Kidney (renal) failure is the inability of the kidneys to adequately filter metabolic waste products from the blood.

Kidney failure has many possible causes. Some lead to a rapid decline in kidney function (acute kidney failure). Others lead to a gradual decline in kidney function (chronic kidney failure, also called chronic kidney disease). In addition to the kidneys being unable to filter metabolic waste products (such as creatinine and urea nitrogen) from the blood, the kidneys are less able to control the amount and distribution of water in the body (fluid balance) and the levels of electrolytes (sodium, potassium, calcium, phosphate) in the blood.

When kidney failure becomes chronic, blood pressure often rises. The kidneys lose their ability to produce sufficient amounts of a hormone (erythropoietin) that stimulates the formation of new red blood cells, resulting in a low red blood cell count (anemia). In children, kidney failure affects the growth of bones. In both children and adults, kidney failure can lead to weaker, abnormal bones.

Although kidney failure can affect people of all ages, both acute and chronic kidney failure are more common in older than in younger people. Many causes of kidney failure can be treated, and kidney function may recover. The availability of dialysis has transformed kidney failure from a fatal disease to a chronic one.

Last full review/revision October 2007 by James I. McMillan, MD