Published by Bupa's Health Information Team, May 2010.
This factsheet is for people who have chronic renal failure, or who would like information about it.
This factsheet is relevant for both adults who have chronic renal failure and parents of children with the condition. However, for simplicity we will refer to 'you' throughout.
Chronic renal failure is a condition of the renal system. If the renal system isn't working as it should, substances which the body usually gets rid of can build up causing long-term illness. The condition can be life-threatening in some people.
Your kidneys are the main part of your renal system and are found towards the back of your abdomen (tummy). Most people have two kidneys that filter water and waste products from their blood to make urine, which is passed out of the body via the bladder. These waste products are toxic if not removed.
Chronic renal failure
This is diagnosed if your kidneys aren't functioning as well as they should be over three or more months.
Acute renal failure
This happens quickly over a few hours or days. Your kidney function can drop and you may not have any symptoms. It's more common if you are over 65 or are being treated in hospital.
This factsheet focuses on chronic renal failure.
You may not have symptoms but if you do, you may have the following:
If you have these symptoms, see your GP.
You're more at risk of high blood pressure and high cholesterol if you have chronic renal failure, which can lead to health complications. If your condition gradually gets worse, you are more likely to develop:
The following are common factors that increase your risk of chronic renal failure:
Rarer causes include:
You may get chronic renal failure due to a cause not listed here.
If you have a condition which increases your risk of renal failure, ask your GP for advice.
Your GP will ask about your symptoms and examine you. He or she may ask about your medical history. A blood or urine sample may be needed for testing.
You may be referred to an urologist or nephrologist (a doctor specialising in conditions affecting the kidney). You may need to have an X-ray or an ultrasound scan. If the cause isn't clear from these tests, a sample of kidney tissue may be taken (a renal biopsy).
Your doctor will measure your glomerular filtration rate (GFR), which is the rate at which your kidneys remove waste products, to see how well your kidneys are working. End-stage renal disease is diagnosed if your kidneys are no longer working as they should be and you need dialysis or a transplant.
Understanding your condition can be helpful. It isn't clear if changing your intake of salt, taking more exercise or stopping smoking prevents renal failure. Maintaining a healthy, balanced diet and body weight, drinking alcohol within recommended limits, exercising regularly and quitting smoking can help you stay as healthy as possible.
If there is a direct cause of your condition, this will be treated with medicines. Your doctor may stop any medication that you are taking that may be affecting how your kidneys are working.
You may be given antibiotics to treat an infection or you may be prescribed medicines to reduce high blood pressure. Medicines called diuretics (eg furosemide, metolazone) can reduce leg or arm swelling if you have these symptoms.
Medicines such as angiotensin-II receptor antagonists (eg irbesartan, losartan) or angiotensin-converting enzyme (ACE) inhibitors (eg enalapril, lisinopril) may be prescribed.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
Try not to take over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) unless they are prescribed by your doctor.
You may need to take other medicines as your condition progresses. For example, erythropoietin may be prescribed if you become anaemic or to prepare you for dialysis or transplantation.
When you are first diagnosed, you may be treated as an inpatient, this means you will go to hospital but return home the same day. This is usually in the renal unit of a hospital. A nurse will regularly check your blood pressure, vein pressure and urine levels. You may need to have a catheter to collect urine. You may have a drip inserted to give you sugars or minerals directly into your bloodstream.
If your kidneys are not working as well as they need to be, you may need to have dialysis. There are two types of dialysis: haemodialysis and peritoneal dialysis. If you have haemodialysis, your blood is passed through a machine to filter the blood. During peritoneal dialysis, fluid is passed into the peritoneal cavity in your abdomen via a catheter and the peritoneal membrane acts as a filter for dialysis. This is sometimes used with a machine. Long-term dialysis may be done at home or at a renal unit in hospital, depending on the options available to you.
You can discuss dialysis options with your doctor.
Dialysis
When you're pregnant, your kidneys work harder to remove the waste products you and your baby produce. This can increase the amount of damage to the kidneys but this depends on how well your kidneys are functioning before your pregnancy. If you have chronic renal failure, you should discuss any plans to get pregnant with your doctor.
If you have chronic renal failure, you will need to have a hepatitis B vaccination because you are at an increased risk of getting hepatitis B.
If you need dialysis, discussing options with your healthcare professional can help you manage your condition effectively. You will need to regulate your diet, your fluid intake and how much you weigh if you have dialysis. You may also choose to discuss end of life care. You can discuss this with your doctor.
Have your blood pressure checked regularly. Drink enough fluids and eat a healthy, balanced diet. Maintaining a healthy weight, drinking alcohol within recommended limits, keeping active and quitting smoking all help to keep you as healthy as possible.
Talk to your GP about any medicines you are taking and be aware if they increase the risk of renal failure so you get treatment early.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: May 2010
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