Kidney Failure

Also known as: end-stage renal disease, renal failure, acute or chronic renal failure.

What is kidney failure?

The kidneys are responsible for balancing body water and salt levels (plus other functions) by filtering the water and waste material brought it by the bloodstream and transforming it into urine to be emptied from the bladder. Renal failure results when damage to the kidneys impairs this function. It may occur acutely (sudden and temporary) or follow chronic (slowly progressive and permanent) damage to kidney function.

What causes kidney failure?

Acute renal failure may result from less blood going to the kidneys (from bleeding, surgery or shock, cardiac arrest or causes that damage the small blood vessels which supply the kidney with blood), some toxins, medications or inflammations of the kidneys.

Chronic failure is typically caused by other conditions such as:

  • inherited conditions (like Alport syndrome)
  • polycystic kidneys
  • cystinosis
  • blockage of the urinary outflow tract

In older adolescents risks are increased with high blood pressure, diabetes mellitus, autoimmune disorders and others.

What are the symptoms of kidney failure?

Depending on the cause, common acute renal failure symptoms may include a high or low urine output, abdominal pain, a rash, vomiting or bloody diarrhea, pale skin, swelling of hands or feet or the whole body. Chronic symptoms include poor growth, diminished appetite, pale skin, nausea, vomiting, muscle cramps, bone pain, itching, swollen feet and ankles, recurrent urinary tract infections, high or low urine output, and many others.

What are kidney failure care options?

Treatments depend on the type, underlying cause and severity. Management of acute renal failure may require hospitalization, with administration of intravenous fluids and monitoring of electrolytes, medications to increase urine output and to control blood pressure and specific diets. If water and electrolyte imbalances become severe, or toxins need to be removed, dialysis may be indicated.

Treatment of chronic renal failure includes special diets, medications to enhance urine output and to address anemia and bone thinning. Removal of excess water, correcting abnormal salt levels and waste products may require dialysis or kidney transplantation.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: May 22, 2023 10:45 AM


The Division of Nephrology at Nicklaus Children’s Hospital treats kidney disorders and provides comprehensive evaluation of renal functions, including kidney biopsies.

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