Ram Gokal, Manchester Royal Infirmary, Manchester, UK
Published online: April 2001
DOI: 10.1038/npg.els.0002121
Renal failure is the state resulting from a reduction in the capacity to fulfil the essential functions of the kidney (excretory, acid–base and fluid electrolyte control). It may be acute and potentially reversible, or chronic and irreversible. It may require artificial blood purification techniques (dialysis and transplantation), but in its extreme form can be fatal.
Keywords: kidney; uraemia; acute; chronic; renal replacement therapy
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Figure 1. Diagrammatic representation of the various stages of renal failure progression. (1) Loss of ‘renal reserve’. This represents the capacity of the kidneys to provide more than their usual function in response to a stimulus. (2) Renal insufficiency. Here serum urea and creatinine levels are increased but patients are asymptomatic. Changes in the production of hormones (calcitriol, parathyroid hormone) may be seen. (3) Chronic renal failure. A broad range of biochemical abnormalities is seen and symptoms are mild to severe depending on creatinine clearance. Anaemia is common. (4) End-stage renal failure. This is a terminal uraemic state with a creatinine clearance rate of less than 10 ml min
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