Precursors of renal failure

Written by Li Liu Sheng
Nephrology
Updated on April 25, 2025
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The kidneys have a very strong compensatory ability. When kidney function is slightly impaired, many people do not have any uncomfortable symptoms and feel everything is normal. However, if one actively seeks out early signs, it is possible to detect precursors to kidney failure. At this time, if one can go to the hospital in time for routine blood tests, urine tests, and kidney function tests, it is possible to determine if there is kidney failure. The most obvious precursor symptom of kidney failure is usually general fatigue, which many people tend to overlook. This is because there are indeed many reasons that can cause fatigue, especially since many people attribute it to fatigue or stress factors. Additionally, many patients with precursors to kidney failure experience edema, particularly the kind that disappears after rest, so it is especially not taken seriously. Another symptom of kidney failure precursors is a significant increase in the frequency of urination at night, which is also often overlooked.

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Written by Zhou Qi
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Does chronic renal failure require dialysis?

Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.

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Chronic Renal Failure Treatment Plan

The treatment of chronic renal failure primarily requires a clear understanding of the cause, and treatment targeting the cause is essential to slow the progression of chronic renal failure. The most common causes of chronic renal failure are diabetes, hypertension, and chronic nephritis. Therefore, for patients with chronic renal failure caused by diabetes, insulin is often needed to control blood sugar. For patients with hypertensive kidney disease, antihypertensive drugs are certainly necessary to control blood pressure. However, in the early stages of renal failure, ACE inhibitors or ARBs are the preferred choices. For patients with chronic nephritis in the early stages, corticosteroid medications are required for treatment. However, if the serum creatinine has already exceeded 256 micromoles per liter, treatment then focuses mainly on managing complications, and corticosteroids are no longer used. (Please use medications under the guidance of a doctor.)

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Chronic kidney failure is not contagious.

Chronic kidney failure is not contagious. Strictly speaking, chronic kidney failure is not an independent disease; it is a state of disease. It refers to various causes that damage the kidneys, leading to the loss of kidney tissue, and ultimately, the kidneys lose their ability to perform excretory functions. This state is called chronic kidney failure. Chronic kidney failure itself is not contagious. Contagious diseases involve some type of pathogen, whereas the common causes of chronic kidney failure include chronic nephritis, diabetes, kidney diseases, hypertensive nephropathy, etc. None of these diseases are contagious, hence chronic kidney failure is also not contagious.

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Is stage five chronic kidney failure serious?

Strictly speaking, there is no condition called "chronic renal failure stage five," but there is a term "chronic kidney disease stage five." Chronic kidney disease is divided into five stages based on the glomerular filtration rate (GFR). Stage five chronic kidney disease indicates that the patient's GFR is less than 15 milliliters per minute, which is about 15% of normal kidney function and is essentially equivalent to uremia. Therefore, chronic renal failure or chronic kidney disease stage five is very dangerous and can cause many complications. Moreover, this type of kidney failure is irreversible and incurable, and the patient may need to undergo dialysis or a kidney transplant.

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What are the symptoms of chronic kidney failure?

Chronic kidney failure generally may have some clinical symptoms, but many patients do not have any discomfort. Some common clinical symptoms mainly include increased urine foam and decreased urine output. Due to the decline in renal function for urine excretion, it can lead to edema, particularly in areas such as both ankles and the face. In the state of renal failure, patients may also experience hyperkalemia and metabolic acidosis. Due to metabolic acidosis, patients might exhibit deep and labored breathing. In the advanced stages of kidney failure, patients may suffer from renal anemia, leading to fatigue and potentially experiencing bone pain and susceptibility to fractures due to renal osteodystrophy.