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Signs and Symptoms of Dying With Renal Failure

author image Rebecca Dahlberg, MD
Rebecca Dahlberg, MD, has five years of clinical experience in internal medicine as a primary care provider. She brings this knowledge to her career as a physician writer and consultant. She is board-certified in internal medicine and nephrology.
Signs and Symptoms of Dying With Renal Failure
A woman is lying in a hospital bed. Photo Credit Ancika/iStock/Getty Images

The signs and symptoms of dying from renal failure can be recognized with some understanding of what happens in the body as the kidneys fail. The kidneys eliminate toxins as well as manage fluid balance and blood salts, called electrolytes. Chronic kidney disease is the term used when the kidneys are no longer functioning properly. This decrease in kidney function happens on a continuum. Typically, renal failure refers to the time when kidney function is so diminished that it cannot sustain life long-term. Left untreated, renal failure will result in death. It is important to remember that many of the signs and symptoms of renal failure are not specific to renal failure and can occur in other diseases.

Signs and Symptoms of Toxin Buildup

The most common symptom of dying from renal failure is fatigue. This results from the buildup of toxins in the body. Fatigue becomes more pronounced with time and is often the easiest symptom to recognize. In the end, an individual dying of renal failure will sleep often and may be difficult to wake up. Other common symptoms of active dying, related to the buildup of toxins, include:
-- Restlessness.
-- Confusion.
-- Irritability or agitation.
-- Poor appetite.
-- Nausea and vomiting.
-- Itchiness.

Signs and Symptoms of Fluid Buildup

Another common indicator of dying from renal failure is fluid buildup in the body. Often this begins as swelling in the feet and ankles, and moves up the legs. Fluid can also build up in areas of the body that cannot be seen from the outside. Fluid can collect in the lungs, around the heart and within the abdomen. The only indication that this is happening may be difficulty breathing. It may be harder for the person to walk, lie down flat or talk due to shortness of breath.


Pain may also be present when someone is dying from renal failure. The cause of the pain, however, may not be directly related to the renal failure. In some cases, the cause of the pain is a manifestation of the disease that led to the renal failure. Specific examples of causes of pain include:
-- Bone disease related to renal failure.
-- Diabetic nerve pain.
-- Fatty blockages in the arteries, called peripheral vascular disease, leading to leg pain.
-- Polycystic kidney disease leading to abdominal pain.
-- Calciphylaxis, a rare condition affecting the skin resulting from dialysis.

It is important to know that pain can be treated and controlled, and often the other signs and symptoms of dying from renal failure overshadow the pain in the end.

Palliative Care

The symptoms of dying with renal failure are often manageable with medications. The best medical specialty to guide end-of-life care is palliative care. The palliative care team -- usually consisting of a doctor, a social worker and nurses -- is committed to delivering compassionate care directed toward comfort. The palliative care providers work with the primary care provider and the kidney doctor. This team provides support to the caregivers as well as the dying person. It is possible for death to occur at home and away from the hospital, if that is the choice of the person receiving care.

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