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Angels in Neon Genesis Evangelion

The Angels (使徒) are fictional entities from the anime television series Neon Genesis Evangelion, which was produced by Gainax studio and directed by Hideaki Anno. Angels also appear in the manga adaptation of the same name, which was illustrated by Yoshiyuki Sadamoto.

In the original animated work, almost all of the Angels are antagonists of mankind who repeatedly try to reach the headquarters of the special agency Nerv in the city of Tokyo-3. Most of the Angels originate from an entity called Adam, but the eighteenth specimen, humanity, is descended from Lilith, the second Angel. To counter the Angels' invasion, Nerv builds the Evangelions, mechas that just like the Angels have a force field called an AT Field.

The Angels appear in works from the animated series, in spin-off manga, video games, visual novels, in the yonkoma manga Petit Eva: Evangelion@School, and the Rebuild of Evangelion film tetralogy. The names of the Angels past Adam and Lilith, which are revealed in the fourteenth and twenty-third episodes of the series, refer to the namesake angels of the Judeo-Christian tradition. The characteristics and functions of each Angel are deliberately similar to those of their namesakes in ancient sacred texts. Their designs have been praised by critics and animation enthusiasts, and influenced subsequent animated series.

Conception
During the making of Neon Genesis Evangelion, the production staff decided to set the work on a battle between gods and humans. In one early draft, which was published about two years before airing, Gainax included enemies named Apostolos (アポストロ), which they conceived as ancient relics scattered all over the globe and left in hibernation by a species called "First Ancestral Race" (第1始祖民族). These enemies were referred to as simple weapons with almost no biological component. According to Gualtiero Cannarsi, the editor who was in charge of the first Italian-language edition of the series, the Gainax studio members might have been inspired by James P. Hogan's Giants series, Arthur C. Clarke's short story "The Sentinel" and 2001: A Space Odyssey. The Apostolos would have been the servants and apostles of the giant Adam, the divine sentinel of a distant alien race formed long before humanity, drawing on Hogan's evolutionary and science fiction themes. Anno also drew inspirations from classic carnivorous kaiju such as Gyaos from the Gamera franchise and Gaira from the 1966 film The War of the Gargantuas.

The original authors intended there to have been twenty-eight enemies, the first of which, Adam, would have been found in the Dead Sea region but destroyed in an explosion fifteen years before the events of the series. The initial scenario also included the introduction of two Apostolos named Shateiel (シャテイエル), which was described as the "Angel of silence" and Turel (テゥレル), "the rock of God". Writer Virginie Nebbia compared Turel design with the Emperor Neo mask from Nadia: The Secret of Blue Water. The project was shelved during the production, but the ideas were recycled for the Angels Ramiel and Sahaquiel. The first episode would have featured a confrontation between the Eva-01, with Rei as its pilot, and an Angel named Raziel, a "metal Angel", which would have had anthropomorphic features similar to those of a giant. In the twenty-fourth episode, titled "Now, the Promised Time" (今、契約時間), there would be a great lunar battle against twelve Apostolos; humans would realize their helplessness in the face of their enemies' overwhelming superiority and "the promised time" would approach. For their number, the authors took inspiration from the twelve apostles of the Lamb that are mentioned in the book of Revelation, but the idea of multiple clashes on the Moon was abandoned, eventually being recycled for the battle against the nine Mass Production Model Evangelions in the 1997 theatrical conclusion.

Another scenario planned two ancient prehistoric civilizations equipped with advanced technology appearing on Earth before the appearance of humanity. The first of the two, known as the "First Ancestral Race", would create artificial humanoids Evangelion, which would then rebel against their creators causing their extinction. A "Second Ancestral Race" would then create the Spear of Longinus in an attempt to defeat them, scattering the dormant Angels around the globe in case anyone tried to reactivate the humanoids. Moreover, in a draft of the twenty-first episode of the series, Misato would mention the origin of the enemies, saying; "I know the Angels aren't just battle weapons left by the First Ancestral Race". According to Nebbia, staff took inspiration both from Nadia and Nausicaä of the Valley of the Wind for the scenario, in which ancient civilizations are destroyed by their own creations, while for the opposition between Adam and Lilith Gainax possibly took clue from the works of artist Daijiro Morohoshi. Nebbia also compared Angel red core with Ultraman's Color Timer, and the AT Field to the Ideon's barrier from Space Runaway Ideon.

In the final version of the show, the Angels were renamed and indicated in the characters' dialogue with the word Shito (使徒), after Jesus twelve disciples, rather than the term Tenshi (天使), with which the angels of the Christian tradition are usually indicated. Within the series' narrative, Gainax chose to use the English translation for Angel, "messenger", which is written in Latin characters and is readable in graphemes and written in overlays, as in the case of Nerv's computers. Michael House, the only American member of Gainax, protested about the juxtaposition of the two terms, but Hideaki Anno decided to keep the dual naming of the enemies.

In one early draft of the series, the Nerv's supercomputer, the Magi System, would assign a name to each Angel. The director gave general guidelines for the design of each Angel. Their shapes became reflections of the feelings of Anno's generation, reflecting the climate of Japan in the 1990s. During the broadcast of the series, the Japanese economy and society were perceived in the country as inherently corrupt and decadent, with no one being able to trace the causes, making the concept of "enemy" ambiguous. The enemy of twentieth-century Japan, according to Anno, was neither political nor defined, as in the case of the religious sect Aum Shinrikyō, which in March 1995 attacked the Tokyo subway with sarin gas. The Angels and the character Gendo Ikari were represented as amorphous beings, since for the director the concept of "enemy" is per sé undefined.

Mahiro Maeda drew Gaghiel and Israfel, while Yoshitō Asari designed Sachiel, Shamshel, and Zeruel. The artists avoided giving them anthropomorphic designs, which would have been more challenging during production. In the first two episodes, in which Sachiel appears, the staff had enough resources to hire animators, but for the fifth and sixth they already changed course.

Characteristics
Angels are organic beings whose atomic structure has both particle and wave nature, and therefore characterized by the wave-particle duality of light. At the beginning of the series, their objectives and identity are unknown. but they are all attracted by an Angel – called Lilith – that is locked in the deepest section of the Nerv's headquarters, the Terminal Dogma. Academic Thouny described them as "polymorphous figures of destruction that mark irruption of the world into the everyday, the opening of the social structure to alterity and death". The Angels' genetic makeup has a 99.89% affinity with that of humans. They can change shape from vaguely anthropomorphic to that of a geometric solid, and equally variable sizes. Many are equipped with a red sphere known as the "core" or "sphere of light", which is also their main source of energy and weakness. The "fruit of life", an organ of unknown nature, is responsible for their regenerative abilities. Humanity, the last example of an Angel, has the "fruit of knowledge" instead.

Angels have the universal ability to generate a force field called the Absolute Terror Field, or simply AT Field, which is similar to that of Evangelion units and makes them nearly indestructible. Their names and attacks have been prophesied in the Dead Sea Scrolls, ancient documents in the possession of a secret organization called Seele. The reason they appear in Tokyo-3 one at a time, never attacking collectively, is unknown. In the opening sequence of the seventeenth episode, Nerv director Gendō Ikari says the Angels "are beginning to attain intelligence". According to academic Satoshi Tsukamoto, the sentence means that the Angels "are attempting to acquire abilities to compete against human beings and control them". Writer Kitamura similarly stated that the Angels gradually make progress in communicating with the Evas they fight and send message to them during the series. According to a guide on the series contained in a manual for the card game Neon Genesis Evangelion RPG (新世紀エヴァンゲリオンRPG), there is a connection between the Angels; each Angel seems to be an evolutionary outgrowth of the previous one, and the fact they attack one at a time suggests they are aware of the status of each of the other specimens and react accordingly.

Adam
Adam (アダム) is the progenitor of most of the Angels. It is represented as a giant of light with features similar to those of an Evangelion. A research team named the Katsuragi expedition, lead by Misato Katsuragi's father, finds Adam in Antarctica and begins to examine its energy source, the S2 engine. The scientists of the expedition accidentally awaken Adam as a result of a contact experiment, causing a planetary catastrophe known as the Second Impact to occur. Half of the human population dies, and Adam is reduced to an embryonic state. Behind the event is the secret organization Seele, which is devoted to the search for the "path to Adam Kadmon". Agent Ryoji Kaji transports Adam to the Nerv headquarters, handing it over to the commander of the agency, Gendo Ikari. Adam's soul is incorporated in the seventeenth Angel Tabris, while its embryo is implanted into Gendo's body. Adam is cloned and used as basis to build the Evangelions, with the only exception of Eva Unit 01, created by Lilith.

Its name comes from the Biblical Adam. In the Book of Genesis, God creates Eve, the first woman, from Adam. In the twenty-first episode of Neon Genesis Evangelion, it is revealed the Evas were similarly created from Adam. In the Jewish Kabbalah, Adam is described as a kind of deity, a being that is capable of giving life and as an entity to which all things are destined to return at the end of time. According to writers Kazuhisa Fujie and Martin Foster, in the series Kaworu Nagisa states "those who come from Adam must return to Adam" referring to this tradition.

Critic Marc MacWilliams noted Evangelion Adam is portrayed as a giant being of light "as portrayed again in Kabbalistic texts before his Fall". Academic Fabio Bartoli likened Adam's role to the Kabbalistic concept of Adam Kadmon; in Hermetic terminology, Adam Kadmon refers to humanity in a state of mental and spiritual perfection. He is also described in Kabballah as an androgynous being. In the twenty-fourth episode of the series, Kaworu Nagisa describes Adam as the "mother" of all Angels. Carl Gustav Horn similarly noted; "the Kabbalistic view is that all other creatures without exception – even the angels and archangels – are based on Adam (Kadamon) but were left incomplete: only Adam (of Genesis) was a complete image of the Divine". A being named Adam was also introduced by Gainax in the series Nadia.

Lilith
Lilith (リリス) is the second Angel. It is kept in the Terminal Dogma, the deepest section of the Nerv headquarters. Lilith's face is covered with a mask on which are drawn the seven eyes of a symbol called the Seele emblem. Lilith has the appearance of an anthropomorphic giant whose hands are nailed to a cross. Instead of lower limbs, it has small, humanoid legs. Lilith is pierced on the cross by a weapon called Spear of Longinus. The soul of the Angel is kept inside Rei Ayanami. In the film The End of Evangelion (1997), the Angel's body unites with Rei, takes on the form of a giant Ayanami, and grows to the size of the Earth, developing a giant anti-AT Field and starting the Third Impact, an event in which the souls of all human beings merge into one being. Writer Gerald Miller noted that just as the intercourse between Adam and Eve was the genesis of humankind's lineage in the Judeo-Christian story, so does the union of Adam and Lilith lead to "a new genesis for humankind".

Lilith, according to the video game Neon Genesis Evangelion 2, arrived by chance on Earth in a celestial object called Black Moon, also called Lilith's Egg, which along with a White Moon of Adam was sent by an alien "First Ancestral Race". The Angels are thus the legitimate successors of Adam and the original inhabitants of Earth. The video game also says; "Some [Angels] were trying to access Lilith and reset all life, some of them had nothing in mind, and some were trying to recover their progenitor Adam". Writer Virginie Nebbia compared Lilith's arrival on Black Moon to Ultraman's arrival on a red sphere in the series of the same name.

Its name comes from Lilith, Adam's first wife. According to Jewish legends, demons called Lilim were born from their union. The Angel Lilith's design was elaborated upon by Mitsuo Iso. According to character designer Yoshiyuki Sadamoto, the original scenario did not include Lilith, which was introduced following the airing of the series and some staff research on Christianity because "not touching Lilith seemed to hurt Anno's pride".

In the Rebuild of Evangelion tetralogy, Lilith is present from the beginning. Misato shows Lilith to Shinji before the battle against Ramiel. In the saga, Lilith's aspect has been modified by animator Okama and Hideaki Anno: in Evangelion 1.0 (2007) Lilith has scars on its chest, the result of scientific experiments; its mask is similar to that of the Angel Sachiel. Lilith, along with Rei and Eva-01, has been compared to the Jungian archetype of the Great Mother, the feminine authority that represents protection, fertility, darkness and inescapable abyss. Its role can also be likened to the astrological concept of the Black Moon, which is also named Lilith.

Sachiel

Sachiel (サキエル), the third Angel, has an anthromophorpic appearance. On the upper part of its trunk, it has a disk that is similar to a face, while on the outer sides of the legs it has two gills. Once on land, the armed forces of the United Nations attack Sachiel, which can survive the UN's most powerful weapon, the N2 mine. The attack damages Sachiel's face and temporarily stop its advance. Sachiel then regenerates and replaces its face with a second face. After the crash, Sachiel learns how fighter aircraft work and can replicate their effectiveness, developing the ability to launch explosive light beams. It can also use a pair of "protractile spears" or "spears of light" incorporated into the forearms. In the second episode, "The Beast", Sachiel fights with Eva-01, which goes into a berserk mode and manage to defeat the Angel. Eva-01 neutralize Sachiel's AT Field, and Sachiel commits suicide self-exploding.

Its name comes from Sachiel, the angel of water. Sachiel is considered a cherubim, who according to the Old Testament protect the tree of life with spears of fire, a detail that possibly inspired the fictional Angel's protractible spears. Academics Sellés de Lucas and Hernández-Pérez linked its second face to the Book of Ezekiel, where cherubims are described as having four heads. The authors initially intended the Angel to fight at sea against Unit 02 in the eighth episode "Asuka Strikes!", but this idea was set aside and used for Gaghiel. Writer Dennis Redmond described it as a "strangely abstract, gilled creature" and a "neo-Expressionistic Godzilla". Sachiel is based on Ishtar, an android that appears in the manga Wahhaman by Yoshitō Asari; its back is inspired by that of a cat. Writer Virginie Nebbia also compared its design to Jamila from Ultraman and King Bockle from Return of Ultraman. At the storyboard stage, Sachiel's figure had different connotations and its fight was similar to the Ultraman battles. In the Rebuild of Evangelion, Sachiel is referred to as the fourth Angel. The animators superimposed images of a light reflecting on an expanse of water and one of the Milky Way on its luminescent core.

Shamshel
Shamshel (シャムシェル), the fourth Angel, has an insect-like appearance and its form fuses that of a mollusk and that of a cetacean. Although it has limbs, Shamshel slowly flies at low altitude, to avoid detection by Nerv radar equipment. Shamshel uses two weapons that are similar to luminescent whips that have high cutting capabilities, which can pierce the abdomen of the Eva-01 in battle. Shamshel is shot down by the Unit 01, which pierces it with a weapon called Prog-Knife. According to Ritsuko Akagi, the DNA map of the Angel corresponds with 99.89% of that of human DNA.

Its named after Shamsiel, who is believed to be the angel of the day. The name, according to official sources, is an allusion to its fight with Unit 01, which takes place in daylight and ends just before sunset. Its appearance is similar to that of an Alien Bira from Ultraseven, and is inspired by that of a creature called "the three-meter extraterrestrial", whose garage kit was made by a Gainax-associated company called General Products. Its battle took inspration from the Ultraman battles by director Akio Jissoji. In the Rebuild of Evangelion, Shamshel is the fifth Angel. Shamsiel's torso opens into a set of articulating ribs that claw the air like crab legs.

Ramiel
Ramiel (ラミエル) is the fifth Angel. Its body is a regular octahedron. A 17.5 meter wide drill, which pierces the strong armor of the underground Nerv headquarters, extends from the lower body. Ramiel is equipped with a strong AT Field and an accelerated-particle cannon, which, exploiting the collision of subatomic particles, emits a powerful beam of photons due to an inner torus reactor. Ramiel's core, unlike those of previous Angels, is located inside its body, overcoming the biggest weakness of its predecessors and revealing the existence of a direct link between the Angels. In the fifth episode, "Rei I", Ramiel strikes the Eva-01 with its light beam before the mecha's exit to the surface. To face the threat, in the episode "Rei II" Misato Katsuragi conceives a strategy called Operation Yashima to destroy Ramiel, involving both Eva-01 and Eva-00. At the end of the fight, the mecha hits Ramiel with a positron cannon, permanently destroying it.

As a source of inspiration for Ramiel, the authors took the monster Pris-Ma (プリズ魔) from Return of Ultraman. Anime News Network's Lynzee Loveridge described Ramiel's design as "Anno's shout out to Future Police Urashiman", while Yasutaka Yoshimura compared it with some abstract shapes in the final scenes of Stanley Kubrick's film 2001: A Space Odyssey. It is named after Ramiel, the angel of thunder, in reference to its particle cannon. Initially, in correspondence of each face of the octahedron Ramiel would have had a solid, floating, triangular shape and its beam of light would have used positrons. In the first Rebuild of Evangelion film, Ramiel is referred to as the sixth Angel, and it can transform its regular octahedron form into a variety of solids. For the Rebuild design, the staff took inspiration from the microorganism Andromeda from the science fiction film of the same name and an image depicting a four-dimensional body moving in a three-dimensional world that Takashi Watabe drew twenty years earlier.

Gaghiel
Gaghiel (ガギエル), the sixth Angel, appears in "Asuka Strikes!" in the Pacific Ocean and goes to attack the UN fleet, which is transporting Eva-02 and secretly the embryonic form of Adam. Gaghiel resembles an aquatic creature; its body has fin-like appendages and a hydrodynamic shape, allowing it to quickly move through water. The upper body has a face identical to the faces of Sachiel. The Angel attacks the naval fleet using the bulk of its body, sinking ships. When approaching its targets, it opens its mouth and squeezes its enemies in its jaws. Gaghiel's core, unlike those of previous Angels, is located inside the mouth.

During the fight, Gaghiel jumps onto the aircraft carrier Over the Rainbow and moves to attack the Eva-02. The Angel and the Eva crash into the sea in the Itō area. Its body is 600 m long. Eva-02 neutralizes the Angel's AT Field and opens its mouth to allow two armored warships, which were evacuated and sunk with the Kingston valves, to penetrate its jaws and fire on the Angel's core. The operation is successful and Gaghiel is defeated by Asuka Langley Soryu and Shinji Ikari. The behavior of the Angel, which appeared at sea away from Tokyo-3, is attributable to the presence of the first Angel Adam on the ships of the fleet.

The name Gaghiel (Hebrew: גגיאל), also called Gagiel, Daghiel or Dagiel, in Judeo-Christian folklore is the angel of the fish. Its Hebrew name can be translated as "roaring beast of God", and has been interpreted by writer Will Raus as a possible allusion to its appearance, which is similar to that of a beast fighting in the water.

Israfel
Israfel (イスラフェル) is the seventh Angel. Asuka Langley Soryu, aboard her Eva-02, strikes it with its Sonic Glaive splitting it in half. After the attack, the Angel regenerates into two parts, both of which able to fight individually. Israfel attacks and defeats the two mechas, which return to their base to await a second confrontation. Following their first defeat, the UN armed forces attack Israfel, the two parts of which they nickname Kō and Otsu. Thanks to the use of N² weapons, the UN can temporarily stop its advance. The only way to defeat Israfel, according to Misato, is "a double coordinated attack on its core"; between the two parts of the divided Angel is a bond that allows Kō and Otsu to share their behaviors and vulnerability. After a regeneration process, the Angel merges, regains its original form, and again begins its advance. In the second clash with the units, Israfel imitates the weapons used against it in the first battle, launching rays with high destructive potential against the Eva and using its upper limbs as blades. During the fight, Eva-01 and Eva-02, moving in synchronization, attack the Angel. Israfel splits again, and the two units jump into the sky, launching a synchronized kick that destroys its cores.

The seventh Angel is named after the messenger of music and resurrection, Israfil (Arabic: إسرافيل), a detail related to the musical attack of Eva-01 and 02. According to Will Raus, Israfel's role of resurrection could allude to the Angel's ability to split. The terms Kō and Otsu come from the series of Heavenly Stems. Writer Virginie Nebbia compared Israfel with Pestar from Ultraman. Its capacity of fission and brithness have been compared with those of a single-cell organism and mercury.

Sandalphon
Sandalphon (サンダルフォン), the eighth Angel, is detected inside the volcanic crater of Mount Asama in a human-embryo-like state and enclosed in a chrysalis. The Nerv decides to attempt to capture it, but the being awakens during the attempt and quickly mutates. Gualtiero Cannarsi, editor of the first Italian adaptation of the series, compared its adult form with the Limanda fish. Sandalphon collides with Eva-02, demonstrating high levels of physical endurance. Its core is concealed within its body and is not visible to observers. During the fight, Asuka and other Nerv members using the concept of thermal expansion to develop a plan to defeat it. Eva-02, using a coolant in its equipment, causes Sandalphon to undergo thermal constriction, resulting in damage to its body structure.

The fictional Angel's name alludes to Sandalphon, the angel of embryos. During its metamorphosis into its adult form, the producers included a plaintive background voice using the electronically distorted howls of an infant. The Angel's design took inspiration from prehistoric creatures such as the trilobite and the Anomalocaris. The idea of an enemy-capture attempt was planned for the eleventh episode, but moved to the tenth during the production. According to a guide on the original series contained in the game Neon Genesis Evangelion RPG, the Sandalphon episode suggests dormant, larval Angels are hidden around the world. An official encyclopedia on the series links its appearance with the biblical Book of Enoch, in which the word "Heaven", the abode of angels, actually refers to an Earthly location; because Sandalphon is discovered in the magma chamber of a volcano, Evangelion Angels similarly exist "in the same world as ours". According to writer Virginie Nebbia, for Sandalphon's battle staff took inspiration from the novel Sundiver.

Matarael
The ninth Angel, Matarael (マトリエル), resembles an arthropod arachnid chelicerate. Unlike arthropods, it has a single central body, from the top of which extends four oversized legs, making it akin to the opilionid subclass. The main body is similar to a geometric solid obtained from the section of ellipsoid, reminiscent of an upside-down turtle. Nine human-eye-like drawings are evident on its main body. The eyes are arranged in an equilateral triangle, and one of them is placed at the center of the body's lower section; from the central eye it pours a corrosive liquid on its enemies. The acid is likely produced by an exocrine gland inside the Angel. Once ashore, Matarael invades Tokyo-3 and decides to penetrate Nerv by corroding an armored portcullis leading to the organization's headquarters. The Angel pours its acid into the wells dug in the sixth episode of the series by the Angel Ramiel, and its strategy suggests it is mindful of its predecessor's actions. It clashes with Eva 00, 01 and 02, which defeat it with gunfire.

The name Matarael (Hebrew:מטראל) comes from the Book of Enoch, which describes it as the angel of rain. The name of Evangelion Matarael refers to its offensive strategy and its powerful, corrosive acid, which it rains on its enemies.

Sahaquiel
Sahaquiel (サハクィエル), the tenth Angel, appears in Earth's orbit above the Indian Ocean using its body as a bomb. Its symmetrical body shape is similar to that of some single-celled organisms such as amoebas. On its body are three geometric figures that resemble the human eye, with a big central eye in which the core is located. Before attacking the Nerv headquarters, Sahaquiel detaches some small portions of its main mass that are equipped with an AT Field, and hurls them to the ground to correct its trajectory. Gualtiero Cannarsi compared its ability to divide with the budding of protozoa and mesozoa. It can materially interfere with Nerv's military equipment, destroying a research satellite and jamming enemy ground communications. Its destruction requires the collaboration of all the three Evas owned by Nerv. Once it arrives at Tokyo-3, Sahaquiel is jammed by Unit 01, while its AT Field is breached by Unit 00. Eva-02 destroys its core, defeating it.

For Sahaquiel staff took inspiration from the angel of the same name, the angel of the sky and guardian of the fourth heaven of Paradise, which is referenced in the fictional Angel's aerial attack strategy. The connection with the biblical Sahaquiel's guardian function is realized in its elongated shape, which resembles that of a deformed eye. The name Sahaquiel (Hebrew: סהקיאל) is translatable as "Ingenuity of God", which Will Rauss interpreted as a possible allusion to the Angel's uses of its AT Field. Its design was inspired by surrealist art. In the initial draft, Sahaquiel had a sharp, string-shaped body similar to Armisael's. Sadamoto drew the Angel to show Evangelion enemies may not always be anthropomorphic, like Seele.

In the Rebuild of Evangelion tetralogy, Sahaquiel is introduced as the eighth Angel. Its design by Mahiro Maeda has several changes; in the movie Evangelion 2.0, its AT Field is powerful enough to distort the path of light and its body, which was initially spherical, unravels and changes shape, revealing silhouettes of humans on its surface. At the bottom of its main body, Sahaquiel develops an anthropomorphic entity that pierces Unit 01's hands with spear-like weapons, which were designed by director Takeshi Honda. Masayuki suggested having Sahaquiel die in a wave of blood that floods Tokyo-3, which was inspired by the tokusatsu tradition and the scene in which Sapporo collapses in Japan Sinks (1974).

Iruel
Iruel (イロウル) is the eleventh Angel, which first manifests itself as corrosive stains on a wall of the Nerv headquarters. At this early stage, Iruel behaves as an obligate anaerobic bacterium. Nerv attempts but fails to eradicate Iruel by increasing the presence of ozone in the air, but Iruel starts a fast evolution process which allows it to resist to ozone. Iruel is a biological microprocessor and a colony of microscopic nanomachines-sized individuals rather than a single Angel. These singularities, similar to bacteria, are united in an agglomeration that quickly evolves radically to take on the form of a computer. Iruel hacks and seeks the access code to the three Magi supercomputers, the most important part of the structure, to activate a program of self-destruction at the headquarters. Dr. Ritsuko Akagi devises a "reverse hacking" strategic plan, believing it is better to increase the enemy's evolution and insert a program to make Iruel choose to coexist with the Magi System. Ritsuko's program defeats Iruel, saving Nerv's headquarters.

Mitsuo Iso suggested a battle against an invisible enemy and the basic plot. In religious texts, Iruel is referred to as the angel of fear. Writer Will Raus interpreted the sense of dread felt by Nerv members during its attack as a reference to the biblical angel. Evangelion Chronicle encyclopedia likened the Angel's program of self-extinction with cellular apoptosis, while coexistence with the Magi System as a form of symbiosis. Iruel's properties, such as self-replication, are similar to those of a universal molecular assembler.

Leliel
Leliel (レリエル), appears as a black-and-white-streaked floating sphere and a black shadow. The spherical body is its true shadow, while the apparent shadow on the ground is the main body. The Angel is 680 m wide and 3 nm thick. It extends its AT Field in the vicinity of its enemy, a process that coincides with the manifestation of the apparent shadow, which is capable of engulfing the matter it encounters. This physicality is maintained using an inverted AT Field, within which extends a dimension called "number-imaginary space", a parallel dimension known as the "Dirac Sea". During a fight, the dark shadow extends to the feet of the Eva-01 and begins to engulf it. It is not made clear whether Leliel's goal is the absorption of the humanoid or direct contact with its pilot, Shinji Ikari. Dr. Ritsuko Akagi devises a strategy to destroy Leliel and recover Unit 01 using all existing N2 bombs. During the countdown to ordnance release, the spherical body breaks and Unit 01 emerges, causing an anomaly in the imaginary number circuit and shooting down the enemy.

To explain the Angel's nature and its Dirac sea, Ritsuko said its body is made up of strings. Leliel is the angel of the night and is called the "prince of conception". The fictional Angel's shadow and the outflow of Unit 01, which resembles childbirth and gives it the characteristics of a womb, allude to the biblical angel. Geometric figures similar to female genitalia are also visible in its pattern. Its name means "jaw of God", which Will Raus interpreted as a reference to the fictional Angel's ability to consume any object. Its design is inspired by Surrealism and optical art. Japanese architect Yasutaka Yoshimura compared Leliel's design with Bridget Riley's work Fragment 5. Writer Virginie Nebbia compared it with Dada from Ultraman, while academic Dennis Redmond noted that Neuromancer makes use of moiré patterns in a scene in which Case tries to break free from a neural trap set by one of the AIs of the story.

While trapped inside the Angel, Shinji encounters and converses with another self, which is presumed to be Leliel. The scene, which is set on a train, was the idea of Kazuya Tsurumaki, who took inspiration from a dream he had as a child. The staff decided to include an episode with an Angel that is interested in humans to avoid revealing the riddles about the Angels' true nature. For the clash, Gainax condensed the ideas of what would have been a trilogy of episodes with the same theme. In the initial scenario, Leliel would select Japanese from the verses of some animals and several human languages so it could communicate with Shinji. Tsurumaki and the production staff changed their minds, finding the idea of an Angel conversing in human language "too anti-climactic" and "pulp fiction". According to the official film books of the series, the two Shinji in the sequence represent the psychological concepts of ego and superego. The Dirac Sea depicted in the anime took inspiration from Paul Dirac's concept of the same name and is also drawn from the novel Ten Billion Days and One Hundred Billion Nights (億の昼と千億の夜) by Ryu Mitsuse.

Bardiel
Bardiel (バルディエル) has a nature similar to that of a fungus or a parasitic bacterium, which allows it to infiltrate the body of the Eva-03 during its transport by air from the United States of America to Japan. After the contamination, a crack opens on the unit's back, inside which molten filaments similar to hyphae are visible. During its advance towards Tokyo-3, Bardiel fights against Eva-02 and Eva-00, making a white, irritant liquid drip inside the unit's body. Bardiel's attack mode does not belong to a single being, but to a colony of microscopic Angels. The Angel is defeated by Shinji Ikari's Eva-01, which is activated by a new piloting system named the Dummy System, which destroys the infected Evangelion.

It is named after Bardiel, angel of hail and lightning. The fictional Angel's contamination of Unit 03 during its passage in a blanket of storm clouds alludes to the biblical angel. Writer Dennis Redmond interpreted the scream of the infected Eva-03 as a reference to Godzilla. Redmond also noted that Bardiel is framed against a setting sun reminiscent of the Japanese flag in the episode. According to him, this is "a dead ringer for John Woo's Hong Kong thrillers, and the conclusion will subtly quote Woo's trademark theme of warring brothers or battling doubles". Most of the scenes where Bardiel appears were produced by Production I.G, who also contributed to the animation of the fight against Iruel. Writer Virginie Nebbia compared Bardiel's role to Imit Ultraman from the Ultraman series, fake Ultramans controlled by Alien Zarab. In Rebuild of Evangelion, Bardiel is introduced as the ninth Angel.

Zeruel
Zeruel (ゼルエル), the fourteenth Angel, is almost anthropomorphic. On its back are signs of a pair of wings, which in classical and popular iconography are the symbol of angelic creatures. In combat, Zeruel shows great physical strength, easily surpassing the line defences of Nerv and destroying 18 armor plates of the Nerv headquarters by a single attack. It is also able to evade detection by radar equipment, allowing it to penetrate the headquarters of the organization unimpeded. It emits explosive beams of light from its eyes, and can use its thin upper limbs by means of a blade-and-bellows-like mechanism. Although the Angel's core is exposed in the center of the chest, it has a protective armor to hide it in case of danger. This ability suggests the enemy is aware of the N2 device and that there is some kind of communication system between the Angel specimens. After defeating Eva-02 and Eva-00, Zeruel is defeated by the Eva-01, which enters the berserk state to devour it, introjecting its S2 engine.

Zeruel's first attack technique is similar to that of Ultraman Jet Beetle. Writer Virginie Nebbia also compared Zeruel to another Ultraman monster, Zetton. Zeruel is the angel of power, a reference to its physical strength. Its name can be translated as "arm of God", to which its second offensive technique alludes. According to Will Raus, its limbs are as thin as a sheet of paper and suggest a pun on the Japanese words for "paper" (紙) and "god" (神). The manga artist Yoshitō Asari collaborated in the conception of its basic structure. According to Asari; "When I was asked to collaborate, I was told that the Angel's body should appear slow and clumsy, but that it was so strong that it could make fun of [the Evangelion]".

In the Rebuild of Evangelion, Zeruel is introduced as the tenth Angel. Asari again designed the creature; except for the skull, which is almost identical to the one in the classic series, the movie's Zeruel has paper-like tentacles it wraps around its body like the bands of a mummy. During the fight, it devours Unit 00 with Rei Ayanami, assuming the appearance of an anthropomorphic female figure. For the likeness of the new Zeruel, the animators took inspiration from the monster King Joe from Ultraseven and an Angel in the original draft of the series, a cube-shaped "origami Apostolo" inspired by the Möbius strip. Its anthropomorphic female form is inspired by Riderman from Kamen Rider. Writer Virginie Nebbia also noted that Zeruel's battle closely resembles the final battle in Revolutionary Girl Utena.

Arael
Arael (アラエル) is the fifteenth Angel. It appears and remains in geostationary orbit for the entire duration of its observation. At first, it is motionless at a constant distance from Earth, deploying giant luminescent wings. Asuka Langley Soryu with her Eva-02 positions herself at the center of Tokyo-3 to intercept it, but the Angel begins to erode her mind using a wave that radars cannot detect. The Angel makes Asuka relive her childhood trauma in an attempt to investigate her mental wavelength by learning her mechanisms and rendering the human on board the Evangelion harmless. According to Ritsuko, Arael's attack is an attempt to investigate the human heart and contact the unit's pilot. The energetic light beam is visible to humans, a phenomenon attributed to the presence of an unknown energy, something similar to an AT Field. Units 00 attacks Arael with its firearm, but its attempts are thwarted by its strong AT Field. Arael is ultimately defeated by Eva-00 after it launches into orbit a weapon called Longinus' spear, which quickly reaches Arael, piercing through its AT Field.

Virginie Nebbia compared Arael's design with Perolynga from Ultraseven, and its exploration of Asuka's mind with Solaris from the novel of the same name. Arael is the angel of birds; its bird-like appearance in the show is a reference to this. Its name means "light" or "vision of God", which Will Raus interpreted as referenced by its beam of light. Arael was planned to appear in the nineteenth episode; it would appear in the Earth's atmosphere and would use its twelve semi-transparent wings as a high-frequency cutting weapon. The Evangelion units would face it in an aerial confrontation, in which Shinji would attempt to save Asuka. The sequences of the psychological battle between the Angel and Asuka have been compared to Gestalt psychology, in particular by the field theory of the German psychologist Kurt Lewin, according to which each individual is part of a context in which each one creates a personal reality.

Armisael
Armisael (アルミサエル) has a luminescent body and an ill-defined circular shape that later stabilizes above the valley of Ōwaku, rotating around its axis. Once its rotation stops, the Angel metamorphosizes into a string, It launches an attack against Unit 00, piercing its body at the level of the womb. Armisael seeks physical and mental contact with the target, violating the components of the unit, which is led by pilot Rei Ayanami. It is speculated Armisael continues Arael's psychic incursion, launching into a communicative attack on Rei. Under attack, Rei loses her senses and inside her mind she meets another self that is Armisael, which sweetly speaks to her using the words from her own unconscious mind. The Angel asks Rei to unite with it to alleviate the pain caused by the attack. After awakening, Rei activates a process of self-destruction of her unit. Rei causes a violent explosion that engulfs and annihilates the Angel, and much of Tokyo-3.

Shortly before the explosion and the Angel's defeat, Eva-00 assumes the silhouette of Rei Ayanami, while Armisael is arranged on her head like a halo, an iconographic Christian attribute of angels and saints. Armisael, confirming the hypotheses of communication between the Angels and mindfulness of their predecessors' experiences, is aware of the human psyche. In religious texts, Armisael is the angel of the womb; in Jewish tradition a woman could relieve the pain of childbirth by invoking his name. During the battle on 00's back, a heteromorphic organism with contours that recall the forms of the previous Angels develops. Armisael thus contains the genetic information of the other Angels. Its shape is similar to a double helix ring and has been compared with the DNA or a mathematical surface that cannot be oriented, such as the Möbius strip and the Klein's bottle.

Tabris
Tabris (タブリス) is known as Kaworu Nagisa, the replacement pilot of Eva-02. After arriving in Tokyo-3, Tabris becomes a friend of Shinji Ikari, but betrays him and takes possession of Eva-02 in an attempt to break into the Terminal Dogma, where it believes Adam is kept. Upon discovering the giant guarded in Nerv is Lilith, Tabris decides to stop its attack and entrusts its fate to Shinji's Unit 01, allowing itself to be killed. Writer Virginie Nebbia compared Kaworu's role to Perolynga and Metron from Ultraseven. According to the Nuctemeron of Apollonius of Tyana, Tabris is a demon and the angel of free will. This is reflected in Evangelion Tabris’s choosing to die at the hands of Shinji. Nuctemeron also mentions a demon called Cahor, pronounced Kahoru (カホル) in Japanese, which is referred to as the angel of deception, a detail the Evangelion Chronicle encyclopedia relates to Tabris' deceptive, anthropomorphic appearance.

Like Arael and Armisael, which both attempt to make contact with Asuka's and Rei's souls, Kaworu aggressively tries to touch Shinji's thoughts through peaceful human exchange rather than an open attack. Tabris claims that the Angels' AT Fields are the light of the soul and "the walls of the heart" everyone possesses, so it neutralizes Shinji's AT Field by eliminating the wall around his heart. Following previous Angels, which have taken various forms, Tabris adopted the form of a man by gathering information from its predecessors.

Lilin
Lilim (リリム), or Lilin (リリン), is the name used by Kaworu Nagisa to refer to human beings. In the movie The End of Evangelion, it is revealed humans are the eighteenth and final Angel, and direct descendants of Lilith. According to rabbinic scriptures, the Lilim, known as Lilin, are the children of Adam and his first wife, Lilith.

In Rebuild of Evangelion
Other Angels are introduced in the film tetralogy Rebuild of Evangelion, while those that appear in the original anime have a different numbering. In the films, the Angels were made with three-dimensional and CG models, with the exception of the ninth and tenth Angels, which are based on Bardiel and Zeruel. A rainbow appears when the Angels are killed; according to Comic Book Resources' Danny Hernandez, the symbol may refer to Genesis, according to which God placed a rainbow in the sky by God as a testimony of His covenant with Noah. Writer Virginie Nebbia noted that a rainbow appears after Gorbagos death in Return of Ultraman and in Tokyo: The Last Megalopolis (1988). In the Rebuild series, the Angels do not have names; according to Masayuki, their names were excluded in the scripting phase because they were never used by the staff, who barely remembered them.

The new Angels that appear in the films are:
 * The third Angel (第3の使徒). Its body, which is composed of bones, is similar to a snake skeleton. The third Angel is equipped with four small limbs for walking, an Evangelion cockpit, a tail and a long neck similar to wings which it uses to fly. It is unearthed from permafrost in the Palearctic, and is sealed by the European branch of Nerv to be researched and dissected. To kill its enemies, the third Angel uses light beams, which it uses to fight against Eva-05. The fight takes place in Bethany base, where it is defeated. Its basic design was conceived by Hideaki Anno, who during production thought of giving it the ability to spit acid, taking inspiration from the monster Stegon (ステゴン) from Ultraman. Anno asked Mohiro Kitoh to redefine its appearance, suggesting something in the style of Narutaru. Writer Virginie Nebbia interpreted it as a possible homage to Ultraman Seabosu.
 * The seventh Angel (第7の使徒) is shaped like a grandfather clock; its head is identical to Sachiel's mask and is capable of rotating like the hands of a clock. It has a fake oscillating core that it uses as a decoy and an authentic core that is hidden inside its body. The seventh Angel moves by freezing the sea's surface; it uses water to kill its enemies and is defeated by Eva-02. It reprises the role of Gaghiel, which appears in the eighth episode of the classic series. The seventh Angel was included in the movie due to technical necessity; the genga or key frames of the eighth episode were lost and the production staff rethought the entire scenario of Asuka's arrival. It was designed by second unit director Daizen Komatsuda to resemble a drinking bird. The creature's face is the work of animator Shigeto Koyama, while the body, which was designed by Anno, is inspired by the Toshiba IHI building at the 1970 Osaka Expo.
 * The twelfth Angel (第12の使徒), which is introduced in the film Evangelion: 3.0 You Can (Not) Redo (2012), takes the form of a set of black filaments that emerge from Mark.06 and is eventually killed as it gets eaten by Evangelion 13.

In other media
Angels appear in works based on Neon Genesis Evangelion with different appearances and roles. In the comic book adaptation of the series, which was drawn by character designer Yoshiyuki Sadamoto, Sandalphon, Matarael, Iruel and Leliel do not appear and the number of Angels is reduced to twelve. More differences are introduced in the manga Neon Genesis Evangelion: Campus Apocalypse, in which they are depicted as creatures that take possession of dead bodies to obtain gems called "cores".

In the video game Shin seiki Evangelion: 2nd Impression, an Angel called Original Angel (オリジナル使徒) is introduced. The Angel presents itself in different forms. In the first form, the Angel's body is formed by disc-shaped plates, from which sprout small, scissor-like spines, and on the bottom some limbs similar to those of an insect. After a metamorphosis, it transforms into a pupa and then evolves into its final flying-insect-like form. In its third form, the Angel splits its AT Field and absorbs the energy of the Evangelion units. Original Angel's core is hidden inside a girl named Mayumi Yamagishi. Mahiro Maeda worked on the Original Angel design.

In the board game Neon Genesis Evangelion RPG (新世紀エヴァンゲリオンRPG), which was published by Kadokawa Shoten, Angels Sachiel, Shamshel, Ramiel, Gaghiel, Israfel, Materael and Sahaquiel, and two new Angels appear. The first, Iblis (イブリース), has the appearance of a purple-colored mollusk. On the top of the shell is a graphic motif in the shape of a human eye. The second, called Barakijal (バラキエル), is orange and spherical. Additional Angels appear in a board game called Shinseiki Evangelion RPG Kessen! Daisan Shin Tōkyō Shi (新世紀エヴァンゲリオンRPG　決戦！第3新東京市): Adovaquiel (アドヴァキエル), similar to an aquatic spore that shoots energy projectiles; Zefon (ゼフォン) is a humanoid Angel equipped with an energy cannon; Atalibu (アタリブ) is dinosaur-like and attacks with its claws; and Azrael (アズラエル) is shaped like a virus and able to attack by manipulating gravity.

The Angels have also been used in video games based on the television series and other games detached from the Evangelion franchise, as in MapleStory, Million Arthur, Monster Hunter Explore and in the video games Princess Punt Sweets (ケリ姫スイーツ) and Summons Board by GunHo Online Entertainment. In the Divine Gate video game by the same production company, the Angels of the Rebuild series are depicted in anthropomorphic robes and have different names. An enemy similar to Neon Genesis Evangelion Angels appears in a crossover episode of the anime Shinkansen Henkei Robo Shinkalion, whose design combines those of several Rebuild Angels.

Cultural references and interpretations
Writer Patrick Drazen analyzed the series' cosmology, comparing it with the Shinto cosmology presented in the texts of the Kojiki and Nihon shoki. According to Drazen, the cosmogony proposed by Anno, despite the Judeo-Christian references, presents a strong Japanese background. He compared the First Impact, and the presence of the White Moon of the Angels and the Black Moon of humanity, to the Japanese myth on the origin of the world, according to which the cosmos was born from a primordial, chaotic, egg-like soup from which light and darkness were separated. The Spear of Longinus has also been compared with Amenonuhoko (天沼矛), the spear of the two creator kamis Izanagi and Izanami; according to the myth, the two creator deities formed the first island of the Japanese archipelago with the spear. Drazen, noting the Black Moon is placed on the Izu Peninsula, interpreted the mythopoiesis of the series as a cosmogony according to which all human life on Earth springs from Japan, as a hi-tech version of Kojiki.

According to writers Jonathan Clements and Helen McCarthy, the use of Western religious symbols, such as cruciform explosions generated by Angels, leads one to think of Western beliefs as an alien invasion within Evangelion, but in their view the symbols are rooted in Anno's insights into archetypes and Jungian psychology. Writers have interpreted Evangelion as a recreation of the Pacific War from the Japanese point of view, especially regarding the final apocalyptic events. Susan J. Napier, an American critic and writer, linked the monstrous creatures in Neon Genesis Evangelion and other anime to the atomic bomb trauma suffered by the Japanese people after the bombings of Hiroshima and Nagasaki. Writer Virginie Nebbia similarly compared the Second Impact to the World War II and its consequences on Japan.

According to researcher Marcello Ghilardi, the Angels reflect the feelings of a part of Japanese youth of the 1990s, a time when Japanese society was in the midst of an economic crisis and when "the ability to react and trust in the future seemed to have vanished", while the impossibility of clearly identifying the origin of the difficulties paralyzed society and made it made "prey to a sense of expectation and precariousness". Their identification code, "Blood Type – Blue", is an homage to the alternative title of the sci-fi film Blue Christmas (1978) by Kihachi Okamoto, an influential author for Anno. Neon Genesis Evangelion manga editor Carl Gustav Horn also noted that in some doctrines of the Jewish Kabbalah angels are not conceived as alien entities, but as beings that were present and recently awakened in the Creation.

Critics compared the Angels to the kaijū, monsters typical of Japanese science fiction. Anime Academy reviewers linked Evangelion to earlier monster-of-the-week products, such as Sailor Moon and Power Rangers, tracing influences to Macross and the works of Gō Nagai. Art magazine Real Time also analyzed the Angels, saying their design reflects ancient and modern archetypes, comparing them to Aztec paintings, Joan Miró murals and Donald Judd cubes. IGN's Ramsey Isler interpreted the battles against the Angels as a metaphor for Anno's attempts to defeat his internal demons and depression.

Scholar Mariana Ortega, noting the mythological Lilith represents "the Other Side", a dark world in which deep libidinal and unconscious desires are not controlled, interpreted Neon Genesis Evangelion as a possible tale of psychic struggles between ego and unconscious, Jungian shadow and anima/animus. According to Ortega, the purpose of the Nerv, the Seele and the Angels is "a kind of return to an original womb". Fifth Wall Renaissance's Alexander Greco similarly interpreted them as representations of Shinji's fears. Other scholars have described the Angels as representations of the Other that Shinji must face to form his identity, while Japanese writer Kotani Mari interpreted them as a representation of the concept of abjection, which was formulated by philosopher Julia Kristeva. Susan Napier, noting the Angels are explicitly associated with Gendo throughout the series, described them as father figures. Hideaki Anno himself compared Gendo and the first Angel Adam to father figures, saying he took inspiration from the Oedipal complex postulated by Sigmund Freud.

Popularity and critical reception
The Angels' designs and fighting styles  received positive reviews from critics and audiences. In 2017 the news magazine Livedoor News opened a survey asking the fans to choose their favorite Angel; in the poll, Adam and Ramiel ranked first and second, respectively. The magazine, talking about the reasons for Ramiel's popularity, discussed the beauty of its geometric features and felt sorry for Arael's low position of the eleventh place. Anime News Network's Nick Creamer praised the first confrontation against Sachiel, calling its disc face "iconic". Creamer also lauded the battles against the Angels, describing them as "a captivating combination of eerily distinct monster designs, creative tactical setups, and gorgeous, horrifying fight animation".

The synchronized battle against Israfel received positive reviews from critics. Comic Book Resources described the fight as one of the best action scenes in the entire series. The fights against Bardiel and Zeruel also drew positive opinions. The US magazine Anime Invasion ranked the Zeruel battle as the eighth-best fight in Japanese animation history. Stuart Nilson, a reviewer for Hoopla.nu, praised the changes introduced in the film Evangelion 2.0 and the variety of Angels' appearances. Martin Theron of Anime News Network and Nicoletta Browne of THEM Anime Reviews also made positive comments about their design, describing them as "jaw-dropping" and "nothing short of astounding". Anime News Network's Justin Sevakis appreciated the omission of their names in the Rebuild of Evangelion films without the Judeo-Christian references from the original series, which he described as "confusing and problematic".

Merchandise and legacy
Images of the Angels have been used to produce merchandising items, such as action figures, T-shirts, paperweights, bags, underwear, collectible models and foodstuffs. In 2005, to celebrate the tenth anniversary of the first airing of the series, manga artist Mine Yoshizaki designed several action figures of the Angels in anthropomorphic likenesses for a line titled Angel XX; among the various models, he designed Lilith and Sachiel puppets inspired by Rei Ayanami's character design. The website Evastore, the official distributor of articles and merchandise inspired by Neon Genesis Evangelion, adopted as its mascot an Angel named Yuru-Shito, which was later used for products and an official role-playing game of the series.

According to Guido Tavassi, a scholar and critic of Japanese animation, the "revolutionary" appearance of the Angels is among the stylistic innovations introduced by the anime, "[which] proposes a complete abstraction of the shapes of the enemies ... with a choice that will have an enormous impact on the design of the series of the [mecha] genre that followed". Matarael's design inspired Nobuhiro Watsuki to create the eye costume of Usui Uonuma, one of the characters in the manga Rurouni Kenshin. Leliel inspired Yūichirō Oguro to create the enemies of Gekiganger 3, the aliens of the Kyo'akk Empire who come from a dimension called "Dark String Universe". Staff of Avatar: The Last Airbender also took inspiration from the Angels of Evangelion for the design of the panda Hei Bei.

Jonathan Clements and Helen McCarthy have traced a possible Evangelion influence on the Dolems, RahXephon main antagonists. For Sci Fi Weekly Tasha Robinson, Aquarion Shadow Angels can also be influenced by Evangelion Angels. IGN's Jemima Sebastian compared a scene in Godzilla vs. Kong, in which King Kong on a ship suffers an underwater attack from Godzilla, to the fight between Gaghiel and Eva-02 from the eighth episode of the series. The same author also noted how an evolution of Algomon presented in the Digimon anime is reminiscent of the design of some of the Angels from Neon Genesis Evangelion'. Sachiel's design inspired Jordan Vogt-Roberts for Kong: Skull Islands Skullcrawler. Polygon compared the unfurled design of the flying cryptid movie monster Jean Jacket in Jordan Peele's Nope with Sahaquiel. On July 25, 2022, Slashfilm confirmed via Peele's production notes for Nope that Jean Jacket had been specifically inspired by the Angels of Neon Genesis Evangelion; Peele himself stated that he was particularly influenced by their "hyper minimalism" and "biomechanical design flair". The creators of the video game Genshin Impact also drew inspiration from Ramiel's design for the conception of some life forms called Hypostasis.

title: Angels in Neon Genesis Evangelion


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Teddybears (band)

Teddybears (formerly Teddybears STHLM) is a Swedish music group formed in Stockholm in 1991. The group consists of members Patrik Arve, Joakim Åhlund, and Klas Åhlund. Initially starting as a hardcore punk band, Teddybears began to incorporate a variety of sounds from hip hop, pop, rock, dancehall, and electronica after a few years.

The band was originally named Skull but changed its name to Teddybears Sthlm shortly before Klas Åhlund joined the group. In 2006, the band dropped “Sthlm” from its name and became simply Teddybears.

Career
1991 - 1992

Joakim Åhlund was a member of the grindcore band Skull, alongside Glenn Sundell, Patrik Lindqvist, and Jens Näsström. For a period, Åhlund left the band, and during his absence, Patrik Arve joined as the vocalist. Åhlund later returned, and it was then that he got to know Arve, leading to the band changing its name from Skull to Teddybears Sthlm. In an interview with Göteborgs-Tidningen, Joakim Åhlund explained the reason behind the name change: "We wanted to avoid clichés; stuff like Kill Death Fuck Squad Bunch Murder and ... well, that kind of thing. And actually, it's better to call ourselves Teddybears in that case." The addition of "Sthlm" was intended to indicate their origins, with Patrik Arve noting in the same interview that the idea came from "the rockers and their vests. It also annoys people in Gothenburg and Malmö."

Teddybears' first public appearance took place during a Lucia celebration at a church in Farsta in 1991, where an anti-drug event was being held. The audience, consisting of seven youths and a priest, witnessed the band, led by Patrik Arve, performing with their trousers pulled down. The guitarist for this gig was Reine Fiske, who is now a member of Dungen and Träd, Gräs och Stenar.

The band's debut record, Women in Pain, was released in 1991 on Isse Samie's record label, Dolores Recordings, in Gothenburg. Women in Pain, which sold over 7,000 copies, included tracks such as "The King Lives On" (about Elvis Presley) and "Servants of Authority."

After several member changes, with Martin Renck playing guitar for a while, Joakim Åhlund's brother Klas joined the band. Upon their emergence on the Swedish rock scene in 1991, Teddybears were noted for their unique genre, appearances, hard music, and energetic stage performances. In February 1992, the band played at Tre Backar in Stockholm, where after the gig, Aftonbladet's critic Anna Björkman lauded their performance, writing: "music in machine gun form and when Teddybears play live, the fans stage dive unrestrainedly from the about half-meter high Tre Backar stage."

Later that year, the band signed a record deal with MVG Records and released the EP Extra Pleasure on the label in 1993.

1993 – 1999

You are Teddybears (1993)

Teddybears' debut album, You Are Teddybears (released by MVG), was released on December 15, 1993. The band initially sought Michael B Tretow, famed for his work with ABBA, to produce the album, but he declined. Consequently, Teddybears took on the production role themselves. The album, clocking in at 37 minutes, boasts an uncompromising hardcore punk sound across its 17 tracks. Its cover art provocatively features a pentagram in blue and yellow, the colors of the Swedish flag. Joakim Åhlund expressed his astonishment in Göteborgs-Tidningen that the controversial symbol hadn't sparked more reactions, highlighting it as “a devil's star in the colours of the Swedish flag.”

The album elicited varied reactions from the press. Sound Affects magazine described it as "The most painful earache Svensson has ever encountered. A definite investment." In contrast, guitarist Yngwie Malmsteen offered a less favorable review in Metal Zone magazine, disparagingly commenting, "sucks ass! (...) Polka beat on the drums! A singer that BLOWS into the mic! Damn, I hate this kind of stuff!"

I can’t belive it’s Teddybears Sthlm (1996)

For Teddybears' second album, I Can't Believe It's Teddybears Sthlm (MVG), Christian Falk was hired as the producer. The album was released on February 23, 1996. This period also saw Erik Olsson replacing Glenn Sundell on drums.

I Can't Believe It's Teddybears Sthlm includes a cover of Kraftwerk's "The Robots," which they began performing while touring in Germany. Two of the songs on the album have boy's names. "Jim" is named after Joakim's son, and the final song "Boris" is named after Patrik's favorite author, Boris Vian.

2000 – 2005

Rock ’n’ Roll Highschool (2000)

With the release of Rock ’n’ Roll Highschool (MVG/MNW), the band achieved commercial breakthrough. The album reached first place on the Swedish album chart. During the Grammis Awards in 2001, the band was awarded four Grammis, among them for Album of the Year and Pop/Rock Group of the Year. The jury's motivation read: "besides being a wonderful melting pot of all new music, Teddybears succeed in chiseling out several big hits."

Rock ’n’ Roll Highschool was released on June 7, 2000, and was produced by the band themselves along with Fabian Torsson. The album name is taken from the movie Rock ’n’ Roll High School (1979), in which The Ramones, among others, appeared. With the album, the band left hardcore punk behind in favour of a distinctive version of electronic pop with elements of hip-hop and reggae.

"Rock 'n' Roll Highschool" and "Yours to Keep" were released as singles. The song "Punkrocker" was also recorded that same year by Joakim Åhlund's other band, Caesars Palace, as well as by Thomas Rusiak featuring Teddybears, under the title "Hiphopper."

Fresh (2004)

Four years later, the fourth album Fresh (Sony Music) was released on March 26, 2004. Like the previous album, it was produced by the band themselves along with Fabian Torsson.

The fixed roles that the band members previously had were now essentially completely dissolved. Dagens Nyheter wrote on March 23, 2004: "Klas is not just a guitarist, often not at all. Joakim doesn't play the bass any more than anyone else in Teddybears, he believes. And the singer Patrik Arve - never sings." On Fresh, the vocalist changes with each song, and among the contributors is Mad Cobra on "Cobrastyle" and a mysterious street musician the band found, who called himself Lord of Lightning, guest sings on "The Lord's 115th Dream."

Fresh includes the song "Cobrastyle," which has been streamed over 70 million times on Spotify. The song has appeared in the movies "Employee of the Month" and "Snakes on a Plane" from 2006, commercials for Heineken and WWE (American wrestling), the TV series "Entourage," and in the video games FIFA 06, FIFA 23, and Forza Motorsport 2. Charli XCX sampled Robyn's version of "Cobrastyle" for the song "Speed Drive" on "Barbie the Album."

The music video for "Cobrastyle," shot in Cuba with Mad Cobra at the Cuban film institute Instituto Cubano del Arte e Industria Cinematográficos (ICAIC), features a stop-motion gorilla and robot cobra battling it out in front of a mountain range, providing a visual backdrop to Teddybears and Mad Cobra's performance.

2006 – today

In 2005, Teddybears began to wear bear masks on stage and in media contexts. The masks were not just a visual idea but also freed up time for the band members: "Being an artist can sometimes feel like being in Top Model. You go around in a tour bus and do press and spend a lot of time discussing with stylists and getting makeup done for concerts and TV appearances. We decided to eliminate that part by always wearing bear heads."

The origin of the bear masks comes from Ingmar Bergman's 1975 film "The Magic Flute," where the first bear mask appeared. It was when Patrik Arve shared a studio with the artist and puppet maker Arne Högsander, the creator of the papier-mâché bear mask for Bergman, that Teddybears ordered several of the same kind.

In 2006, the band dropped "Sthlm" from their name and became simply "Teddybears."

Soft Machine (2006)

With Teddybears' fifth album Soft Machine, they made their album debut in the USA on Atlantic Records. The album was released on September 12, 2006, and was a special edition for the American market where one of the guest artists is Iggy Pop, who guest sings on "Punkrocker." The album was praised in the American cultural magazine Entertainment Weekly as "the very distillation of sunshine."

Soft Machine contains six tracks from Fresh, five remixed hits from Rock'n'Roll Highschool, and one entirely new song, "Riot Going On," where Ebbot Lundberg sings.

In 2004, Teddybears hired the Värmland orchestra Torgny Melins as the opening act for one of their concerts to perform dance band interpretations of Teddybears songs, including "Punkrocker" renamed to "Dansbander." The performance was a success for Torgny Melins, and the dance band released a whole album of Teddybears interpretations that same year, called "Dansbander."

With Soft Machine, Teddybears toured North America and Mexico. In 2007, the band played on the third day of the Coachella Music Festival 2007, which took place at Empire Polo Field in Indio, California. That same year, they performed on "Jimmy Kimmel Live!" where they played in the same episode as Alice Cooper. In 2008, they appeared on "The Late Show with David Letterman" and performed the song "Cobrastyle" together with Robyn.

Devil’s Music (2010)

Teddybears' sixth album Devil's Music (Sony Music) was released on March 24, 2010. This album also features several guest artists, including world stars Cee Lo Green, The Flaming Lips, The B-52's, and Eve, along with Swedish names such as Mapei, Rigo, ADL, and Desmond Foster.

In Dagens Industri, Jan Gradvall wrote the following about the album: “Artists who in this way combine ‘state of the art’ production and classic pop songwriting with adrenaline, anarchism, attack - and also have a visual thinking - are extremely rare."

On January 22, 2010, Teddybears opened the P3 Gold Gala at the Scandinavium, premiering the song "Rocket Scientist" from the album.

Don Carlos

On May 31, 2010, Teddybears presented the set Teddybears vs Don Carlos on the main stage of the Royal Dramatic Theatre (Dramaten) together with actors from the Don Carlos ensemble. Johanna Paulsson, a critic for Dagens Nyheter, wrote about the performance: "Just making something so retrospective sound innovative is an achievement in itself, and Teddybears at the theater are far from being party animals. For this kind of project, they don't even need celebrity guest vocalists, not even the actors on stage. The bears have never sounded so multi-layered before."

The year before, Klas Åhlund had written the music for Staffan Valdemar Holm's original production of Schiller's Don Carlos. The music from the performance was recorded by Teddybears and released as a vinyl album that was only sold at the Dramaten performance.

''Rock on! (2016)''

On January 22, 2016, Teddybears released their sixth and latest album Rock On!. The album was recorded in Los Angeles, Atlanta, London, and Jamaica. Among the guest artists on the album are Beenie Man, Cutty Ranks, and Ninja Man, as well as former Boyz In Da Hood member Gorilla Zoe, and then 12-year-old Baby Trish who sings on "What’s Your Problem."

Baby Trish came to Sweden to record a music video for "What’s Your Problem?" as well as to perform with Teddybears at the 2015 Grammis Awards. The band used the performance to make a statement against racism. Words related to sexual orientation, ethnic origin, and religious affiliation followed by an equal sign and the word "Swedish" were projected on screens around the stage. This was in response to a statement by Björn Söder (SD) in which he had spoken about who was ethnically Swedish or not.

In 2014, Teddybears made a similar statement when they printed band merchandise with the text "SD = racists" which they used during a performance on the TV4 program "Sommarkrysset."

On January 30, 2017, the documentary "You are Teddybears" premiered at the Gothenburg Film Festival and on July 23, 2017, it was broadcast on SVT. The documentary was directed by John Boisen and Björn Fävremark.

Movies and TV-shows
"Different Sound” (feat. Malte) was used in the Sci-fi series “The Lost Room” in the episode “The Comb”, and in episode 14 “Starlet Fever” of CBS's “Shark”. It was also used in the 2007 romantic comedy “Music and Lyrics”, in episode 41 “The Mole” of the TV series “Numb3rs”, in the episode “Everything In Its Right Place” from the fourth season of “One Tree Hill”, and in the 2007 movie “Mad Money” starring Diane Keaton, Queen Latifah, and Katie Holmes.

“Move Over” was featured on the soundtrack to the 2004 video game “Driv3r”.

“Ahead Of My Time” (feat. Daddy Boastin') appeared in the 2007 movie “The Air I Breathe,” and was featured in the TV series “Life” in season 1, episode 11 (2007).

“Rocket Scientist” was prominently used in the opening scenes of the episode “Moving the Chains in House”, in the 5th episode of the 3rd season of “Breaking Bad” during a strip club scene, in the 1st episode “A New Day” of the 3rd season of “The Good Wife”, and in the trailer for the movie “Seven Psychopaths”.

“Cobrastyle” was used in trailers for the movies “Epic Movie” and “Paul”, in the movies “Employee of the Month” and “Snakes on a Plane” from 2006, the pilot episodes of “Chuck” and “Grey's Anatomy”, the pilot episode of the first season of “Teen Wolf”, the 2006 movie “The Benchwarmers”, the 2010 movie “Diary of a Wimpy Kid”, and in the thirteenth episode of the first season of “90210”. “Cobrastyle” has also been featured in commercials for Heineken and WWE (American wrestling), the TV series “Entourage”, and in the video games “FIFA 06”, “FIFA 23”, and “Forza Motorsport 2”. Charli XCX sampled Robyn's version of “Cobrastyle” for the song “Speed Drive” on “Barbie the Album”.

“Devil's Music” was featured in the video game “Need for Speed: Hot Pursuit”, and “Get Fresh With You” was used in the second episode of the fourth season of “90210”.

“Sunshine” was included as the third official theme song for “SummerSlam 2014”, on the “FIFA 15” soundtrack with Natalie Storm, on the soundtrack to “Pitch Perfect 2”, and in The Royal Caribbean's sponsorship idents for “The Masked Singer UK”.

Studio Albums

 * 1993 – You Are Teddybears (as Teddybears Sthlm)
 * 1996 – I Can't Believe It's Teddybears STHLM (as Teddybears Sthlm)
 * 2000 – Rock 'n' Roll Highschool (as Teddybears Sthlm)
 * 2004 – Fresh (as Teddybears Sthlm)
 * 2006 – Soft Machine
 * 2010 – Devil's Music
 * 2016 – Rock On!

Singles

 * 1991 – "Woman in Pain" (as Teddybears Sthlm)
 * 1993 – "Extra Pleasure" (as Teddybears Sthlm)
 * 1994 – "Step on It (We Are the Best!)" (as Teddybears Sthlm)
 * 1995 – "Purple Rain" (as Teddybears Sthlm)
 * 1996 – "The Robots" (as Teddybears Sthlm)
 * 1996 – "Magic Finger" (as Teddybears Sthlm)
 * 1999 – "Ahead of My Time" (as Teddybears Sthlm)
 * 2000 – "Yours to Keep" (as Teddybears Sthlm) (with Paola)
 * 2000 – "Automatic Lover" (as Teddybears Sthlm)
 * 2000 – "Punkrocker" (as Teddybears Sthlm)
 * 2000 – "Rock'n'Roll Highscool" (as Teddybears Sthlm)
 * 2004 – "Cobrastyle" (as Teddybears Sthlm)
 * 2004 – "Hey Boy" (as Teddybears Sthlm)
 * 2004 – "Little Stereo" (as Teddybears Sthlm)
 * 2009 – "Get Mama a House"
 * 2010 – "Rocket Scientist”
 * 2014 – "Sunshine"
 * 2014 – "No More Michael Jackson"
 * 2014 – "Shimmy Shimmy Style"
 * 2015 – "What's Your Problem?" (with Baby Trish)
 * 2015 – "Broken Heartbeat"
 * 2016 – "Best you ever had" (with Gorilla Zoe)
 * 2018 – "Hustla" (med Ward 21)
 * 2018 – "Shimmy Shimmy Style" (with Petite Meller)
 * 2019 – "Young, Handsome & Fast" (with Rakel and Rigo)

Guests

 * Thomas Rusiak – Magic Villa (2000), appears on "Hiphopper" & "STHLM's Finest"
 * Daddy Boastin' – Efterlyst (2002), co-writers & producers of 4 tracks
 * Robyn – The Rakamonie EP (2006), co-writers & producers of "Cobrastyle"
 * Robyn – Robyn (2007, international edition), co-writers & producers of "Cobrastyle"

Appearances

 * "Different Sound (feat. Malte)" has been used in the following places:
 * On the Sci Fi series The Lost Room episode "The Comb"
 * On episode 14 "Starlet Fever" of CBS' Shark
 * On an Intel Core Duo TV advertisement
 * In the 2007 romantic comedy Music and Lyrics
 * On episode 41 "The Mole" of Numb3rs
 * On episode 4.11 ("Everything In Its Right Place") of One Tree Hill
 * In the 2007 movie Mad Money (film) starring Diane Keaton, Queen Latifah, and Katie Holmes
 * "Move Over" has been used in:
 * The soundtrack of the 2004 video game Driv3r.
 * Xbox Live's Major Nelson weekly Blogcast
 * "Ahead Of My Time (feat. Daddy Boastin')" has been used in:
 * The movie The Air I Breathe (2007)
 * A series of Telus commercials, Canada-Wide, spring 2009
 * The TV series Life season 1 episode 11 (2007)
 * Axe Dandruff commercial has "Hey Boy" playing in the club
 * "Rocket Scientist" has been used in:
 * The opening scenes of episode "Moving the Chains" of House
 * The 5th episode of the 3rd season of Breaking Bad during the strip club scene
 * The 1st episode "A New Day" of the 3rd season of The Good Wife
 * The trailer for the movie Seven Psychopaths.
 * "Cobrastyle" has been used in:
 * The trailer for the movie Epic Movie
 * The trailer for the movie Paul
 * The 2006 film Employee of the Month
 * The pilot episodes of Chuck and Grey's Anatomy
 * The pilot episode of the first season of Teen Wolf
 * The 2006 film "The Benchwarmers"
 * The 2010 film "Diary of a Wimpy Kid (film)"
 * The thirteenth episode of the first season of 90210
 * "Devil's Music" in Need for Speed: Hot Pursuit
 * "Get Fresh With You" in the second episode of the fourth season of 90210
 * "Sunshine" has been used in:
 * The third official theme song of SummerSlam 2014.
 * FIFA 15 Soundtrack featuring Natalie Storm
 * The 2015 Peugeot 208 European commercial
 * Pitch Perfect 2 soundtrack
 * The Royal Caribbean sponsorship idents for The Masked Singer UK

Remixes

 * Lisa Miskovsky — Still Alive (Teddybears Remix)
 * Marilyn Manson — Arma-Goddamn-Motherfuckin-Geddon (Teddybears Remix)
 * Daft Punk — Adagio for TRON (Teddybears Remix)
 * Bee Gees — Stayin' Alive (Teddybears Remix)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Teddybears (band)


text:
Kidney failure

Kidney failure, also known as end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; and chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, hyperkalemia, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anaemia.

Causes of acute kidney failure include low blood pressure, blockage of the urinary tract, certain medications, muscle breakdown, and hemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, high blood pressure, nephrotic syndrome, and polycystic kidney disease. Diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine. Diagnosis of chronic failure is based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. It is also equivalent to stage 5 chronic kidney disease.

Treatment of acute failure depends on the underlying cause. Treatment of chronic failure may include hemodialysis, peritoneal dialysis, or a kidney transplant. Hemodialysis uses a machine to filter the blood outside the body. In peritoneal dialysis specific fluid is placed into the abdominal cavity and then drained, with this process being repeated multiple times per day. Kidney transplantation involves surgically placing a kidney from someone else and then taking immunosuppressant medication to prevent rejection. Other recommended measures from chronic disease include staying active and specific dietary changes. Depression is also common among patients with kidney failure, and is associated with poor outcomes including higher risk of kidney function decline, hospitalization, and death. A recent PCORI-funded study of patients with kidney failure receiving outpatient hemodialysis found similar effectiveness between nonpharmacological and pharmacological treatments for depression.

In the United States, acute failure affects about 3 per 1,000 people a year. Chronic failure affects about 1 in 1,000 people with 3 per 10,000 people newly developing the condition each year. Acute failure is often reversible while chronic failure often is not. With appropriate treatment many with chronic disease can continue working.

Classification
Kidney failure can be divided into two categories: acute kidney failure or chronic kidney failure. The type of renal failure is differentiated by the trend in the serum creatinine; other factors that may help differentiate acute kidney failure from chronic kidney failure include anemia and the kidney size on sonography as chronic kidney disease generally leads to anemia and small kidney size.

Acute kidney failure
Acute kidney injury (AKI), previously called acute renal failure (ARF), is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults, less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants); and fluid and electrolyte imbalance. AKI can result from a variety of causes, generally classified as prerenal, intrinsic, and postrenal. Many people diagnosed with paraquat intoxication experience AKI, sometimes requiring hemodialysis. The underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes.

Chronic kidney failure

Chronic kidney disease (CKD) can also develop slowly and, initially, show few symptoms. CKD can be the long term consequence of irreversible acute disease or part of a disease progression. CKD is divided into 5 different stages (1–5) according to the estimated glomerular filtration rate (eGFR). In CKD1 eGFR is normal and in CKD5 eGFR has decreased to less than 15 ml/min.

Acute-on-chronic kidney failure
Acute kidney injuries can be present on top of chronic kidney disease, a condition called acute-on-chronic kidney failure (AoCRF). The acute part of AoCRF may be reversible, and the goal of treatment, as with AKI, is to return the person to baseline kidney function, typically measured by serum creatinine. Like AKI, AoCRF can be difficult to distinguish from chronic kidney disease if the person has not been monitored by a physician and no baseline (i.e., past) blood work is available for comparison.

Signs and symptoms
Symptoms can vary from person to person. Someone in early stage kidney disease may not feel sick or notice symptoms as they occur. When the kidneys fail to filter properly, waste accumulates in the blood and the body, a condition called azotemia. Very low levels of azotemia may produce few, if any, symptoms. If the disease progresses, symptoms become noticeable (if the failure is of sufficient degree to cause symptoms). Kidney failure accompanied by noticeable symptoms is termed uraemia.

Symptoms of kidney failure include the following:
 * High levels of urea in the blood, which can result in:
 * Vomiting or diarrhea (or both) that may lead to dehydration
 * Nausea
 * Weight loss
 * Nocturnal urination (nocturia)
 * More frequent urination, or in greater amounts than usual, with pale urine
 * Less frequent urination, or in smaller amounts than usual, with dark coloured urine
 * Blood in the urine
 * Pressure, or difficulty urinating
 * Unusual amounts of urination, usually in large quantities
 * A buildup of phosphates in the blood that diseased kidneys cannot filter out may cause:
 * Itching
 * Bone damage
 * Nonunion in broken bones
 * Muscle cramps (caused by low levels of calcium which can be associated with hyperphosphatemia)
 * A buildup of potassium in the blood that diseased kidneys cannot filter out (called hyperkalemia) may cause:
 * Abnormal heart rhythms
 * Muscle paralysis
 * Failure of kidneys to remove excess fluid may cause:
 * Swelling of the hands, legs, ankles, feet, or face
 * Shortness of breath due to extra fluid on the lungs (may also be caused by anemia)
 * Polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause:
 * Pain in the back or side
 * Healthy kidneys produce the hormone erythropoietin that stimulates the bone marrow to make oxygen-carrying red blood cells. As the kidneys fail, they produce less erythropoietin, resulting in decreased production of red blood cells to replace the natural breakdown of old red blood cells. As a result, the blood carries less hemoglobin, a condition known as anemia. This can result in:
 * Feeling tired or weak
 * Memory problems
 * Difficulty concentrating
 * Dizziness
 * Low blood pressure
 * Normally proteins are too large to pass through the kidneys. However they are able to pass through when the glomeruli are damaged. This does not cause symptoms until extensive kidney damage has occurred, after which symptoms include:
 * Foamy or bubbly urine
 * Swelling in the hands, feet, abdomen, and face
 * Other symptoms include:
 * Appetite loss, which may include a bad taste in the mouth
 * Difficulty sleeping
 * Darkening of the skin
 * Excess protein in the blood
 * With high doses of penicillin, people with kidney failure may experience seizures

Acute kidney injury
Acute kidney injury (previously known as acute renal failure) – or AKI – usually occurs when the blood supply to the kidneys is suddenly interrupted or when the kidneys become overloaded with toxins. Causes of acute kidney injury include accidents, injuries, or complications from surgeries in which the kidneys are deprived of normal blood flow for extended periods of time. Heart-bypass surgery is an example of one such procedure.

Drug overdoses, accidental or from chemical overloads of drugs such as antibiotics or chemotherapy, along with bee stings may also cause the onset of acute kidney injury. Unlike chronic kidney disease, however, the kidneys can often recover from acute kidney injury, allowing the person with AKI to resume a normal life. People with acute kidney injury require supportive treatment until their kidneys recover function, and they often remain at increased risk of developing future kidney failure.

Among the accidental causes of renal failure is the crush syndrome, when large amounts of toxins are suddenly released in the blood circulation after a long compressed limb is suddenly relieved from the pressure obstructing the blood flow through its tissues, causing ischemia. The resulting overload can lead to the clogging and the destruction of the kidneys. It is a reperfusion injury that appears after the release of the crushing pressure. The mechanism is believed to be the release into the bloodstream of muscle breakdown products – notably myoglobin, potassium, and phosphorus – that are the products of rhabdomyolysis (the breakdown of skeletal muscle damaged by ischemic conditions). The specific action on the kidneys is not fully understood, but may be due in part to nephrotoxic metabolites of myoglobin.

Chronic kidney failure
Chronic kidney failure has numerous causes. The most common causes of chronic failure are diabetes mellitus and long-term, uncontrolled hypertension. Polycystic kidney disease is another well-known cause of chronic failure. The majority of people affected with polycystic kidney disease have a family history of the disease. Systemic lupus erythematosus (SLE) is also a known cause of chronic kidney failure. Other genetic illnesses cause kidney failure, as well.

Overuse of common drugs such as ibuprofen, and acetaminophen (paracetamol) can also cause chronic kidney failure.

Some infectious disease agents, such as hantavirus, can attack the kidneys, causing kidney failure.

Genetic predisposition
The APOL1 gene has been proposed as a major genetic risk locus for a spectrum of nondiabetic renal failure in individuals of African origin, these include HIV-associated nephropathy (HIVAN), primary nonmonogenic forms of focal segmental glomerulosclerosis, and hypertension affiliated chronic kidney disease not attributed to other etiologies. Two western African variants in APOL1 have been shown to be associated with end stage kidney disease in African Americans and Hispanic Americans.

Measurement for CKD

 * Stages of kidney failure

Chronic kidney failure is measured in five stages, which are calculated using the person's GFR, or glomerular filtration rate. Stage 1 CKD is mildly diminished renal function, with few overt symptoms. Stages 2 and 3 need increasing levels of supportive care from their medical providers to slow and treat their renal dysfunction. People with stage 4 and 5 kidney failure usually require preparation towards active treatment in order to survive. Stage 5 CKD is considered a severe illness and requires some form of renal replacement therapy (dialysis) or kidney transplant whenever feasible.

 * Glomerular filtration rate

A normal GFR varies according to many factors, including sex, age, body size and ethnic background. Renal professionals consider the glomerular filtration rate (GFR) to be the best overall index of kidney function. The National Kidney Foundation offers an easy to use on-line GFR calculator for anyone who is interested in knowing their glomerular filtration rate. (A serum creatinine level, a simple blood test, is needed to use the calculator.)

Use of the term uremia
Before the advancement of modern medicine, renal failure was often referred to as uremic poisoning. Uremia was the term for the contamination of the blood with urea. It is the presence of an excessive amount of urea in blood. Starting around 1847, this included reduced urine output, which was thought to be caused by the urine mixing with the blood instead of being voided through the urethra. The term uremia is now used for the illness accompanying kidney failure.

Renal failure index
Two other urinary indices, are the fractional sodium excretion (FENa) index and the renal failure index (RFI). The renal failure index is equal to urine sodium times plasma creatinine divided by urine creatinine. A FENa score greater than 3% or a renal failure index (RFI) greater than 3 are helpful in confirming acute renal failure.

Complications
Those with end stage renal failure who undergo haemodialysis have higher risk of spontaneous intra-abdominal bleeding than the general population (21.2%) and non-occlusive mesenteric ischemia (18.1%). Meanwhile, those undergoing peritoneal dialysis have a higher chance of developing peritonitis and gastrointestinal perforation. However, the rate of acute pancreatitis does not differ from the general population.

Treatment
The treatment of acute kidney injury depends on the cause. The treatment of chronic kidney failure may include renal replacement therapy: hemodialysis, peritoneal dialysis, or kidney transplant.

Diet
In non-diabetics and people with type 1 diabetes, a low protein diet is found to have a preventive effect on progression of chronic kidney disease. However, this effect does not apply to people with type 2 diabetes. A whole food, plant-based diet may help some people with kidney disease. A high protein diet from either animal or plant sources appears to have negative effects on kidney function at least in the short term.

Slowing progression
People who receive earlier referrals to a nephrology specialist, meaning a longer time before they must start dialysis, have a shorter initial hospitalization and reduced risk of death after the start of dialysis. Other methods of reducing disease progression include minimizing exposure to nephrotoxins such as NSAIDs and intravenous contrast.

title: Kidney failure