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In the normal, healthy body, waste products are removed from the blood by the kidneys. This allows the body to get rid of toxic products we create, such as the urea (the waste product formed from the breakdown of proteins and usually passed in urine), as the body repairs its tissues. The kidneys also play a vital role in the control of salt and water balance in the body.

If the kidneys start to fail, both of these functions can start to go awry. Serious illness develops and although various treatments are available to control some of the symptoms, the kidneys cannot recover. Eventually, if end-stage kidney failure develops, you will need to have your blood cleaned artificially, by dialysis.

How is kidney failure diagnosed?

The symptoms of kidney failure are varied and can occur with a number of other conditions, so a blood or urine test is needed to confirm a diagnosis. Blood tests are done to measure the levels of urea (the waste product formed from the breakdown of proteins and usually passed in urine)and creatinine (a substance present in your blood and produced by your muscles that is normally removed by the kidneys as waste). If your kidneys are not functioning normally, these levels will be raised.

Levels of electrolytes such as potassium and calcium may be abnormally high or low, and there may be a serious deficiency of red blood cells causing anaemia. In the urine, the presence of protein, blood or pus, or excretion of solid materials can indicate kidney disease.

To assess kidney disease, an ultrasound scan of the kidneys and bladder may be performed, and occasionally a biopsy of the kidney may be required to confirm a diagnosis and identify the cause.

Can kidney failure be treated?

In the case of acute kidney injury, the treatment is usually to remove or correct the cause. This can involve:

  • Removal of any blockage, such as kidney stones or blood clots.
  • Intravenous fluids (injection of fluids into your bloodstream) to correct dehydration.
  • Treatment of any infection or inflammation.
  • Treatment of underlying illness or injury.

Usually, unless the problem has been present for long enough to cause irreversible damage, treatment of the acute underlying cause will lead to recovery of kidney function.

In the case of chronic kidney disease, the damage to the kidneys has occurred over a long time and is not reversible but may be stabilised by treatment of blood pressure, anaemia and correction of electrolyte abnormalities.

Management of end-stage chronic kidney disease can include:

  • Dietary adjustments to reduce fluid and protein intake.
  • Dialysis to artificially purify the blood which could be haemodialysis or peritoneal dialysis
  • A kidney transplant

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