RENAL FAILURE

Renal failure is any acute or chronic loss of kidney function and is the term used when some kidney function remains. ESRD (end-stage renal disease) is total, or nearly total, and 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 ESRD.

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.