Kidney failure

What is kidney failure?

The kidneys filter waste products and excess fluid from the blood, regulate blood pressure, balance electrolytes, and produce hormones that support red blood cell production and bone health. Kidney failure occurs when this function deteriorates significantly.

There are two main forms:

• Acute kidney injury (AKI) occurs suddenly, often from infection, dehydration, medication, or reduced blood flow to the kidneys. It is potentially reversible with prompt treatment.

• Chronic kidney disease (CKD) develops gradually over months or years, most commonly from diabetes, high blood pressure, or chronic inflammation. It is classified in five stages based on how well the kidneys are filtering, with stages 3 to 5 indicating significant and progressive loss of function.

Most people with early to moderate CKD have no symptoms at all, which is why blood testing is the primary detection tool.

Symptoms of kidney failure

Kidney failure symptoms are often absent until function is significantly reduced. When they do appear, common signs include:

• Swelling in the ankles, feet, or around the eyes from fluid retention

• Fatigue and weakness from anaemia caused by reduced kidney hormone production

• Shortness of breath when fluid builds up in the lungs

• Reduced or increased urine output, or foamy urine

• Persistent itching from waste product buildup in the blood

• Nausea, loss of appetite, or a metallic taste in the mouth

• High blood pressure that is difficult to control

• Muscle cramps or restless legs

What causes kidney failure?

Kidney failure rarely develops without an underlying cause. The most common contributing factors include:

• Diabetes is the leading cause worldwide. Persistently high blood sugar damages the small blood vessels inside the kidneys over time.

• High blood pressure reduces blood flow to kidney tissue, causing progressive scarring and loss of filtering capacity.

• Chronic inflammation from conditions such as lupus, vasculitis, or IgA nephropathy directly damages the kidney's filtering units.

• Recurrent kidney infections cause scarring that progressively reduces function.

• Certain medications including long-term use of anti-inflammatory painkillers can impair kidney function over time.

• Genetic conditions such as polycystic kidney disease cause cysts to replace normal kidney tissue.

• Obstruction from kidney stones, an enlarged prostate, or tumours can block urine flow and damage the kidneys.

Kidney failure is primarily detected through blood and urine tests that measure filtering capacity, with abdominal MRI providing structural assessment.

Blood tests Elfcare's panel includes a comprehensive kidney function profile:

• Creatinine and eGFR: measure how well the kidneys are filtering waste. eGFR below 60 indicates reduced kidney function requiring follow-up.

• Cystatin C: is a more sensitive early marker of kidney filtering capacity than creatinine alone, particularly in people with low muscle mass.

• Urea: reflects protein waste buildup in the blood and rises as kidney function falls.

• Electrolytes (sodium, potassium, bicarbonate): assess the kidneys' ability to maintain the body's chemical balance. Abnormal potassium in particular can affect heart rhythm.

• Calcium and phosphate: become dysregulated in CKD, contributing to bone disease and cardiovascular risk.

• Haemoglobin: identifies anaemia caused by reduced erythropoietin production from the failing kidneys.

• CRP: reflects systemic inflammation, a major driver of kidney disease progression.

• HbA1c and glucose: assess blood sugar control, the leading cause of kidney failure worldwide.

• Total cholesterol, LDL, and triglycerides: assess cardiovascular risk, which is substantially elevated in CKD.

Abdominal MRI Elfcare's full body MRI images both kidneys directly. It can identify reduced kidney size, structural changes consistent with scarring, cysts from polycystic kidney disease, obstructions, and any kidney masses that may be contributing to impaired function.

Why early detection matters

CKD is largely silent in its early stages, yet progression to later stages significantly increases the risk of cardiovascular disease, heart failure, and complete kidney failure requiring dialysis or transplantation. Identifying impaired kidney function at stage 1 or 2, when eGFR is still relatively preserved, allows for treatment of the underlying cause and lifestyle changes that can slow or halt progression entirely. Early detection is the difference between preserving kidney function for life and facing a future of dialysis.

How Elfcare can help

Elfcare's blood panel covers the complete kidney function profile including eGFR, cystatin C, urea, electrolytes, calcium, phosphate, haemoglobin, and metabolic markers. Together these provide a detailed picture of kidney health and the conditions most likely to be driving any impairment.

Our abdominal MRI images both kidneys directly, identifying structural changes that blood tests alone cannot reveal.

If our blood tests or MRI identify a suspicious finding, we take care of further diagnostics or refer you to the appropriate specialist.