Kidney failure, medically known as end-stage renal disease (ESRD), denotes the incapacity of an individual's kidneys to meet physical requirements on a daily basis. Those with ESRD have their kidneys functioning below ten percent of the standard rate, which naturally leads to a buildup of various toxins in the body. Kidney failure creates multiple symptoms with some being easily perceptible while others are far more subtle. Individuals living with kidney failure will typically experience several stages of illness before receiving an end-stage renal disease diagnosis. People with end-stage renal disease require dialysis or a kidney transplant to survive. Since it's a dire, life-threatening condition, early detection is critical.  

Decreased Urine Output

The primary function of the kidneys is to filter out waste products from the blood and excrete them from the body in urine. During kidney failure, the organs don't adequately remove the waste from the body. As a consequence, there's a decrease in urine production. In some cases, people may develop an inability to urinate at all, signaling a critical portion of end-stage renal disease. Anyone experiencing a decrease in the amount of urine—especially those with a history of kidney disease, should seek medical assistance immediately.


Dry Skin

Apart from filtering out waste products from the blood, kidneys also help in maintaining the balance of calcium and phosphorus in the body. Comprised kidney function alters elements in the blood which is known to cause dry and itchy skin. Typically, this symptom only occurs in the very advanced stages of kidney disease. Therefore, in those people already experiencing kidney dysfunction, the development of dry and itchy skin may be a sign of kidney failure occurring.



The most common of all gastrointestinal symptoms associated with end-stage renal disease are nausea and vomiting. The main reason they occur is that there's a rise in intestinal excretion of urea when the kidneys are malfunctioning. When urease (the enzyme that breaks down urea) acts on this increased urea, it leads to the production of excessive ammonia. Ammonia, in turn, stimulates the intestinal tract to produce a sensation of nausea, which—in people with more sensitive systems, may cause a vomiting spell as well. People with nausea and vomiting can have difficulty in consuming food and medications.


Swollen Ankles

Individuals experiencing kidney failure also complain of swollen legs and ankles. Swelling is due to the decreased kidney function causing sodium retention in the body. This retention of sodium then leads to an increase in body fluids, resulting in swelling (edema) in the lower extremities. This symptom can be relieved by switching to a low-sodium diet and keeping the affected limbs elevated.



The primary cause of fatigue in people with end-stage renal disease is anemia. Anemia is a decrease in the oxygen-carrying capacity of red blood cells. The build-up of toxins and impurities in the body due to kidney malfunction can also have a significant impact on energy levels. The body works overtime to prevent the toxins from harming the system, leading to feelings tiredness, weakness, and generally feeling unwell most of the time. Sleep apnea is another condition that people with kidney disease are vulnerable to, which further causes energy levels to dip.


Breathing Problems

People living with kidney failure often complain about trouble catching a breath. Shortness of breath is an alarming symptom that's caused by the presence of extra fluid that has accumulated in and around the lungs. People experiencing heart failure will also exhibit this symptom. In those with an end-stage renal disease, anemia can also exacerbate the shortness of breath. It'd be difficult for a person with this symptom to walk for an extended period or to lie down flat.


Ammonia Breath

The build-up of urea in a person's body and blood can result in an unpleasant smell of ammonia on the breath. These waste products in the body can also make food taste different. One can even experience a metallic taste in the mouth as if a person is drinking iron. Someone with this symptom cannot have the same appetite as before and eventually the desire to eat decreases, and weight loss becomes apparent. Before beginning dialysis, a person with kidney failure may lose as much as ten pounds.


Other Symptoms

There are many other symptoms that a person with kidney failure may experience. Sometimes people complain about pain in the flank area of the back. Fluid-filled cysts may cause this in the kidneys. Because of the fluid on the lungs and anemia, the brain may not get enough oxygen and folks can find themselves feeling dizzy and confused, or have memory-related problems, and trouble concentrating. Another symptom is that-even in a warm room, a person with end-stage kidney disease may feel cold.


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