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 Associate Professor Terence Kee, Senior Consultant, Department of Renal Medicine, Singapore General Hospital (SGH), a member of the SingHealth group.

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 Assoc Prof Terence 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 Assoc Prof Terence 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.

10 Ways to prevent kidney failure

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

  1. Eat a diet low in sugar, salt and fat. Prepare your own meals (as much as possible). Doing so allows you to control what goes into your food

  2. Avoid a high-protein diet that can overtax the kidneys

  3. Practice portion control - Have 2 servings of fruits and 2 servings of vegetables daily, with whole grains and lean meat

  4. Minimise your risk of obesity, diabetes, high blood pressure and other chronic illness. Maintain a healthy weight by keeping active and not overeating

  5. If you have diabetes or are diagnosed with hypertension:

    • Maintain good blood sugar levels

    • Keep blood pressure in the normal range

    • Control blood cholesterol

    • Visit your doctor regularly

    • Take your medication as prescribed

  6. Limit alcohol consumption (max of two drinks per day for men, and one drink per day for women)

  7. Do not smoke

  8. Maintain a healthy body weight (Asian should aim for a BMI of 18.5 to 22.9)

  9. Exercise 3 to 5 times per week, for a total of 150 minutes of moderate to vigorous exercise

  10. Early health screenings are key to detecting kidney failure, as most people with early stages of kidney disease do not present clear symptoms

Ref: S13

Check out other articles on kidney health:

Glomerulonephritis: A Leading Cause of Kidney Disease

Kidney Cancer: How It Is Diagnosed and Treated

Link Between Red Meat and Kidney Failure

Kidney Stones: Causes and Common Symptoms

Kidney Failure in Singapore: Quick Facts

How Diabetes Affects Your Kidneys and More

SGH Kidney Transplant Reaches New Milestone