysis that are available?

Ans: The two main types are Hemodialysis, where a machine filters blood outside the body, and Peritoneal Dialysis, where the lining of the abdomen is used as a natural filter and treatment can often be performed at home.
Q11. Can anyone donate a kidney in India?

Ans: Under the Transplantation of Human Organs Act (THOA), kidney donations generally come from living related donors such as parents, siblings, or spouses. Donations may also come from emotionally related donors or deceased (cadaver) donors under specific regulations.
Q12. Is a kidney transplant better than dialysis?

Ans: In most cases, a kidney transplant is considered the preferred treatment for ESRD because it offers better long-term survival rates and quality of life compared to lifelong dialysis.
Q13. How long do transplanted kidneys usually last?

Ans: A kidney from a living donor may function for approximately 15–20 years, while a kidney from a deceased donor may last around 8–12 years. Outcomes vary depending on individual health factors.
Q14. What dietary changes do kidney failure patients need?

Ans: Patients are often advised to limit sodium, phosphorus, potassium, and sometimes protein intake. Because nutritional needs vary, a personalized meal plan should be developed with the guidance of a healthcare provider and dietitian.
Q15. Can I travel and work while on dialysis?

Ans: Yes, many people on dialysis continue to work and travel. Hemodialysis requires a regular treatment schedule, but travel is often possible by arranging dialysis sessions in advance at centers near the destination.

Kidney Failure: What it is, Causes, Symptoms, Treatments & More