The kidneys filter your blood of toxins and waste products daily, keep fluid balance at an optimum level, and regulate electrolytes in your bloodstream. But when your kidneys stop functioning, all these processes will stop working. As a result, the consequences of your kidneys malfunctioning will manifest in most of your body parts.
Kidney failure is a dangerous medical disorder, but it does not always lead to your health deteriorating immediately. How the situation will progress depends on how fast your kidneys stop working, why they stopped doing their job, and if there will be some complications. Knowledge of what kidney failure is will help you to notice the danger.
We will help you understand what happens if your kidneys fail, what symptoms and complications this disorder causes, and how it can be treated, including dialysis and kidney transplants.
What Does Kidney Failure Mean?
Failure of the kidneys happens when your kidneys are functioning below 15 percent of their total capacity. They cannot effectively filter your blood anymore in order to remove all the waste products and balance the fluids and minerals in your body. When a person reaches stage 5 of his/her CKD, their estimated glomerular filtration rate (eGFR) is already below 15 mL/min/1.73 m² [1].
Kidney failure doesn’t always happen slowly. It can suddenly occur in just hours or even days because of the presence of acute kidney injury (AKI). These cases are caused by factors like a severe infection, dehydration, some types of medications, and even a blockage in the urinary tract of the person. There are times when the kidney failure occurs gradually within several months or years because of the chronic kidney disease. [6]
There are five stages in CKD depending on one’s eGFR and additional signs of kidney damage. Read more about the five stages of chronic kidney disease and their meaning to your kidney’s health.
For those who have just obtained a creatinine or eGFR test result, our eGFR calculator might be useful to determine the meaning of your figure. Nevertheless, a healthcare professional should interpret your test results in light of your medical history.
Acute vs. Chronic Kidney Failure
| Aspect | Acute Kidney Injury (AKI) | End-Stage Kidney Disease (CKD Stage 5) |
|---|---|---|
| How fast it develops | Develops over hours to days. | Usually develops gradually over months to years. |
| Common causes | Severe infection, dehydration, certain medicines, or blocked urine flow. | Diabetes, high blood pressure, glomerulonephritis, or polycystic kidney disease. |
| Can kidney function recover? | Kidney function can often recover partly or fully if the underlying cause is treated promptly. | Lost kidney function generally does not return once CKD reaches end stage. |
| Usual treatment | Treatment focuses on the underlying cause; temporary dialysis may be needed in severe cases. | Treatment may include long-term dialysis, a kidney transplant, or conservative kidney care. |
What Happens if Your Kidneys Fail?
Understanding what takes place if your kidneys stop functioning requires knowledge of some of the important roles of the kidneys within your body. Your kidneys have numerous tasks that extend far beyond simply filtering waste from your blood. In addition to fluid regulation, mineral balance, blood pressure regulation, and bone health, your kidneys play a role in the production of red blood cells.
The following table shows the effects of kidney dysfunction.
What The Kidneys Normally Do and What Happens When They Stop Working
| Job the Kidneys Do | What Happens When They Fail? | What You May Notice |
|---|---|---|
| Remove waste products such as urea and creatinine. | Waste products build up in your blood, a condition called uremia. | Tiredness, nausea, poor appetite, a metallic taste in your mouth, and itchy skin. |
| Remove extra water and salt. | Excess fluid collects in your body. | Swelling in your legs and face, breathlessness, and unexplained weight gain. |
| Balance potassium levels. | Potassium levels rise, causing hyperkalaemia. | Often no obvious warning signs, but severe cases can cause weakness or an irregular heartbeat. |
| Maintain the body’s acid balance. | Acids build up in your blood, causing metabolic acidosis. | Fast breathing, fatigue and muscle loss. |
| Produce erythropoietin, a hormone that supports red blood cell production. | Red blood cell production decreases, leading to anemia. | Pale skin, tiredness, and breathlessness during physical activity. |
| Activate vitamin D and regulate phosphorus. | Mineral balance becomes disrupted, affecting bone health. | Bone pain, itching, and weakened bones. |
| Help regulate blood pressure. | Blood pressure may become difficult to control or rise further. | Headaches and additional strain on the heart. |
One serious result of kidney failure is uremia, wherein the waste products that would have otherwise been filtered out by normal functioning kidneys build up in your bloodstream. This affects various organs, such as your brain, heart, and digestive system, producing symptoms like nausea, itching, poor appetite, and inability to concentrate [5].
Not all of these symptoms need necessarily happen at once. Their intensity is dependent upon the amount of kidney function left and how rapidly this function deteriorates. This happens slowly in case of chronic kidney disease (CKD), which is the reason why people feel relatively healthy until the disease advances significantly.
End-Stage Kidney Failure Symptoms: Signs Your Kidneys Are Shutting Down
The symptoms of kidney failure generally develop only after the kidney function reaches 15% of its full capacity and generally develop slowly over many weeks. But symptoms of CKD do not generally appear during the early stages, and that’s why people are unaware of the reduction in kidney function. More about early signs of kidney disease.
As kidney function declines further, waste materials and excess fluid begin to accumulate in your body. The symptoms of end-stage kidney failure are as follows:
1. Signs of Waste Buildup: Constantly feeling tired, having symptoms of nausea and vomiting, lacking appetite, and losing weight. Some patients describe a metallic taste in their mouth or bad breath resembling ammonia. Other symptoms include skin itching, muscle cramps, sleep loss, and difficulty concentrating.
2. Signs of Fluid Build-Up: Swelling in the legs and feet or around the ankles or even in the face because of the extra fluid retained by the body. Shortness of breath and feeling breathless, especially when lying down, indicate that the fluid affects your lungs. Passing very small amounts of urine may be a sign that you have developed fluid buildup in your body, but some patients at advanced stages of kidney disease continue to pass a normal amount of urine.
3. Signs Requiring Urgent Care: Symptoms like chest pain, arrhythmia, confusion, excessive sleepiness, convulsions, or shortness of breath suggest serious complications that require immediate action. You should visit an emergency room right away at the onset of these symptoms. Do not wait until they go away on their own. For further details about seeking urgent care, refer to this guide.
In case of experiencing many of these symptoms or having a higher level of creatinine in your blood test or a lower value of eGFR, you should see a nephrologist right away.
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What Happens if Kidney Failure is Left Untreated?
If you have end-stage kidney disease and do not have dialysis or a kidney transplant, then kidney failure will eventually be fatal. This is due to waste, potassium, and extra fluid building up in the body. But this is treatable.
If kidney failure is left untreated, then the following problems can occur:
- Hyperkalemia: This is when the kidneys cannot remove enough potassium, so there is too much in the blood. Severe hyperkalemia can cause an arrhythmia, which can be very dangerous and even lead to cardiac arrest.
- Fluid Buildup in Lungs: Too much fluid can build up in the lungs, causing difficulty breathing. If the fluid is severe, it can become life-threatening.
- Cardiac Complications: Waste products can make the membrane around the heart inflamed (uraemic pericarditis), which can cause chest pains and other serious complications.
- Neurological Effects: Build-up of wastes can cause confusion, fits, and in severe cases can cause coma.
- Increased Risk of Bleeding: Uraemia can make platelets ineffective, causing the blood to have difficulty clotting [5].
These symptoms do not always occur together and can be different for each individual. If you suffer from suspected renal failure, you should get assessed by a specialist nephrologist quickly. If you are severely short of breath, have severe chest pain, are very confused, or are having seizures, you should seek emergency medical help.
There are many options available for treating kidney failure, based on your general health, kidney function, and how you want to be treated. These will be explained below.
Can You Survive if Both Kidneys Fail?
Yes, it is possible to survive if your two kidneys fail. Those suffering from end-stage renal failure will be able to survive with the help of dialysis, which helps in performing some of the vital functions of the kidneys, or transplantation of the kidneys that may help in regaining most of the lost functions of the kidneys.
Not all patients have to go through the procedures of dialysis and transplantation. Many older patients who suffer from various diseases opt for conservative kidney management, where the main focus remains on alleviating the symptoms and keeping the quality of life intact.
In one study conducted in the UK of those over the age of 75 years who suffer from a high burden of comorbidities, the median survival in the case of dialysis is 25.8 months and 20.4 months for conservative treatment. There was no statistical significance between the two [4].
Opting for conservative therapy does not amount to quitting. It is an individual therapeutic decision and should be considered after discussing it with your nephrologist and family, in light of your overall health status, risks and benefits associated with it, and your own preferences.
Your physician will be able to help you understand what the right choice is and what assistance you might require.
Do You Need Dialysis if Your Kidneys Fail?
The choice to commence dialysis therapy for individuals with ESKD is not decided on the basis of the results of one test or the level of the eGFR alone.
Commencement of dialysis is suggested to occur at the time of appearance of symptoms and complications of poor renal function that do not respond to other forms of therapy. Such problems may include fluid in the lungs, very high potassium levels, blood acidity, symptoms of uremia like nausea and confusion, or poor nutrition.
Dialysis is usually recommended to be commenced at an eGFR range of 5 to 10 mL/min/1.73 m². Some individuals require earlier commencement, while others should continue under observation. According to KDIGO, factors that should be considered include the presence of symptoms and signs, quality of life, preference, and lab values other than just eGFR [1].
Remember that there should not be any single value for high creatinine to justify dialysis or no dialysis. The physician will evaluate the pattern of your tests, your symptoms, and your general health.
Your kidney specialist will evaluate all of these and recommend the proper schedule and modality for you.
How Long Can You Live With Kidney Failure?
Although these can vary person to person and may not all occur together, suspected kidney failure should be seen by a nephrologist quickly. If you have severe shortness of breath, chest pain, confusion, or fits, then you should seek immediate medical attention.
How long you live will depend on many factors. These include your age, any other medical problems you have (particularly diabetes and heart disease), how well you are responding to dialysis, how regularly you receive dialysis, how well nourished you are, if you are able to have a kidney transplant, and your general health.
Factors that can affect survival are included in this table.
What Affects Life Expectancy With Kidney Failure
| Factor | Effect on Survival |
|---|---|
| Age | Younger patients generally live longer on any treatment. |
| Diabetes and heart disease | These are among the strongest predictors of shorter survival in patients receiving dialysis [4]. |
| Type of treatment | Kidney transplantation is associated with longer survival than remaining on dialysis [2] [3]. |
| Regular, adequate dialysis | Missing or shortening sessions increases the risk of dangerous potassium build-up and fluid overload. |
| Diet, fluid limits, and medicines | Following your prescribed renal diet, fluid limits, and medication plan helps manage complications and reduce strain on your heart. |
| Timely access to dialysis | Planning access, such as an arteriovenous fistula, before dialysis is needed can help avoid an unplanned start and emergency access procedures. |
Scientific studies have shown that transplantation offers survival advantages for certain patients. In one such study conducted in the United States, individuals with a kidney transplant had approximately two-thirds less chance of dying when compared to comparable individuals still on dialysis from the waiting list [2]. A review of 110 scientific studies concluded that most showed lower mortality rates, fewer heart conditions, and improved quality of life due to transplantation [3]. Nonetheless, this does not mean transplantation is right for everyone.
Nephrologist’s insight for medical reviewer approval:
If you are planning for a transplantation procedure, then you must read our article on post-kidney transplantation life.
Kidney Transplant vs. Dialysis: What are the Options When Kidneys Fail?
If your kidneys stop working properly, the two common ways of replacing kidney function include dialysis and kidney transplant. If you are healthy enough to undergo surgery, then a transplant should be the more ideal choice. Dialysis keeps you alive by doing some of the work of the kidneys until you receive a kidney transplant or if transplanting a kidney does not suit you [3].
Depending on your kidney function, your general health condition, preference for treatment, and eligibility, your healthcare provider may suggest the best way forward. Please refer to our guide to CKD treatment options.
What Happens When You Start Dialysis?
Who Can Get a Kidney Transplant in India?
Kidney Transplant vs Dialysis at a Glance
| Aspect | Hemodialysis | Peritoneal Dialysis | Kidney Transplant |
|---|---|---|---|
| Where | Usually a dialysis center; home treatment is possible in some cases. | At home. | Surgery in a hospital, followed by recovery at home. |
| Time commitment | Usually three sessions a week, about four hours each. | Daily exchanges or overnight machine-assisted treatment. | Recovery takes weeks, followed by regular check-ups. |
| Diet and fluid limits | Usually strict. | May be less restrictive, depending on your treatment and test results. | Usually fewer restrictions, but a healthy diet remains important. |
| Survival and quality of life | Generally less favorable than transplantation for suitable patients [3]. | Generally less favorable than transplantation for suitable patients [3]. | Generally the better long-term option for eligible patients [2] [3]. |
| Main drawbacks | Fixed schedule, fistula care and possible tiredness. | Risk of infection, including peritonitis, and a daily treatment routine. | Surgical risks, donor requirements, and lifelong immunosuppressant medicines. |
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Can Kidney Failure Be Reversed?
Kidney failure due to acute kidney injury often improves with prompt treatment of the underlying cause and, in some cases, short-term dialysis. But kidney failure at the end stages of chronic kidney disease cannot be reversed due to the kidney filters being replaced by scar tissue [1][7][8].
This can be an important distinction. With acute kidney injury, kidney function may return once you’ve received treatment for the cause, which could be severe dehydration, infection, drug-related issues, or a blockage in the urinary system. But in advanced chronic kidney disease, the damage is usually permanent. Treatment aims to manage complications and provide support to the functions that your kidneys are no longer able to perform.
Some people with chronic kidney disease can develop acute kidney injury. This is known as acute-on-chronic kidney failure. This means that after treatment, some kidney function may return. Your medical team will monitor your creatinine levels, eGFR, urine output, and general well-being to decide if you require long-term dialysis.
Important Warning
Be careful of any treatment that promises to “reverse kidney failure” or “remove the need for dialysis.” Stopping or delaying dialysis because of such a promise can be fatal. Always discuss any additional treatment with your nephrologist before trying it.
Not at Kidney Failure Yet? How to Protect the Kidney Function You Have
If you have an eGFR greater than 15 mL/min/1.73 m², taking these steps can help reduce progression of a drop in kidney function and delay the onset of kidney failure. Keep your blood pressure and blood sugar levels controlled, take any kidney-protective medications prescribed by your doctor, eat fewer salty foods, and do not take painkillers like ibuprofen unless advised to do so by your doctor [1]. Knowing why CKD can progress will help you identify what affects your kidney function. It is also important to know what everyday habits can cause damage to your kidneys.
Where Combination Therapy Fits
A Doctor’s Perspective
Living with CKD and want to support the kidney function you have?
Find out whether doctor-supervised combination therapy is suitable for your stage of kidney disease.
When to Get Urgent Medical Help?
Kidney failure could give rise to various complications that would require immediate attention from a physician. The moment you have any of the symptoms listed below, report to the nearest emergency unit or contact your doctor immediately:
- You find that you are passing less or no urine at all.
- You are breathless, particularly when lying down, and you are having increased swelling in your legs, feet, or face.
- You have chest pain, palpitations, an irregular heartbeat, or severe weakness.
- You are feeling confused or excessively sleepy, or you have had a seizure.
- You miss a dialysis session and feel ill as a result.
- You vomit repeatedly.
Do not wait until you start feeling better. If you are experiencing severe breathlessness, chest pain, seizure, or altered mental state, report immediately to the nearest emergency unit.
Conclusion: What Happens if Your Kidneys Fail?
What will happen in case of kidney failure? Toxic substances, fluids, and potassium will accumulate in the blood and affect your heart, brain, and other vital organs. Even though it is impossible to reverse end-stage kidney failure, it can be treated through either dialysis or transplantation of a new kidney. Dialysis keeps you alive, and many people survive for many years with the help of this treatment.
As for patients who are eligible for surgery, kidney transplantation gives much better chances for long survival and good quality of life than continuing to receive dialysis treatment.
In case you have CKD but have not yet developed kidney failure, proper control over your blood pressure and sugar, adherence to your treatment regimen, and timely check-ups can help you preserve kidney function.
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You can also explore kidney transplant in India and Combination Therapy for CKD.
Frequently Asked Questions (FAQs):
Q1. Can kidney failure be cured?
A. Kidney failure caused by acute kidney injury can often be improved with short-term dialysis. If the cause of kidney failure is treated quickly, then it can improve. But end-stage kidney disease caused by severe chronic kidney disease can’t be cured, as the damage is usually irreversible. Treatment will focus on trying to replace your kidney function using dialysis or a transplant. Managing any complications will also help you to be as well as possible [1][7].
Q2. If your kidneys stop working, will you be able to pass urine?
A. Yes. Many patients with severe kidney failure will still be passing urine. This can be at normal volumes. The kidneys carry out many roles, including producing urine and removing waste products from the blood. It is possible that your kidneys will still produce urine but be unable to pass sufficient amounts of waste, excess water, and toxins. This means that urine volume does not reflect kidney function [5].
Q3. Can you die suddenly from kidney failure?
A. Yes. If the kidneys fail badly, then levels of potassium in the body can become extremely high. This can cause a dangerous arrhythmia (irregular heartbeat) or cardiac arrest. This is why it’s very important to attend regular blood tests, follow your special diet, and attend dialysis appointments on time. If you suffer from chest pain, palpitations, severe weakness, or shortness of breath, seek urgent medical attention [5].
Q4. How long can you live on dialysis?
A. Individuals can survive for many years on dialysis. Survival depends on many factors, including age, diabetes, heart disease, nutritional status, and how well dialysis is being performed. Patients who have significant comorbidities may have less of a life expectancy. A good idea of how long you could live for can be given by your nephrologist after they have looked at your medical history, tests, and general health [4].
Q5. Is a kidney transplant better than dialysis?
A. A kidney transplant is generally associated with improved survival and quality of life for patients suitable for the operation. But it does require having a suitable donor, an operation, and taking anti-rejection medications for life. Not everyone will be suitable for a transplant. Your transplant team will need to take a look at your general health, risk of infection, heart function, and other medical factors to see if you would be suitable [2][3].
Q6. Can I survive without dialysis if my kidneys fail?
A. Yes, if you don’t have dialysis or a kidney transplant, then end-stage kidney failure will be fatal. But some elderly patients with multiple severe comorbidities will choose to have conservative kidney management. This means they don’t have dialysis but will manage their symptoms to keep them comfortable. This should be discussed with your nephrologist and family to determine if it would be of benefit to you or cause more problems [4].
References
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Medically Reviewed by MedicoExperts Editorial & Clinical Review Board on 12 November 2026
Medical Disclaimer: This content is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider regarding any medical condition or dietary needs.
