Acute Kidney Failure

There are two primary types of kidney failure, acute and chronic. Acute kidney failure is a current and often sudden issue where the kidneys are not working as well as they usually do. In many cases, acute issues with the kidneys that are treated quickly often completely resolve or cause minor issues with a return to near-normal function.

For some patients, an issue such as dehydration is present and the problem can be treated by something as simple as drinking more water or receiving IV fluids. The term acute technically means an illness less than six months in length, while chronic typically means six months or greater in length.

Chronic Kidney Failure

Chronic kidney failure is a condition where the kidneys lose their ability to filter waste and excess water from the bloodstream to convert into the urine.

Once the kidneys are so damaged that they cannot filter the blood enough to sustain life, the patient will require dialysis or a kidney transplant in order to live. When the kidneys fail, dialysis—a treatment where the blood is filtered and cleaned to do the work the kidneys can not—is performed.

While dialysis can do the essential work of the kidneys, the treatment is expensive and time-consuming, requiring a minimum of three 3-hour treatments per week.

Kidney transplant surgery is the only “cure” for end-stage renal disease, as a functional kidney transplant will remove the need for dialysis. A transplant poses its own challenges but provides a great improvement in overall health when the surgery is successful.

Over time, high levels of glucose in the blood destroy the kidney’s ability to filter toxins and waste from the blood. The glucose molecule is larger than the molecules that the kidney is supposed to filter.

The filtering mechanism is damaged as glucose is forced into the urine, and thus the kidney loses the ability to filter small molecules. The damage continues until it is so severe that waste begins to build up in the bloodstream.

Blood tests will typically show both elevated creatinine and BUN levels. When the waste begins to build up, dialysis or a kidney transplant is the next step for treatment.

The more frequent and more serious the infections, the greater the likelihood that kidney failure will result. Urinary tract infections that are ignored can lead to kidney infections that persist until treated with antibiotics. If enough infections are severe enough, or ignored and untreated, the result can be the need for dialysis or a kidney transplant.

Autosomal Recessive PKD (ARPKD) is less common but is a far more severe form of the disease. Both parents must be a carrier for the disease, and their children have a 25% chance of having ARPKD. Approximately 1 in 20,000 newborns have the disease.

In this form of the disease, cysts grow inside the kidney, causing such severe damage that many patients die in the first month of life. For those who survive, one-third will require dialysis by the age of 10. To make matters worse, children with ARPKD also have associated liver disease that can also cause life-threatening problems.

By the time the tumor is found, even if it is noncancerous, the kidney may no longer be functioning. In some cases, the damage is so severe that the kidney must be removed to prevent damage to other organs, including the heart. If the remaining kidney is also not functioning well, dialysis or a kidney transplant may be required.

Once the blockage is severe, the kidney becomes damaged as urine continues to be produced, but cannot flow out of the kidney. This condition can be extremely painful and may result in surgery to release the build-up of urine.

If the problem is left untreated, the kidney may no longer function and may even need to be surgically removed. In most cases, the undamaged kidney will be able to compensate; however, if the other kidney is also damaged, dialysis or a kidney transplant may be necessary.

The difference in rates of disease is attributed to several things, including higher rates of diabetes in some races, access to health care, willingness to control diseases such as high blood pressure, and the ability to afford essential medications.

Men are slightly more likely to have kidney failure than women—approximately 55% of patients are male. The rate of disease is highest between the ages of 45 to 64, an age when diabetes and other diseases have had decades to damage the kidneys.