Abstract. This article explores the complex pathophysiological mechanisms underlying the development of kidney failure. It highlights the key roles of hemodynamic changes, cellular injury, inflammation, oxidative stress, and hormonal imbalances in the progression of renal dysfunction. The chronic activation of the renin-angiotensin-aldosterone system and its contribution to fibrosis and nephron loss are discussed in detail. The article also examines how inflammatory processes and oxidative damage exacerbate kidney tissue injury, while hormonal disturbances contribute to systemic complications such as anemia and mineral imbalance. Emphasis is placed on the importance of early detection and targeted treatment strategies to slow disease progression and improve patient outcomes. The review concludes with a discussion on future research directions aimed at developing novel diagnostic markers and therapeutic approaches for kidney failure.