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What are signs your kidneys are not working?

Decreased urine output, although occasionally urine output remains normal. Fluid retention, causing swelling in your legs, ankles or feet. Shortness of breath. Fatigue.

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Overview

Kidney cross section Open pop-up dialog box Close Kidney cross section Kidney cross section The kidneys remove waste and excess fluid from your blood through filtering units called nephrons. Each nephron contains a filter (glomerulus) that has a network of tiny blood vessels called capillaries. When blood flows into a glomerulus, tiny molecules — water, essential minerals and nutrients, and wastes — pass through the capillary walls. Large molecules, such as proteins and red blood cells, do not. The filtered solution then passes into another part of the nephron called the tubule. The water, nutrients and minerals your body needs are transferred back to the bloodstream. The excess water and waste become urine that flows to the bladder. Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly, usually in less than a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care. Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal or nearly normal kidney function.

Symptoms

Signs and symptoms of acute kidney failure may include:

Decreased urine output, although occasionally urine output remains normal

Fluid retention, causing swelling in your legs, ankles or feet

Shortness of breath

Fatigue

Confusion

Nausea

Weakness

Irregular heartbeat

Chest pain or pressure

Seizures or coma in severe cases

Sometimes acute kidney failure causes no signs or symptoms and is detected through lab tests done for another reason.

When to see a doctor

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Causes

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Acute kidney failure can occur when:

You have a condition that slows blood flow to your kidneys

You experience direct damage to your kidneys

Your kidneys' urine drainage tubes (ureters) become blocked and wastes can't leave your body through your urine

Impaired blood flow to the kidneys

Diseases and conditions that may slow blood flow to the kidneys and lead to kidney injury include:

Blood or fluid loss

Blood pressure medications

Heart attack

Heart disease

Infection

Liver failure

Severe allergic reaction (anaphylaxis)

Severe burns

Severe dehydration

Damage to the kidneys

These diseases, conditions and agents may damage the kidneys and lead to acute kidney failure:

Blood clots in the veins and arteries in and around the kidneys

Cholesterol deposits that block blood flow in the kidneys

Glomerulonephritis (gloe-mer-u-loe-nuh-FRY-tis), inflammation of the tiny filters in the kidneys (glomeruli)

Hemolytic uremic syndrome, a condition that results from premature destruction of red blood cells

Infection, such as with the virus that causes coronavirus disease 2019 (COVID-19)

Lupus, an immune system disorder causing glomerulonephritis

Medications, such as certain chemotherapy drugs, antibiotics and dyes used during imaging tests

Scleroderma, a group of rare diseases affecting the skin and connective tissues

Thrombotic thrombocytopenic purpura, a rare blood disorder

Toxins, such as alcohol, heavy metals and cocaine

Muscle tissue breakdown (rhabdomyolysis) that leads to kidney damage caused by toxins from muscle tissue destruction Breakdown of tumor cells (tumor lysis syndrome), which leads to the release of toxins that can cause kidney injury

Urine blockage in the kidneys

Diseases and conditions that block the passage of urine out of the body (urinary obstructions) and can lead to acute kidney injury include:

Bladder cancer

Blood clots in the urinary tract

Cervical cancer

Colon cancer

Enlarged prostate

Kidney stones

Nerve damage involving the nerves that control the bladder

Prostate cancer

Risk factors

Acute kidney failure almost always occurs in connection with another medical condition or event. Conditions that can increase your risk of acute kidney failure include:

Being hospitalized, especially for a serious condition that requires intensive care

Blockages in the blood vessels in your arms or legs (peripheral artery disease)

Diabetes

High blood pressure

Heart failure

Kidney diseases

Liver diseases

Certain cancers and their treatments

Complications

Potential complications of acute kidney failure include:

Fluid buildup. Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breath. Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breath. Chest pain. If the lining that covers your heart (pericardium) becomes inflamed, you may experience chest pain.

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If the lining that covers your heart (pericardium) becomes inflamed, you may experience chest pain. Muscle weakness. When your body's fluids and electrolytes — your body's blood chemistry — are out of balance, muscle weakness can result. When your body's fluids and electrolytes — your body's blood chemistry — are out of balance, muscle weakness can result. Permanent kidney damage. Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive. Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive. Death. Acute kidney failure can lead to loss of kidney function and, ultimately, death.

Prevention

Acute kidney failure is often difficult to predict or prevent. But you may reduce your risk by taking care of your kidneys. Try to:

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