Sometimes, the kidneys are no longer able to maintain vital functions because of disease or physical damage.

When the kidneys are not capable of removing excess water and waste from the blood, they cause general discomfort or some specific symptoms.

Some symptoms of kidney failure are:

• Extreme tiredness
• Nausea and vomiting
• Shortness of breath
• Difficulty in getting to sleep
• Swelling of the face, hands and feet
• Loss of appetite
• Itching
• High blood pressure (hypertension)

Some symptoms and signs are due to the increase in the blood of waste products and an excess of liquids which are harmful to your body. The increase in these substances is called Uraemia.

These symptoms may be diagnosed as kidney failure or disease.

There are several terms which you may hear that describe kidney disease. They are Acute Renal Failure (ARF), or Chronic Renal Failure (CRF) and the pre-end stage of the disease is also known as "pre- ESRD - pre End Stage Renal Disease".

Acute kidney disease is sudden serious impairment or temporary loss of kidney function. Acute kidney disease may be caused by a serious infection, large burns, chemical intoxication or drug overdose, accidents or major surgery, leading to kidney failure.
This condition is reversible when the cause of the problem is eliminated and the kidneys start to function normally once more. People who have this type of problem only need dialysis for a limited period of time, until they regain normal kidney function.

Chronic kidney disease is when a person suffers from gradual and usually permanent loss of kidney function over time. This happens gradually, usually over many months or even years. Unfortunately, Chronic Renal Failure cannot be reversed or cured. There are various stages, depending on how chronic the disease is. The degree of kidney failure is identified from urine and blood tests.

Some people with Chronic Renal Failure may have toxin (waste) retention even if they are able to urinate:
the amount of waste in the urine is low, while the amount of toxins in their blood will increase continuously.
This is why during monitoring of chronic pre-uraemia, you may periodically be asked to collect your urine over a 24 hour period and to undergo blood tests.

Your doctor will examine the results of these tests, paying special attention to the creatinine, urea and creatinine clearance values.

The results will enable your Nephrologist to assess how much kidney function you have left, in order to decide whether and when to start dialysis. Kidney disease progresses in stages and may persist in the early stage for many years without showing any symptoms.

You may only notice the symptoms of the disease when the kidney stops working.

This is why it is important to have a Nephrologist who sets and oversees your treatment years before the end stage of the disease.

There are many diseases which may be the direct or indirect cause of Chronic Renal Failure.

The two main causes are Diabetes and High Blood Pressure.

Other causes of kidney disease are:

• Glomerulonephritis
• Arthrosclerosis
• Congenital abnormalities of the urinary tract
• Urinary tract obstructions
• Drugs
• Kidney disease caused by polycystic kidney
• Infection
• Kidney stones
• Trauma (physical injury)