Kidney failure means the kidneys have lost most of their ability to filter waste and extra fluid from the blood and maintain the body’s fluid, mineral and acid balance. It may develop gradually after chronic kidney disease or occur suddenly as acute kidney injury. Kidney failure requires medical care and ongoing monitoring.
Symptoms
Kidney disease can progress without obvious symptoms. As kidney function becomes severely reduced, symptoms may include:
- swelling of the feet, ankles or legs
- fatigue, weakness or difficulty concentrating
- nausea, poor appetite or unintended weight loss
- itching
- muscle cramps, weakness or numbness
- sleep problems
- shortness of breath from excess fluid or anemia
- making much less urine, although urine output may sometimes remain relatively normal
- confusion or memory problems in advanced illness
Causes
Kidney failure may result from progressive chronic kidney disease caused by conditions such as diabetes, high blood pressure, glomerular disease, inherited kidney disorders or long-term urinary obstruction. Acute kidney injury can develop after severe dehydration, serious infection, reduced blood flow to the kidneys, urinary blockage or exposure to certain medicines or toxins.
Diagnosis and monitoring
Blood tests measure creatinine and are used to estimate glomerular filtration rate (eGFR). Urine testing for albumin helps identify kidney damage. Other tests may include electrolyte measurements, blood counts, imaging and investigations for the underlying cause.
An eGFR of 15 mL/min/1.73 m² or lower is generally considered kidney failure, but treatment decisions are not based on one number alone. Symptoms, laboratory abnormalities, fluid balance, overall health and the rate of kidney-function decline are also important.
Treatment
Treatment includes managing the underlying cause and complications, reviewing medicines, controlling blood pressure and diabetes when present, and individualized guidance about nutrition, sodium, potassium, phosphorus and fluid. Anemia, mineral and bone disorders, excess fluid and other complications may also require treatment.
Do not make major dietary restrictions or stop prescribed medicines without guidance from the kidney care team.
Treatment options for kidney failure
When the kidneys can no longer adequately support the body, treatment options may include:
- Hemodialysis: blood is filtered through a machine outside the body.
- Peritoneal dialysis: the lining of the abdomen is used to remove waste and extra fluid.
- Kidney transplant: a healthy donor kidney is placed in the body to perform kidney functions.
- Conservative management: active medical care focused on symptom control, preserving remaining kidney function and quality of life without dialysis or transplantation.
Planning these options early gives patients and families time to understand how each approach may affect health and daily life.
When to seek urgent help
Seek urgent medical assessment for a sudden major reduction in urine, rapidly increasing swelling, persistent vomiting, severe weakness, new confusion or a significant deterioration during infection or dehydration.
Use your local emergency medical service for severe breathing difficulty, chest pain, seizures, collapse or loss of consciousness.
Related topics
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases: Kidney Failure
- NIDDK: Chronic Kidney Disease Tests and Diagnosis
- NIDDK: Choosing a Treatment for Kidney Failure
Last reviewed: 4 September 2026. This page provides general health information and does not replace individual medical assessment or treatment.