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Preface and Contents

What is Kidney Failure?

Our kidneys perform several functions in order to maintain balance in our bodies. They filter waste products and excrete them in the urine. They adjust the amounts of water and electrolytes like sodium, potassium and calcium in the body. They also help excrete excess acid or alkali, maintaining acid base balance. A reduction in their ability to perform these tasks is called kidney/renal failure.

How to diagnose kidney failure?

When both kidneys fail, there is a build-up of waste products in the blood, the easiest of which to measure in the laboratory being creatinine and urea. Formulas to estimate kidney function or glomerular filtration rate (GFR) using the serum creatinine are easily accessed on-line or in apps. Importantly, even a slight rise in the serum creatinine reflects a significant decrease in kidney function. A value of just 1.6 mg/dl may indicate over 50% loss of kidney function.

Can failure of one Kidney lead to kidney failure?

No. When only one of two kidneys fails or is removed, overall kidney function may not be significantly affected. The remaining kidney may compensate and take over the workload of both kidneys.

Kidney failure means loss of functions of both kidneys.

Two major types of kidney failure

Kidney failure may either be acute or chronic in nature.

1. Acute Kidney Failure

Acute insults to the kidneys may cause a reduction or loss in their function within a short period of time like a few hours to days. This decline in function was previously called acute renal failure (ARF) but has been recently named Acute Kidney Injury (AKI) .

This type of kidney failure is usually temporary. With proper treatment kidney functions return to normal in most patients.

2. Chronic Kidney Failure

Gradual progressive and irreversible loss of kidney function over several months to years is called chronic kidney disease (CKD), (previously known as chronic renal failure or CRF). Declining kidney function may reach a stage when the kidneys stop working almost completely. This advanced and life-threatening stage of disease is called end stage kidney disease - ESKD (End Stage Renal Disease or ESRD).

When kidney failure is diagnosed, over 50% of kidney function is already lost.