What is renal (kidney) failure?

When the kidneys fail, they are unable to carry out their normal functions, which include the removal of unwanted waste and extra fluid from the body.

Kidney disease (kidney damage) may be present without kidney failure but over time it is possible that disease may progress to kidney failure.

Are there different kinds of kidney failure?


Acute kidney failure occurs suddenly, e.g. after severe dehydration, injury or kidney inflammation (nephritis), and if diagnosed early enough can be reversed.

Chronic kidney (renal) failure (CRF) occurs when kidney failure lasts 3 months or more. It is usually irreversible. When renal failure becomes severe, dialysis is needed. For statistical purposes, chronic renal failure refers to Stage 3, or worse chronic kidney disease (CKD ≥ 3).

When there is kidney failure, are both kidneys damaged?


What are the signs of kidney disease?

You can have kidney disease without having kidney failure. Kidney disease may be silent.

However, symptoms and signs may include:

  • high blood pressure,
  • swelling of the body (oedema),
  • blood in the urine,
  • urine infections,
  • reduced or abnormally increased urine output, or
  • fatigue (due to low blood count).

Additionally, in children there may be:

  • poor growth,
  • failure to gain weight,
  • short stature, and
  • limb deformities (rickets).

Why do children get chronic renal failure (CRF)?

Unlike the situation in adults in whom chronic renal failure is mainly due to diabetes and hypertension, the majority of children develop CRF because they were born with abnormally functioning kidneys or urinary systems. The commonest of these abnormalities is related to the blockage of urinary drainage from kidneys and out of the bladder. In others, the cause may be nephritis (an inflammation of the kidney filters), the cause of which may be unknown.

How many children in Jamaica have kidney disease?

The number is not accurately known, but at least 150-200 children attend the paediatric kidney clinics at the University Hospital of the West Indies and Cornwall Regional Hospitals combined, while probably even more attend the paediatric kidney clinic at the Bustamante Hospital for children. Children with mild disease would most likely be treated by their general practitioners, paediatricians or at regional hospitals.

What are the statistics for chronic renal failure in Jamaican children?

  • About 20 children under the age of 12 years have chronic renal failure. (June 2017)
  • The mean annualized incidence of CRF in Jamaican children is 8.3/million children under age 12 years. (2012)
  • Each year about 4 new children develop chronic renal failure. (2012)
  • The prevalence of chronic renal failure in Jamaican children is 42.6/million children under age 12 years. (Based on 2017 estimates)
  • The prevalence of chronic renal failure in Jamaican adults over age 20 years was 327/million population. (1999)

What is dialysis?

Dialysis is the process by which the body’s impurities and excess fluid are removed by artificial means either by direct blood purification through a machine (Haemodialysis), or by using the lining of the abdominal cavity as a filter and removing wastes by fluid flowing into and out of the cavity on a prescribed schedule (Peritoneal Dialysis).



Peritoneal Dialysis

How often is dialysis done?

Dialysis for children is performed a minimum of 3 times per week.

How much does dialysis cost?

The cost of dialysis depends on the size of the child and the type and frequency of dialysis.

On average, each dialysis session costs about $7,600 JMD ($60 USD) – monthly $121,434 JMD (approximately $950 USD). (March 2017)

$1 USD: $128 JMD

How many children are on dialysis now?

There are now eight (8 children) on dialysis, two of whom are on home dialysis (August 2017).