Symptoms of Renal Failure

Renal Failure Symptoms

Acute renal insufficiency: Characteristic of acute renal insufficiency are a decrease in the amount of urine and a more than 50% increase in the substance creatinine (Metabolic product of the muscle) in blood.

These are the typical symptoms

  • high blood pressure

  • Water retention / edema

  • a headache

  • Fatigue and decreased performance

  • Muscle twitching

  • itching

  • Loss of appetite and nausea

  • Softening of the bones

  • Anemia


The itching - also called pruritus among medical professionals - occurs in the context of uremia. Uremia describes the increasing intoxication of the body with substances that actually have to be excreted via the kidneys. Uremia, which only occurs in advanced renal insufficiency, leads to a multitude of symptoms. One of these is itching, which affects many patients. It is not yet known why uremia causes itching.

Bad breath

In the case of chronic renal insufficiency, an unpleasant halitosis occurs in the late course. It is an intense urine odor. This odor is primarily given off through the exhaled breath. In addition, the urine odor is also given off through the sweat production of the skin. In medicine, this typical body odor is called foetor uraemicus.


The kidney not only has an important function in detoxifying the body and the water balance. It also produces hormones - including erythropoietin, EPO for short. This is also used as a doping agent in sport. The erythropoietin stimulates blood formation in the bone marrow. With renal insufficiency, the production of erythropoietin is reduced, so that blood formation in the bone marrow is no longer sufficiently stimulated. It leads to anemia, also known as anemia. Therefore, if anemia occurs, erythropoietin is given as part of the therapy.

Read more on the topic: Anemia

Emotional disorder

The sensory disturbances that are among the late symptoms are known as polyneuropathy. The sensory disturbances occur primarily in the legs. You can express yourself in different ways. Parasitic sensations, numbness, reduced sensation of warmth and cold and other sensory disorders can occur. Polyneuropathy occurs because, in the late course of kidney failure, the whole body suffers from the accumulation of toxins that have to be excreted through the kidneys. The nerves are affected. There are many other diseases that can lead to sensory disorders in the legs. A widespread disease is diabetes mellitus, which often occurs together with kidney failure.

Softening of the bones

The kidney influences bone metabolism. The activation of vitamin D takes place in the kidneys. Vitamin D, together with two other substances, regulates the breakdown and structure of bones. The task of vitamin D is to promote the mineralization of the bone. A deficiency in vitamin D therefore results in bone softening. In addition, vitamin D ensures that the substances for building bones, i.e. phosphate and calcium, are made available by promoting the absorption of calcium in the intestine and calcium and phosphate in the kidneys. With a vitamin D deficiency there is also a deficiency in phosphate and calcium. In medicine, the negative consequences in bone metabolism caused by chronic kidney failure are also known as renal osteopathy.


Edema is water retention in the tissue. These arise in the context of renal insufficiency due to insufficient water excretion and the resulting accumulation of water in the body. Edema occurs primarily in the legs and is initially noticeable as heavy and thick legs in the evening. The more the water accumulates in the body, the stronger the edema and spread over the whole body. In severe cases, there is also edema on the face.

Read more on the topic: Edema

a headache

Headaches occur as part of uremia, i.e. the accumulation of toxins in the body due to impaired kidney function. In addition to the headache, visual disturbances can also occur. The headache is often accompanied by other general symptoms such as tiredness and decreased performance. In the end-stage of renal insufficiency, the symptoms worsen and lead to drowsiness and drowsiness.

water in the lungs

The water that can no longer be excreted also collects in the lungs, among other things. This is known as pulmonary edema. In a chronic kidney, the water does not collect directly in the lungs but in the tissue between the alveoli and airways of the lungs.
This becomes thicker and thus narrows the airways. The pulmonary edema leads to an increase in the respiratory rate and coughing. The more water that collects in the lungs, the more difficult the breathing becomes.

Also read the article on the topic: Water in your lungs- what to do about it


Real seizures only occur in the end-stage of chronic kidney failure. However, the late symptoms include muscle twitching. Restless leg syndrome, which describes restless legs especially when falling asleep, can also occur. Muscle spasms can also occur during dialysis.

This article might also interest you: Stages of renal failure

Disturbance of the heart function

In the advanced stages of kidney failure, the various toxins that accumulate in the body can cause inflammation of the pericardium, known as pericarditis. The pericarditis causes sharp pains behind the breastbone. In the context of renal insufficiency, cardiac arrhythmias can also occur. The excitation in the heart is sensitive to changes in potassium concentration.
Renal insufficiency results in changes in the water and electrolyte balance, so that the potassium concentration can become too high. This can then trigger cardiac arrhythmias. Therefore, regular electrolyte controls are very important in therapy.

high blood pressure

The blood pressure setting in the body is influenced by a number of factors. The kidneys themselves can regulate blood pressure by releasing hormones. The release of the hormones depends on the pressure and the salt concentration in the small renal arteries. If there is a loss of function, this regulation no longer works and high blood pressure occurs.
This is fatal because high blood pressure itself has a negative effect on kidney function. This creates a vicious circle. Good blood pressure control is therefore essential in the treatment of chronic kidney failure.

These are the symptoms of the onset of kidney failure

The onset of renal failure often shows few or no symptoms. It is therefore not easy to recognize the onset of renal insufficiency. Unfortunately, many are overlooked and diagnosed late. The so-called polyuria is one of the so-called early symptoms. Polyuria is the increased excretion of urine.

Find out more about the topic: Frequent urination

Only in the further course does the amount of urine decrease. The increased amount of urine at the beginning of the disease can be explained by the fact that the kidney loses its ability to concentrate urine. Therefore, it has to excrete more water in order to flush the toxins out of the body. The urine is light and not very colored. In addition, there is increased blood pressure and water retention in the legs. If there is also inflammation of the renal pelvis, fever and pain in the kidney bed will occur.

These are the typical symptoms of chronic kidney failure

As the chronic kidney failure progresses, the symptoms increase. Fatigue and a general reduced performance occur. Skin paleness occurs due to anemia. Furthermore, there are headaches and visual disturbances. The accumulation of toxins, which should actually be excreted via the kidneys, leads to itching, bad breath and uremic gastroenteropathy - that is, nausea and vomiting.
In the end-stage renal failure, uremic encephalopathy occurs due to poisoning of the body. This means that the brain is restricted in its function. Drowsiness, drowsiness, convulsions and coma occur.

For more information, see: Chronic renal failure

Summary renal failure

Depending on the urine produced, the smaller amount of urine is called oliguria or anuria. Oliguria means a daily (24 hours) amount of urine less than 500ml, anuria an amount less than 100ml.

The amount of urine can, however, have normal or higher values ​​despite the presence of renal insufficiency (in approx. 30% of patients); only the creatinine value is then changed.

Chronic kidney failure: The symptoms of chronic kidney failure depend on the stage of the disease. Early onset symptoms include increased excretion of very pale urine (Polyuria), Water retention in the legs and eyelids (edema), increased blood pressure or flank pain. In the course of renal insufficiency, fatigue, headache, nausea, itchy skin or muscle twitching can also occur. Finally, the end stage is characterized, among other things, by a decrease in the amount of urine, vomiting, shortness of breath or a tendency to bleed.