The mortality rate of renal failure has improved in recent decades. However, certain factors can affect the ability to receive timely and effective treatment.

Renal (kidney) failure is the end stage of kidney disease. Also called end stage renal disease (ESRD), this life threatening condition means your kidneys do not work any longer.

Kidney disease itself is relatively common, affecting an estimated 2.4% of U.S. adults. Renal failure may develop in some people who have chronic kidney disease (CKD). Diabetes, high blood pressure (hypertension), or high cholesterol commonly cause CKD.

ESRD is not reversible, but dialysis or a kidney transplant may help extend your life. When left untreated, renal failure can be fatal.

Read on to learn more about the mortality (death) rate of renal failure, including all of the factors to consider, and how a doctor may treat this condition to help improve your overall quality of life.

Renal failure develops when the kidneys can no longer remove waste and excess fluids as they should.

Having CKD, especially when it’s undetected, can increase your risk of developing renal failure. Renal failure is also stage 5 CKD, the last stage of this condition.

While CKD is common, subsequent ESRD is not as prevalent due to early detection and treatment. It’s thought that about 2% of people who have CKD will go on to develop kidney failure.

It’s estimated that more than 500,000 people in the United States have renal failure. Globally, ESRD is thought to affect 144 out of every 1 million people.

The mortality rate of ESRD in the United States varies between 20% and 50% within 24 months of starting renal replacement therapies, such as dialysis. Hyperkalemia (high blood potassium levels) is the primary cause of renal-failure-related death, and cardiovascular events are second.

Overall, the mortality rate of ESRD has been declining in the United States since 2001. This is attributed to early detection and treatment of underlying health conditions that contribute to kidney disease.

However, there was an uptick in ESRD-related deaths in 2020 due to the COVID-19 pandemic. In 2021, it’s thought that COVID-19 was the third leading cause of death in people with renal failure who were also receiving hemodialysis.

The global life expectancy of ESRD varies by region and largely depends on access to care. For example, the 5-year relative survival rate of ESRD for people receiving dialysis is estimated to be 41% in the United States but 60% in Japan.

While the development of CKD and kidney failure is highly individual and based on numerous types of risk factors, research suggests that certain factors may also affect the mortality rate for people with renal failure in the United States.

First, CKD is more common in people of color as well as those with Southeast Asian ethnicities. Having a family history of renal failure may also increase your own risk of CKD and subsequent kidney failure development.

CKD can also develop at any age, but it’s more common in older adults as well as those who have certain chronic medical conditions, such as diabetes. It’s estimated that 6% of people 18 to 44 years old have CKD, while just over 38% of adults over 65 years old have it.

According to a 2022 study of ESRD in adults in Taiwan, researchers found prolonged survival and aging of the ESRD population, as people with the condition were living into their 70s.

They also found a lower mortality rate in younger adults, suggesting that both prompt treatment and age were factors.

If you do develop renal failure, age, ethnicity, and healthcare access are among some of the factors that may affect your outlook. ESRD also affects more males than females.

For example, information collected in the U.S. Renal Data System 2023 Annual Data Report found that the mortality rate declined among Black and Hispanic adults receiving hemodialysis for ESRD between 2020 and 2021. However, mortality rates among white adults increased.

Also, while there was an influx in mortality rate during treatment for ESRD between 2020 and 2021 due to the COVID-19 pandemic, researchers found the overall mortality rate was higher in kidney transplant recipients than in those who received dialysis for kidney failure.

Researchers have also noted disparities among people who are waiting for a potentially lifesaving kidney transplant.

In 2023, the National Kidney Foundation estimated that Black and Hispanic adults stayed on the waitlist 18 to 24 months longer than white adults, on average. People of color also have a higher risk of ESRD-related deaths than white people.

Furthermore, older, non-white adults and those without private health insurance continue to face disparities in transplant opportunities.

Renal failure is not reversible, but certain treatments can help manage this condition.

First, a doctor may recommend dialysis to help replace some of the functions that otherwise healthy kidneys can accomplish in your body. In some cases, a kidney transplant might be recommended.

Additionally, you may continue to receive treatment for any underlying health conditions contributing to reduced kidney function. These can include medications for diabetes and hypertension.

Also, while healthy lifestyle changes cannot treat renal failure alone, these may help reduce your risk of complications, such as heart disease or stroke.

If you or a loved one has renal failure, consider the following frequently asked questions you may wish to discuss further with a healthcare professional.

Can you recover from kidney failure?

Once you develop renal failure, the damage to your kidneys is not reversible. However, treatments and lifestyle changes can help stop further damage while reducing your risk of complications. These can also help improve your overall quality of life.

Also, while a kidney transplant cannot cure renal failure, it may possibly extend your life span.

How long can you live with kidney failure?

The 5-year survival rate for a person undergoing long-term dialysis in the United States is about 35%. It decreases to about 25% in people who also have diabetes.

When chronic kidney disease (CKD) is detected early, it’s possible to live for several years with ongoing treatment and management. In stage 5 CKD, renal failure develops. This condition can shorten your life span and be fatal without treatment.

The overall mortality rate of ESRD has improved in the United States, though the exact outlook is highly individual. Also, several disparities exist based on age, race, and ethnicity as well as socioeconomic status and access to treatment.

If you have received a diagnosis of renal failure, it’s important to talk with a doctor about all of the possible factors that might affect your condition and overall outlook. ESRD cannot be cured, but prompt treatment can help extend your life.