Diabetes and high blood pressure account for most cases of kidney failure. But genetics, autoimmune conditions, and direct injuries to the kidneys can also cause them to fail.

Kidney failure means your kidneys no longer function well enough to keep you alive without treatment.

In this article, we’ll discuss the most common causes of both acute and chronic kidney failure. We’ll also discuss kidney failure risk factors and provide information about prevention strategies.

Acute vs. chronic kidney failure

Kidney failure can be acute or chronic.

Chronic kidney failure is also called end-stage kidney disease (ESKD), end-stage renal disease (ESRD), or stage 5 chronic kidney disease (CKD). It’s due to the gradual loss of kidney function over time.

Acute kidney failure is also known as acute kidney injury. It’s due to a sudden and severe loss of kidney function or kidney damage that accrues over a few hours or days.

Unlike chronic kidney failure, which has no cure, acute kidney failure is often reversible.

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Diabetes and high blood pressure (discussed below) together account for 3 in 4 new cases of kidney failure in the United States, according to the Centers for Disease Control and Prevention (CDC).

Diabetes is the leading cause of CKD. About 1 in 3 adults with diabetes also has kidney disease. Both type 1 and type 2 diabetes put you at risk for this condition.

Your kidneys contain blood vessels and filtering units, called nephrons, that filter waste products, toxins, and excess fluid out of your blood. If you have diabetes, high blood sugar may damage these structures, reducing their efficiency. Over time, this damage can lead to chronic kidney failure.

High blood pressure can damage your kidneys. Damaged kidneys can also cause high blood pressure. You can break this cycle by keeping your blood pressure in a healthy range.

Part of your kidneys’ job is to regulate the amount of fluid circulating throughout your blood vessels. This is known as circulatory volume. Damage to your kidneys increases this volume, thereby increasing your blood pressure.

Uncontrolled high blood pressure can further damage blood vessels in and around the kidneys. This reduces their ability to filter the blood of excess fluid and toxins.

Over time, your arteries weaken, harden, or become narrow, limiting or halting their ability to deliver filtered blood to kidney tissue. Kidney failure can result.

Autoimmune diseases cause your immune system to attack healthy cells erroneously. Some of these conditions can damage your kidneys.

Some autoimmune diseases create inflammation and swelling within blood vessels, so your kidneys can’t efficiently remove waste products. Others cause clogging lumps, called granulomas, to form within your kidneys and other organs.

Autoimmune diseases that may cause kidney failure include:

CKD may sometimes run in families, but over 60 types of kidney diseases are inherited, meaning they are passed down from parent to child.

An inherited kidney disease may increase your risk of kidney failure. For example, autosomal dominant polycystic kidney disease (ADPKD) is the fourth leading cause of kidney failure.

Other inherited kidney diseases include:

Glomeruli are clusters of tiny blood vessels that act as filtering units within your kidneys. Glomerular diseases, which cause damage to the glomeruli, rank third among kidney failure causes in the United States.

These include glomerulonephritis, which is swelling and inflammation of the glomeruli, and glomerulosclerosis, scarring and hardening of the glomeruli.

Glomerular disease is often the end product of other diseases and conditions, such as:

  • infections
  • drugs or chemicals that cause damage to the kidneys
  • lupus
  • diabetes

Acute kidney failure comes on suddenly but is reversible. It’s usually due to one or more of the following:

Reduced blood flow to kidneys

Acute kidney failure may result from conditions that reduce or slow down blood flow to the kidneys, such as:

Direct damage to the kidneys

Damage to the kidneys can also cause acute kidney failure. Causes of severe, sudden kidney damage include:

Urine blockage

A blockage in your urinary tract can result in kidney failure. Conditions that may cause this include:

Having any of the above conditions, especially diabetes and high blood pressure, may increase your risk of kidney failure, especially if the condition is not well managed.

Other factors that increase your risk of kidney failure include:

  • Race: People of color are more likely to experience progression of CKD to kidney failure. Black people are also at greater risk of AKI. Socioeconomic factors may play a role, but researchers’ opinions are mixed.
  • Genetics: Specific gene mutations may increase your risk of CKD progressing to kidney failure.
  • Obesity: People with obesity have triple the risk of CKD progressing to kidney failure.
  • Smoking: People who smoke are more likely to develop kidney failure than those who quit or never smoked.

Most people with ESRD are 75 years or older, but studies suggest that the risk of renal failure from CKD may actually decrease as you get older. Researchers aren’t yet sure of the reasons for this paradox.

You can’t change your genetics, but certain lifestyle habits may help reduce your risk of kidney failure. Experts recommend the following tips to prevent kidney failure:

If you have kidney disease or any of its risk factors, regular checkups with a healthcare professional and following their recommendations can help you manage your risk.

Can you survive kidney failure?

Acute kidney failure is treatable and reversible. Chronic kidney failure isn’t reversible, but you live with it for many years, provided you get dialysis or a kidney transplant.

Can kidney failure be cured?

Acute kidney failure is curable as long as doctors can treat the underlying cause. There’s no cure for chronic kidney failure, but you can live and thrive with the condition if you receive proper treatment.

What are the first warning signs of kidney failure?

Early symptoms of kidney failure include:

  • edema (swelling of hands, ankles, and face)
  • changes in urine output, such as peeing more often
  • muscle spasms
  • extreme fatigue
  • food tasting metallic
  • dry, itchy skin
  • confusion
  • difficulty concentrating
  • nausea or vomiting

Kidney failure can result from chronic kidney disease or acute kidney injury. The leading causes of CKD are diabetes and high blood pressure. Other causes include inherited kidney diseases, glomerular conditions, and some autoimmune conditions, like lupus.

Kidney failure is fatal without treatment. If you’re at risk for this condition, talk with a healthcare professional about treatments and prevention strategies to address your specific risk factors.