Kidney failure

Also known as renal failure

Kidney failure is when your kidneys don’t work well enough to carry out all their functions.

Key points

  1. Kidney (renal) failure can be sudden or gradual.
  2. Symptoms don't usually appear until you have moderate to severe kidney failure.
  3. There is no cure for kidney failure, but treatment include dialysis, kidney transplant and non-dialysis supportive care.
  4. Kidney failure brings many changes to your life, affecting you and your family, friends, work and leisure activities.
  5. However, with treatment you can live a long, active life and continue to do the things you enjoy.

What is kidney failure?

Having kidney failure means that most (85–90 %) of your kidney function is gone. Your kidneys don't work well enough to carry out all their functions. Kidney failure can be sudden or gradual.

  • Acute kidney failure is often short-lived, but you need treatment until your kidney function returns.
  • Chronic kidney disease develops over time and is related to a number of risk factors, including diabetes and high blood pressure.

There is no cure for kidney failure, but with treatment you can live a long, active life and continue to do the things you enjoy.

What are the symptoms of kidney failure?

Most people don’t know they have kidney disease until their kidneys fail because symptoms usually show up late in the development of the condition. The symptoms are caused by the build-up of waste products in your blood.

Symptoms of kidney disease can include the following:
  • tiredness
  • loss of appetite
  • difficulty sleeping
  • headaches
  • lack of concentration
  • shortness of breath
  • nausea (feeling sick) and vomiting (being sick) 
  • changes in the amount and number of times you pee
  • changes in the appearance of your pee or blood in your pee
  • puffiness in your legs and ankles
  • pain in your kidney area
  • high blood pressure
  • itching
  • bad breath
  • a metallic taste in your mouth.

How is kidney failure treated?

(Doc Mike Evans, US, 2014)

The treatment choices for kidney failure include:

  • dialysis
  • kidney transplantation
  • non-dialysis supportive care.

The dialysis treatments or transplanted kidney take over some of the work of your damaged kidneys by removing wastes and extra fluid from your body. This makes many of your symptoms better. Read more about dialysis.

(Kidney Health, NZ, 2015)

Also available in the following languages:

Alan and Barbara give an honest account of their experience of kidney transplant, as recipient and donor.

(Kidney Health, NZ, 2015)

Non-dialysis supportive care is the treatment choice for kidney failure when you have decided, in consultation with your healthcare team, that the options of dialysis and transplant are not appropriate for you. Your care continues to be supervised and supported by health professionals. You may have medication and a restricted diet to improve your quality of life. Non-dialysis supportive care will not prolong your life when your kidneys fail completely.

(Kidney Health NZ, 2015)

Also available in the following languages:

How can I live well with kidney failure?

Living with kidney failure means more than just staying alive. It’s a challenge to live life to the fullest despite the limitations of kidney failure, but people do continue to live active lives.

It includes learning how to cope with the many changes that face most people with kidney failure. These can include challenges to your self-image and relationships and changes to your work, holidays, leisure and recreation. You will manage your fitness, exercise and diet differently. You will also need to find out how to manage physical changes to your body, which also affect your sexual function, fertility and menstruation (periods).

Our top tips for managing all these changes are as follows:

  • Find out as much as possible about kidney failure, your treatment options and what to expect by reading, talking to people and asking questions.
  • Don't make major changes or commitments quickly, such as leaving your job, moving from your home or changing your finances.
  • Have regular, gentle exercise.
  • Set projects and goals important to you and try to achieve these.
  • Keep up your relationships with your family/whānau and friends. Even though you may not feel your best or have a lot of energy, you will need their support – social and psychological support is as important to your mental health as correct medical treatment is to your physical health

Where can I get support?

Renal units are usually in large teaching hospitals. They offer specialised help for you to adjust to kidney failure. The team includes your renal physician, nurses, dialysis staff and social workers. Renal units also have access to psychiatrists, psychologists and chaplains.

Most also have their own patient-run organisations and support groups. You can find out about these from your renal unit staff or from Kidney Health NZ. Kidney Health NZ has patient support centres around the country for people with kidney failure. These are run by trained volunteers who have experienced kidney failure in their own families/whānau, and who offer their time to talk and share stories.

Learn more

Kidney Health NZ This national organisation provides information on how your kidneys work, kidney conditions treatment and how to find a support group. 
Kidney Society An Auckland-based organisation helping people in the Northland,  Auckland, Waikato, Bay of Plenty, Lakes, Tairawhiti and Hawkes Bay regions to live well with chronic kidney disease and kidney failure.

Reviewed by

Dr Hari Talreja is a renal physician/hypertension specialist with advanced training from Canada and a master’s degree from Harvard University in the USA. He is one of the very few American Society of Hypertension-certified hypertension specialists in New Zealand. He is the clinical lead for transplantation, hypertension and clinical research at Counties Manukau Health. He also practises at Ormiston Specialists Centre, Flatbush and Gilgit Road Specialist Centre, Epsom.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Hari Talreja, Specialist Renal and Hypertension Services, Auckland Last reviewed: 09 Jun 2020