WHAT ARE RENAL FAILURE AND END-STAGE RENAL DISEASE?
Renal failure is any acute or chronic loss of kidney function and is the term used when some kidney function remains. ESRD is total, or nearly total, permanent kidney failure. Depending on the form of glomerular disease, renal function may be lost in a matter of days or weeks or may deteriorate slowly and gradually over the course of decades.
ACUTE RENAL FAILURE
A few forms of glomerular disease cause very rapid deterioration of kidney function. For example, PSGN can cause severe symptoms (hematuria, proteinuria, edema) within 2 to 3 weeks after a sore throat or skin infection develops. The patient may temporarily require dialysis to replace renal function. This rapid loss of kidney function is called acute renal failure (ARF). Although ARF can be life-threatening while it lasts, kidney function usually returns after the cause of the kidney failure has been treated. In many patients, ARF is not associated with any permanent damage. However, some patients may recover from ARF and subsequently develop chronic renal failure (CRF).
CHRONIC RENAL FAILURE
Most forms of glomerular disease develop gradually, often causing no symptoms for many years. CRF is the slow, gradual loss of kidney function. Some forms of CRF can be controlled or slowed down. For example, diabetic nephropathy can be delayed by tightly controlling blood glucose levels and using ACE inhibitors to reduce proteinuria and control blood pressure, but CRF cannot be cured. Partial loss of renal function means that some portion of the patient’s nephrons have been scarred, and scarred nephrons cannot be repaired. In most cases, CRF leads to End-Stage Renal Disease.
END-STAGE RENAL DISEASE
To stay alive, a patient with ESRD must go on dialysis–hemodialysis or peritoneal dialysis–or receive a new kidney through transplantation. Patients with CRF who are approaching ESRD should learn as much about their treatment options as possible so they can make an informed decision when the time comes. With the help of dialysis or transplantation, many people continue to lead full, productive lives after reaching ESRD.
Points to Remember
The kidneys filter waste and extra fluid from the blood.
The filtering process takes place in the nephron, where microscopic blood vessel filters, called glomeruli, are attached to fluid-collecting tubules.
A number of different disease processes can damage the glomeruli and thereby cause kidney failure. Glomerulosclerosis is a broad term that includes many forms of damage to the glomeruli.
Some forms of kidney failure can be slowed down, but scarred glomeruli can never be repaired.
Treatment for the early stages of kidney failure depends on the disease causing the damage.
Early signs of kidney failure include blood or protein in the urine and swelling in the hands, feet, abdomen, or face. Kidney failure may be silent for many years.
Source: National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
Email: nkudic@info.niddk.nih.gov
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases. Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.
NIH Publication No. 03-4358
March 2003
