Kidney failure, also called end-stage renal disease (ESRD), is the last stage of chronic kidney disease. When your kidneys fail, it means they have stopped working well enough for you to survive without dialysis or a kidney transplant.

What causes kidney failure?

In most cases, kidney failure is caused by other health problems that have done permanent damage (harm) to your kidneys little by little, over time.

When your kidneys are damaged, they may not work as well as they should. If the damage to your kidneys continues to get worse and your kidneys are less and less able to do their job, you have chronic kidney disease. Kidney failure is the last (most severe) stage of chronic kidney disease. This is why kidney failure is also called end-stage renal disease, or ESRD for short.

Diabetes is the most common cause of ESRD. High blood pressure is the second most common cause of ESRD. Other problems that can cause kidney failure include:

Sometimes the kidneys can stop working very suddenly (within two days). This type of kidney failure is called acute kidney injury or acute renal failure. Common causes of acute renal failure include:

  • Heart attack
  • Illegal drug use and drug abuse
  • Not enough blood flowing to the kidneys
  • Urinary tract problems

This type of kidney failure is not always permanent. Your kidneys may go back to normal or almost normal with treatment and if you do not have other serious health problems.

Having one of the health problems that can lead to kidney failure does not mean that you will definitely have kidney failure. Living a healthy lifestyle and working with your doctor to control these health problems can help your kidneys work for as long as possible.

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Chronic kidney disease (CKD) usually gets worse slowly, and symptoms may not appear until your kidneys are badly damaged. In the late stages of CKD, as you are nearing kidney failure (ESRD), you may notice symptoms that are caused by waste and extra fluid building up in your body.

You may notice one or more of the following symptoms if your kidneys are beginning to fail:

  • Itching
  • Muscle cramps
  • Nausea and vomiting
  • Not feeling hungry
  • Swelling in your feet and ankles
  • Too much urine (pee) or not enough urine
  • Trouble catching your breath
  • Trouble sleeping

If your kidneys stop working suddenly (acute kidney failure), you may notice one or more of the following symptoms:

  • Abdominal (belly) pain
  • Back pain
  • Diarrhea
  • Fever
  • Nosebleeds
  • Rash
  • Vomiting

Having one or more of any of the symptoms above may be a sign of serious kidney problems. If you notice any of these symptoms, you should contact your doctor right away.

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Treatment of kidney failure

If you have ESRD, you will need dialysis or a kidney transplant to survive. There is no cure for ESRD, but many people live long lives while having dialysis or after having a kidney transplant.

There are many options for treating kidney failure, including kidney transplant and several types of dialysis. Your doctor can help you figure out which treatment is best for you. Learn more about the treatment options for kidney failure.

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New to dialysis

Starting dialysis often means creating a new normal for yourself and your family. There’s a lot to think about, from choosing a treatment option, to finding new ways to enjoy your favorite activities, to managing a new diet. The FIRST30 program is all about helping you through this period of adjustment. Here, you’ll find videos featuring people like you, who once were new to dialysis, as well as a checklist of important questions to ask your health care team.

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Adjusting to kidney failure

Learning that you have kidney failure can come as a shock, even if you have known for a long time that your kidneys were not working well. Having to change your lifestyle to make time for your treatments can make coping with this new reality even harder. You may have to stop working or find new ways to exercise. You may feel sad or nervous. All is not lost. You can get help to feel better and have a fulfilling life. Learn more about adjusting to living with kidney failure.

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Complications of kidney failure

Your kidneys do many jobs to keep you healthy. Cleaning your blood is only one of their jobs. They also control chemicals and fluids in your body, help control your blood pressure and help make red blood cells. Dialysis can do only some, not all, of the jobs that healthy kidneys do. Therefore, even when you are being treated for kidney failure, you may have some problems that come from having kidneys that don’t work well. Learn more about the complications of kidney failure.

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Disaster preparedness

We can’t always predict when something will happen to derail our treatment plans. There are some simple steps you can take to make sure you are prepared and have access to the things you need to stay healthy in the event of a disaster. Learn more about being prepared for a disaster if you are living with kidney failure.

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Kidney failure/ESRD diet

Dialysis helps to do some of the work that your kidneys did when they were healthy, but it cannot do everything that healthy kidneys do. Therefore, even when you are on dialysis, you will need to limit what and how much you eat and drink. Your diet needs may depend on the type of dialysis you are on (hemodialysis or peritoneal dialysis) and your treatment schedule. Learn more about the diet for living with kidney failure.

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