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Overview of Renal Failure

What is renal failure?

Renal failure refers to temporary or permanent damage to the kidneys that results in loss of normal kidney function. There are two different types of renal failure - acute and chronic. Acute renal failure has an abrupt onset and is potentially reversible. Chronic failure progresses slowly over at least three months and can lead to permanent renal failure. The causes, symptoms, treatments, and outcomes of acute and chronic are different.

Conditions that may lead to acute or chronic renal failure may include, but are not limited to, the following:

Acute Renal Failure Chronic Renal Failure
Decreased blood flow to the kidneys for a period of time. This may occur from blood loss or shock. A prolonged urinary tract obstruction or blockage.
An obstruction or blockage along the urinary tract. Alport syndrome - an inherited disorder that causes deafness, progressive kidney damage, and eye defects.
Hemolytic uremic syndrome - usually caused by an E. coli infection, kidney failure develops as a result of obstruction to the small functional structures and vessels inside the kidney. Nephrotic syndrome - a condition that has several different causes. Nephrotic syndrome is characterized by protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling.
Ingestion of certain medications that may cause toxicity to the kidneys. Polycystic kidney disease - a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys.
Glomerulonephritis - a type of kidney disease that involves glomeruli. During glomerulonephritis, the glomeruli become inflamed and impair the kidney's ability to filter urine. Cystinosis - an inherited disorder whereby the kidneys have excessive excretion or certain amino acids. This leads to severe kidney stones.
Any condition that may impair the flow of oxygen and blood to the kidneys such as cardiac arrest.

What are the symptoms of renal failure?

The symptoms for acute and chronic renal failure may be different. The following are the most common symptoms of acute and chronic renal failure. However, each child may experience symptoms differently.

Acute symptoms may include:
(Symptoms of acute renal failure depend largely on the underlying cause.)

Chronic symptoms may include:

The symptoms of acute and chronic renal failure may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How is renal failure diagnosed?

In addition to a physical examination and complete medical history, your child's physician may order the following diagnostic tests:

Treatment for acute and chronic renal failure:

Specific treatment for renal failure will be determined by your child's physician based on:

Treatment of acute renal failure depends on the underlying cause. Treatment may include:

In some cases, children may develop severe electrolyte disturbances and toxic levels of certain waste products normally eliminated by the kidneys. Children may also develop fluid overload. Dialysis may be indicated in these cases.

Treatment of chronic renal failure depends on the degree of kidney function that remains. Treatment may include:

Most children with renal failure are followed by a pediatrician and a nephrologist (a physician who specializes in disorders or diseases of the kidneys).

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