Unlike acute renal failure with its sudden (but reversible) failure of kidney function, chronic renal failure is slowly progressive. It most often results from some disease that causes gradual destruction of the kidneys and can range from mild dysfunction to severe kidney failure. Progression may continue to end-stage renal disease. Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly destroyed. In the early stages, there may be no symptoms. Progression may be so gradual that symptoms do not occur until kidney function is less than one-tenth of normal. Chronic renal failure occurs in approximately 2 out of every 10,000 people. Causative diseases include glomerulonephritis of any type (one of the most common causes), polycystic kidney disease, hypertension, Alport syndrome, reflux nephropathy, obstruction, kidney stones, infection, and analgesic toxicity. Diabetes mellitus is a major cause of chronic renal failure.

Chronic renal failure results in the accumulation of fluid and waste products in the body, causing low urine output and waste accumulation. These may occur without symptoms. Most bodily systems are affected by chronic renal failure.

Treatment of the underlying disorders may help prevent or delay development of chronic renal failure. Treatment focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.

Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, congestive heart failure, urinary tract infections, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated as appropriate. Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia.

Fluid intake may be restricted, often to an amount equal to the volume of urine produced. Dietary restrictions may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.

There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic renal failure. Dialysis or kidney transplant may eventually be required.

There are steps that can be taken, but must be taken early, to reduce the complications and symptoms as much as possible. Some ways to help prevent or slow down the onset of chronic renal failure include:-

• monitoring blood pressure regularly
• following recommended treatments for chronic diseases such as diabetes, lupus, and hypertension
• not smoking - for people with diabetes, smoking can speed up the damage to the small blood vessels in the body
• not abusing over-the-counter medications
• getting treatment for urinary tract infections or any type of urinary problems as soon as possible
• reducing autoimmunity activity