Chronic renal failure Dr Rob Hicks There are many possible reasons our kidneys fail, and the risk increases with age.

In this article

What causes it? Causes and risk factors

Symptoms Treatment and recovery

Chronic renal failure (CRF) means a longterm (usually slow) deterioration in kidney function. The phrase CKD (chronic kidney disease) is now being used as an alternative.

In up to 30 per cent of patients (many of whom have small kidneys on an ultrasound) the cause of CRF is unknown. Other causes include:

• Diabetes
• Inflammation (for example glomerulonephritis)
• Polycystic kidney disease
• Renovascular disease (furring up of the blood vessels to the kidney), a common cause in older people
• Certain medicines

The risk of developing CRF increases after the age of 60.

Because the kidneys can manage with only a small proportion of their functional ability, it may be some time before any effects of gradual failure are noticed. Even when they do occur, the symptoms may be quite vague.

People with CRF may feel tired and lethargic. They may notice they go to the toilet to pass water more often, especially at night.

Other symptoms include:

• Itchy skin
• Nausea
• Impotence in men
• Fluid retention that makes the ankles swell or cause shortness of breath

A doctor will look for signs of kidney failure and run a number of tests to help make the diagnosis, including urine tests, blood tests and an ultrasound (sound picture) of the kidneys.

Treatment at a specialist kidney (renal) unit can help to slow the progression of CRF. Most hospitals in the UK don’t have one, so, it’s important to be referred to your regional centre. In some cases it can delay or even avoid the need for dialysis or a kidney transplant.

If it's possible to treat the cause of kidney failure, this will be done. If another condition is present (such as high blood pressure or diabetes), keeping this under control can help prevent the kidney failure worsening.

A kidney transplant is the best treatment for many (about 40 per cent) patients with advanced CRF. Until a transplant becomes possible, the role of the kidneys in filtering out the waste products from the blood can be performed through dialysis.

It's important people with CRF eliminate risk factors for cardiovascular disease (for example, smoking) and are immunised against pneumococcal and influenza infections.

It's common for people with CRF to suffer from depression as a consequence of their condition, so psychological support should always be available.

This article was last medically reviewed by Dr Andrew Stein in August 2009.