Kidney failure is detected by checking the blood for toxins normally cleared by the kidneys such as Urea and Creatinine. In kidney failure, the level of Urea and Creatinine in the blood will be raised. Ultrasound is usually done to check the size and texture of the kidneys as well as to look for stones or blockage to the kidneys. If both kidneys are shrunken, it usually means that the kidney failure has been present for sometime and the kidney damage is irreversible.

Ultrasound is not sensitive to detect early kidney failure. The kidneys will shrink only after the kidney damage has been present for a long time so a normal ultrasound does not always mean that the kidneys are normal.

Often people with mild kidney failure do not feel unwell. The condition is sometimes detected only during medical examination, urine or blood tests. In chronic kidney failure the kidney fails slowly and most patients do not feel ill until the kidneys have failed almost completely.

Symptoms of kidney failure are unfortunately vague and happens late. Often kidney failure does not cause any problems until the kidneys have almost completely failed. You may feel tired, less energetic, have poor appetite, nauseated and itchy. You also become more pale and your skin may darken and develop swelling in the feet or may be puffy in the face. Eventually you may start to vomit and become breathless. You can become pale and your skin may darken.

Most patients can still pass urine even when the kidney failure is very bad. It can take several years for dialysis patients to completely stop passing urine.

There are two types of kidney failure - acute kidney failure and chronic kidney failure. In acute kidney failure the kidney stops functioning suddenly. In many cases the kidney will recover if treated quickly. In chronic renal failure however there is long-standing kidney damage and scarring and it cannot be reversed even with medication.

Discuss with your doctor about definitive treatment for your kidney disease. However many kidney diseases cannot be cured and treatment will not cure any damage already present in the kidneys.

Even though the kidneys cannot be cured, you may be able to make your kidney last longer. If the kidney failure is mild and treated properly the kidney failure can be controlled decline can be stopped. The most important is strict blood pressure control. High blood pressure will make your kidney fail faster. Certain groups of high blood pressure medication may be better at protecting your kidneys. Discuss with your doctor. If you have diabetes, your blood sugar should be well controlled.

Exercise regularly. Do not smoke. Do not take any medication without consulting your doctor. Do not take any pain killers (apart from paracetamol) as it often will worsen your kidney failure. Do not take any traditional medication as they may contain substances harmful to your kidneys.

Limit the amount of protein you take. Do not take vegetables rich in protein for example beans, tau hoo etc. However be careful not to over do it without consulting your doctor or dietician. Reduce your salt and fat intake. If you are over weight reduce your calorie intake and exercise.

Regular check-ups are very important to check the blood pressure and your kidney function. Even if you have mild kidney failure, you will need follow-up for life as the kidney failure may worsen. Discuss with your doctor about how often you need to come back.

If your kidney failure is mild and treated properly the kidney failure may not worsen. In severe kidney failure however the kidney failure may become worse even with treatment. If this occurs, you may need to prepare for dialysis. If you require dialysis it is important that the preparation be done early. Discuss with your doctor.