Kidney failure (ESRD) symptoms, causes and treatment
Learn about kidney failure, also called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD), including symptoms, causes, life expectancy and how to cope with dialysis or a kidney transplant.
- Medically reviewed by
- Shahzia Lakhani
- Last updated
- July 14, 2025
What is kidney failure?
Kidney failure, also known as end-stage kidney disease (ESKD) or end-stage renal disease (ESRD), occurs when your kidneys can no longer filter waste from your blood. While this is the final stage of chronic kidney disease (CKD), it can also happen suddenly due to severe injury or illness (called acute kidney injury or AKI). Whether it develops gradually or suddenly, kidney failure means your kidneys have stopped working well enough to keep you alive and you will need dialysis or a transplant.
You aren't alone
Kidney failure can feel overwhelming and scary, but you're not alone. AKF has resources to help you understand your options, prepare for treatment, and connect with others who've been where you are.
What are the symptoms of kidney failure?
Symptoms of kidney failure may include:
- Itchy skin or rashes (pruritis)
- Muscle cramps
- Nausea or vomiting
- Loss of appetite
- Swelling in your feet and ankles (edema)
- Urinating (peeing) more or less than normal
- Foamy, frothy or bubbly-looking urine
- Trouble catching your breath
- Trouble sleeping
Call your doctor right away if you notice any of these symptoms, especially if you already have kidney problems.
What causes kidney failure?
The most common cause of kidney failure is diabetes. Other causes can include:
- High blood pressure
- Autoimmune diseases, such as lupus and IgA nephropathy
- Genetic diseases (diseases passed down from one or both parents), such as polycystic kidney disease or other rare kidney diseases
- Glomerular diseases which can present as nephrotic syndrome
- Problems in your urinary tract (organs that make urine and remove it from your body), such as kidney stones
Sometimes, acute kidney injury (AKI) can also lead to kidney failure. This type of kidney failure happens quickly, usually within two days, and is most common in people who are already hospitalized for other health problems.
Knowing the cause of your kidney disease can help you and your care team manage your health and plan the right treatment.
Know your cause
Understanding the cause of your kidney disease is key to managing it. AKF's Know Your Cause helps you ask the right questions, explore additional testing, and take control of your kidney health. Learn how knowing your cause can lead to better treatment decisions and outcomes.
How will I know if I have kidney failure?
To see if you have kidney failure, doctors may do tests that include:
Your eGFR (estimated glomerular filtration rate) is an estimated number that is calculated based on measuring creatinine through a blood test, a waste product filtered by the kidneys, along with your age and sex.
Your uACR (urine albumin-to-creatinine ratio) test measures the amount of protein in your urine.
A procedure where doctors take a small piece of tissue from your kidneys to look at it under a microscope, which can help determine the cause of kidney disease.
How do doctors treat kidney failure?
You will need to see a nephrologist (kidney doctor) to discuss the treatment options that are available. Treatment options can include:
- Dialysis: treatment to remove waste and excess fluid from your blood when your kidneys are unable to. There are two types:
- Hemodialysis: is a type of dialysis treatment for kidney failure. It uses a machine to clean your blood.
Peritoneal dialysis: is a type of dialysis treatment for kidney failure. It uses a fluid that you put in your belly and then remove to clean your blood.
- Hemodialysis: is a type of dialysis treatment for kidney failure. It uses a machine to clean your blood.
- A kidney transplant:
- Deceased donor kidney transplant, receiving a healthy kidney from someone who has just died.
- Living donor kidney transplant, receiving a healthy kidney from someone who is alive.
Adjusting to dialysis
Starting dialysis often means creating a new normal for yourself and your family. There is a lot to think about, such as choosing a type of dialysis and making time for it. We have prepared a checklist of questions to ask about when starting dialysis.
Dialysis can feel overwhelming but you're not alone. Use our First 30 Days Checklist to ask the right questions, get support, and feel more prepared for this new chapter in your health journey
Learn more
How long can I live after my kidneys fail?
Kidney failure cannot be cured, but treatment can help you live longer. Your life expectancy depends on many things, including your age.
If you choose not to get treatment for kidney failure, you can choose medical management to relieve your symptoms. Your doctor will work with you to keep you comfortable. While there is no way to know how long you can live with medical management, talk with your healthcare team about what this option may look like.
How do I cope with kidney failure?
Finding out you have kidney failure can cause overwhelming emotions, such as sadness, fear or anger, all of which are normal. Reach out for support from your healthcare team, your family, friends and community. They can help you feel your best while you get dialysis or wait for a kidney transplant.
To feel your best, your doctors may recommend that you:
- Go to every dialysis visit and learn about getting referred and evaluated for a kidney transplant
- See a nephrologist
- Meet with a dietitian to help you create and follow a kidney-friendly eating plan
- Keep your blood pressure at a healthy level and they may prescribe blood pressure medicines
- Keep your blood sugar at a healthy level if you have diabetes and consider seeing an endocrinologist (a doctor who specializes in hormones and the glands that make them) for close management
- Be active for at least 30 minutes on most days of the week
- Do not drink or drink less alcohol and quit smoking or using tobacco
What should I eat when I have kidney failure?
Dialysis does some of the work your kidneys did when they were healthy, but it cannot do everything healthy kidneys do. You may need to limit what and how much you eat and drink while on dialysis. Ask your nephrologist how much you need to drink.
Work with a registered dietitian to develop a eating style tailored to your treatment, lab values and lifestyle.
Learn what healthy eating means for people in every stage of kidney disease, including those on dialysis or with a kidney transplant.
Webinar
Depression: The overlooked complication of kidney disease
Living with chronic kidney disease and kidney failure can take a toll on not only your physical health but your mental health, too. But struggling with depression does not need to be every kidney patient's reality. View our webinar to learn more about treatments available for depression and other proven coping methods.
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