Acute renal failure is caused by damage to the kidneys, which can occur as a result of blood loss, toxins, or physical damage to the kidneys. Acute renal failure occurs rapidly, causing generalized symptoms, such as loss of appetite and confusion. It is a serious condition, but it can be treated. With proper treatment, most people can survive an episode without long-term consequences.
What Are The Symptoms?
If you do have symptoms, they’ll depend on how bad your loss of kidney function is, how quickly you lose kidney function, and the reasons for your kidney failure.
Signs and symptoms of acute renal failure may include:
- Decreased urine output, although occasionally urine output remains normal.
- Fluid retention, causing swelling in your legs, ankles or feet.
- Shortness of breath.
- Irregular heartbeat.
- Chest pain or pressure.
- Seizures or coma in severe cases.
- Stomach and back pain.
Causes of Acute Renal Failure
People who are ill and receiving medical treatment in a hospital are particularly at risk of acute renal failure (ARF). This is especially true of those in an intensive care unit (ICU) setting. Research has estimated that as many as 7 percent of all patients in the hospital and 66 percent of those in an ICU will experience ARF.
Doctors also use three categories to classify the causes of acute renal failure (ARF):
- Pre-renal causes: In this case, something is disrupting blood flow to the kidneys, making the kidneys unable to work correctly. Examples of these causes include low blood pressure, excess blood loss, and dehydration.
- Post-renal causes : Here, something is blocking the ureters where urine leaves the kidneys, which is affecting the proper function of the kidneys. Underlying causes of this include kidney stones, cancer, and an enlarged prostate in men.
- Intrinsic renal causes : In this category, a medical condition damages the kidneys, or something inside the kidneys is not working as well as it once did. Common causes of this include kidney infections, blood clots in the kidneys, or other medical conditions. Taking medications known to damage the kidneys can also be a cause.
Medications that can damage the kidneys include:
- Phenytoin (Dilantin)
- Proton pump inhibitors
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Ideally, a doctor will be able to identify the underlying cause of a person’s ARF quickly. This means they can recommend treatment to prevent an acute condition from becoming chronic renal failure.
Acute renal failure almost always occurs in connection with another medical condition or event. Conditions that can increase your risk of acute renal failure include:
- Being hospitalized, especially for a serious condition that requires intensive care.
- Advanced age.
- Blockages in the blood vessels in your arms or legs (peripheral artery disease).
- High blood pressure.
- Heart failure.
- Kidney diseases.
- Liver diseases.
- Certain cancers and their treatments.
How is acute renal failure diagnosed?
If your signs and symptoms suggest that you have acute renal failure, your doctor may recommend certain tests and procedures to verify your diagnosis. The doctor may ask you to do blood teststhat measure two substances in your blood which are creatinine and urea nitrogen.
Creatinine is a waste product in your blood that’s produced by muscle activity. Normally, it’s removed from your blood by your kidneys. But if those organs stop working, your creatinine level rises. Urea nitrogen is another waste product in your blood. It’s created when protein from the foods you eat is broken down. Like creatinine, your kidneys remove this from your blood. When your kidneys stop working, your urea nitrogen levels rise.
Your doctor will check your urine for blood and protein. He’ll also look for certain electrolytes (chemicals that control important body functions). The results help him understand what’s causing your kidney failure.
Some imaging tests, like ultrasonography or a CT scan, can show whether your kidneys are enlarged or there’s a blockage in your urine flow. An angiogram can tell your doctor if the arteries or veins that lead to your kidneys are blocked. An MRI can show the same thing.
In some situations, your doctor may recommend a kidney biopsy to remove a small sample of kidney tissue for lab testing. Your doctor inserts a needle through your skin and into your kidney to remove the sample.
Complications and Treatment
Some of the complications of acute renal failure include:
- Chronic kidney failure
- Fluid buildup
- Chest pain
- Heart damage
- Nervous system damage
- High blood pressure
- Muscle weakness
The treatment of acute renal failure depends on the cause of the problem, as well as the severity of the situation. Many people improve with treatment and do not experience long-term problems or chronic renal failure.
Identifying the problem, and obtaining treatment as quickly as possible, is the best way to prevent kidney damage that causes a lifetime of kidney issues or requires dialysis treatments.
Treatments can include:
- Intravenous (IV) fluids: A person who has acute renal failure due to severe dehydration after experiencing heat stroke may improve with IV fluids. When a low fluid volume is a reason for the acute renal failure, providing the body with fluids can help restore fluid levels
- Electrolyte management: If your fluids and electrolytes are not within the optimal range, your doctors may give you electrolyte supplements or give you medications that can get rid of some excess electrolytes.
- Stopping the use of toxins: If acute renal failure is caused by a medication or supplement, the treatment should include stopping the medication.
- Dialysis: When toxins are not expected to be eliminated efficiently if you simply stop taking them, treatment of acute renal failure requires ridding the body of the chemical as quickly as possible. Sometimes dialysis is needed, a method through which a machine can do the work of the kidney by removing toxins and regulating fluid and electrolyte balance.
How do I Prevent Acute Renal Failure?
If a person has gone through acute renal failure (ARF) in the past, they are more likely to have it in the future. They are also at greater risk for other health complications, such as stroke, heart disease, or kidney disease.
It is not always possible to prevent ARF. However, there are some steps a person can take to minimize their risk. These steps include:
- Work with your doctor to manage kidney and other chronic conditions. If you have kidney disease or another condition that increases your risk of acute kidney failure, such as diabetes or high blood pressure, stay on track with treatment goals and follow your doctor’s recommendations to manage your condition.
- Following a healthful diet and keeping blood sugar levels at their desired target if someone has diabetes.
- Maintaining a healthy blood pressure through diet, exercise, and medications, if necessary.
- Avoiding excessive use of medications that the kidneys filter, especially ibuprofen and aspirin. Excess amounts of these medicines can damage the kidneys.
- Mayoclinic – diseases-conditions/kidney-failure/symptoms-causes
- Healthline – health/acute-kidney-failure#treatment
- Medicalnewstoday – acute-renal-failure
- WebMD – a-to-z-guides/what-is-acute-kidney-failure