By Michael Webb

There are two primary types of kidney failure in humans. The first occurs fairly suddenly and is called ‘acute renal failure’. We’ll talk later about the causes of this condition. The second disease is more insidious and occurs over time. It is called ‘chronic renal failure’. This type of kidney failure has causes of its own. The treatment for both types of renal failure is roughly the same, with dialysis and kidney transplant being the most common treatments.

One of the most common causes of acute kidney failure, also called acute renal failure, is the sudden loss of blood flow to the kidneys such as seen in trauma, surgery, septic shock, heavy bleeding, burns or acute dehydration. Infections can cause kidney failure, especially if they cause the kidneys to be infected as well. More rarely, acute tubular necrosis can cause the disease.

Sudden blockage of the kidneys can result in acute kidney failure as does auto immune diseases and diseases that clot the small blood vessels of the kidneys. Some of these conditions include having a transfusion reaction, having malignant high blood pressure (extremely high blood pressure), scleroderma or bleeding disorders of pregnancy like an abrupted placenta or a placenta previa.

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Symptoms of acute kidney failure are many. The most common symptoms are a stoppage or slowing down of urine production, swelling of the ankles and legs, fluid retention elsewhere in the body, decreased sensation of the hands or feet, change in mental status, high blood pressure or nausea/vomiting.

Chronic kidney failure affects the kidneys more slowly but results in many of the same problems with the kidneys. In fact, it can occur over several years. While there may be no symptoms in the beginning, eventually the disease is as symptomatic as acute renal failure. Symptoms occur when the kidney function is less than 10% of normal.

Chronic kidney failure occurs in 2 out of a thousand individuals in the US. The most common causes of the disease are diabetes and high blood pressure. These two diseases account for 65% of the cases of chronic kidney failure. Other diseases are more unusual and include glomerulonephritis, polycystic kidney disease, and conditions where blockage or back flow of the urine occurs on a regular basis. Kidney stones and recurrent infections can affect the condition as well as recurrent infections in the kidney.

Symptoms of chronic kidney failure include weight loss, nausea and vomiting, fatigue, headache, frequent hiccups and generalized itching. Eventually the symptoms are similar to acute kidney failure and one can see poor urine output, nighttime urination, easy bruising, decreased alertness (with drowsiness, lethargy, confusion or delirium), seizures, muscle twitching, poor sensation of the hands or feet and high blood pressure.

Both chronic and acute kidney failure result in the build up of fluid and waste products inside the body so that there is a buildup of nitrogen wastes in the body as well as other waste products. Almost all body systems are affected by kidney failure.

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