Although kidney failure can occur over a few hours or few days, it typically develops over months or even years.

Having kidney failure means your kidneys are unable to filter excess fluids and waste products from your blood. This results in a dangerous buildup of toxins, fluids and wastes in the blood. To stay alive, you need regular kidney dialysis, or a kidney transplant.

“Although kidney failure is potentially life-threatening, acute kidney failure may be reversible if the underlying cause of the sudden loss of kidney function is treated or removed early,” says Dr Terence Kee, Senior Consultant, Department of Renal Medicine, Singapore General Hospital (SGH), a member of the SingHealth group.

According to the National Registry of Diseases Office, there were 4,895 end-stage kidney disease patients on kidney dialysis in Singapore in 2011. This is almost twice the number of kidney failure patients that were on dialysis in 1999 (2,461 patients).

What causes kidney failure?

Conditions leading to acute kidney failure, or sudden loss of kidney function, include the following:

  • Heart attack
  • Kidney stones
  • Inflammation of the kidney filters (acute glomerulonephritis)
  • Sudden reduced blood flow to the kidneys (due to surgery, septic shock, severe dehydration and haemorrhagic injuries)
  • Blood clots and infections in the urinary tract
  • Blood clots in the kidney arteries and vessels
  • Crush injuries
  • Certain cancers (prostate, colon, cervical)

As for chronic kidney failure, or the progressive loss of kidney function over a longer period of time, its two main causes are poorly managed diabetes and chronic glomerulonephritis.

Other conditions such as cysts and recurrent kidney infections may also cause the kidneys to gradually lose their waste-filtering capacity.

“If you suffer from diabetes or high blood pressure, it is really important that you properly manage your condition in order to prevent chronic kidney failure, which can progress to end-stage kidney disease,” says Dr Kee.

Symptoms of kidney failure

Early stages of kidney failure usually show no specific symptoms. However, if there are symptoms, they can be easily mistaken for trivial conditions:

  • Nausea and vomiting
  • Loss of appetite
  • Fatigue and unwell feelings
  • Persistent itching and dry skin
  • Insomnia
  • Muscle cramps and muscle twitching
  • Headaches
  • Decreased mental alertness

As chronic kidney failure progressively worsens, the following symptoms may appear:

  • Swelling of feet and ankles
  • Lesser need to urinate
  • Fatigue
  • Drowsiness and confusion
  • Poor concentration
  • Shortness of breath
  • Chest pain
  • Excessive thirst
  • Frequent hiccups
  • Low sex drive
  • Rising high blood pressure

Treatment of kidney failure

Treatment will depend on the underlying cause for the kidney failure.

Kidney failure may be reversible if it has developed suddenly due to an autoimmune disease, an infection or physical injury to the kidneys. For example, doctors can treat blood clots, kidney stones and any infections causing the sudden kidney failure.

“Chronic kidney failure is usually not reversible. The goal of treatment is to slow progression towards end-stage kidney disease,” says Dr Kee.

High blood pressure control is important in combating kidney disease. Doctors may prescribe angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) to lower high blood pressure.

How to prevent kidney failure

You can reduce stress on your kidneys with the following lifestyle changes.

  • Eat a diet low in salt to lower high blood pressure.
  • Avoid a high-protein diet that can overtax the kidneys.
  • Limit alcohol consumption (max of two drinks per day for men, and one drink per day for women).
  • Do not smoke.
  • Maintain a healthy body weight (Asian should aim for a BMI of 18.5 to 22.9).
  • Exercise 3 to 5 times per week, for a total of 150 minutes.

Ref: S13