Kidney failure or renal failure is a situation where the kidneys do not function properly. It can generally be divided into acute kidney injury (AKI) or chronic kidney disease (CKD). Acute kidney injury progresses rapidly whereas chronic kidney disease progresses slowly. In AKD, patients generally show oliguria, which means they produce less urine than healthy people (less than 400 ml in adults). Patients in CKD show few initial symptoms with gradual loss of kidney function, eventually leading to End-Stage Renal Disease (ESRD). ESRD is a permanent kidney failure. Patients have to be treated by dialysis or by a kidney transplant.

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The two most common causes are diabetes and high blood pressure. Besides, individuals with a family background of kidney problems are also at risk in kidney failure. Kidney failure can also be inherited (eg. polycystic kidney disease) or congenital.

1) Change in urination caused by high levels of urea in the blood – characterised by foamy urine, more or less frequent of urination, difficulty in urinating and blood in urine.
2) Swelling in legs, feet, ankles, face and hands as kidneys cannot remove extra fluid in your body.
3) Muscle fatigue as your kidney make less erythropoietin (EPO), causing fewer red blood cells to carry oxygen.
4) Itching. This is because kidney could not remove waste in your body, causing wastes to accumulate in your bloodstream.
5) Muscle cramps, caused by low levels of calcium in the body.
6) Shortness of breath due to excess fluids in the lungs
7) Other symptoms: nausea, vomiting diarrhoea and weight loss.

It depends on which stage of kidney failure the patients have. They can only change their diet when advised to do so by their doctor or dietician. Generally, high protein intakes and restricted salt intakes are often required by dialysis patients. As for transplant patients, most of them do not need any dietary restrictions.

Most of the dialysis patients have sexual difficulties and the most common problem in male is erectile dysfunction. For females, menstrual periods are affected and pregnancy is less likely to occur.

You need kidney transplantation if you are in end-stage renal disease. Requirements vary from country to country. Many countries place limits on age where patients have to be under a certain age to be able to have a kidney transplant. The patients must also be in good health (apart from the kidney disease). Candidates also have to be screened (blood group and tissue type) to ensure that they are suitable and compliant. According to data, the mean waiting time for kidney transplant in UK is 2 years.

The National Kidney Foundation recommends 3 simple tests:
1) Measurement of blood pressure
2) Glomerular filtration rate (GFR) calculation
3) Measurement of urea nitrogen in blood

Other methods include kidney imaging (CT scan, MRI) and kidney biopsy where a tiny piece of tissue (retrieved by a needle inserted into the back of the kidney) is examined with a microscope.