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ACUTE KIDNEY FAILURE

Acute kidney failure is a condition in which the kidney fails to eliminate the waste products, excess salts and fluids from the body. As a result the electrolytes and fluids in the body increase to dangerously high levels. Also, the waste materials accumulate in the body, which becomes life-threatening to the patient.

Acute kidney failure is also known as acute renal failure or acute kidney injury. People who are seriously ill are at a greater risk of developing acute kidney failure.

Symptoms

The symptoms of acute kidney failure are:

  • Shortness of breath
  • Bad odor in the breath
  • Changes in the heart sounds
  • Nose bleeding
  • Sluggish movements
  • Changes in mood
  • Low appetite
  • Numbness in hands and feet
  • Fluid retention and swelling
  • Changes in the urine output
  • Blood in stools
  • Hand tremors
  • Bruising
  • Prolonged bleeding

Causes

There are several causes for acute kidney failure. The most common causes are listed below:

  • Sudden and severe dehydration
  • Use of certain medicines which can be toxic to the kidney
  • Urinary tract blockage
  • Certain kidney diseases such as interstitial nephritis and acute nephritic syndrome

Conditions which decrease the blood flow to the kidneys can damage the kidneys and may result in acute kidney failure. They are:

  • Dehydration
  • Profuse bleeding
  • Low blood pressure
  • Serious illness
  • Surgery

Clotting of the blood vessels that supply blood to the kidneys can also cause acute kidney failure. This is seen in the following conditions:

  • Transfusion reaction
  • Malignant hypertension
  • Hemolytic uremic syndrome
  • Scleroderma

Acute kidney failure can result from infections such as pyelonephritis or septicemia. It can develop within few hours or it may take several days.

Risk factors

The risk factors of acute kidney failure are:

  • Medical conditions such as liver disease, diabetes, heart failure, obesity and high blood pressure
  • Recipients of bone marrow transplant or abdominal surgery or heart surgery
  • Hospitalized patients especially those who need an intensive care

When to consult the doctor?

If the symptoms of acute kidney failure are noticed, then consult the doctor for confirmation of the condition. Check with the doctor especially if the urine output is very low or nil. Also, if the risk of developing acute kidney failure is high, then go for regular checkups to a doctor.

Diagnosis

Physical examination includes checking for crackling sounds in the lungs which indicate fluid retention. The doctor may perform the below mentioned tests to check the kidney function and the underlying cause of acute kidney failure:

  • Creatinine clearance
  • Blood urea nitrogen (BUN) test
  • Serum creatinine
  • Serum potassium
  • Urinalysis

Imaging tests such as a kidney or abdominal ultrasound, x-rays, magnetic resonance imaging (MRI), CT scans are helpful in identifying the blockages in the urinary tract.

Treatment

As acute kidney failure is a critical condition, it needs an intensive treatment in the hospital. However, proper health management may also help in faster recovery. The goal of the treatment is to prevent the accumulation of the wastes and fluids by restoring the functioning of the kidneys.

Treatment is based on the cause of acute kidney failure.

  • Antibiotics will be prescribed to prevent or treat the infections which might occur along with acute kidney failure
  • Diuretics or water pills help to eliminate the fluids from the body
  • Calcium and insulin are given to prevent drastic increase in the blood potassium levels
  • Dialysis may be needed in some patients who have very low or no urine output. It is also recommended in those patients with an altered mental status, or those who have an inflammation in the heart (known as pericarditis)
  • In addition to the above treatments, the doctor will suggest the patient to limit the fluid intake and restrict the diet. This helps to reduce the extent of toxins generated. Diet rich in carbohydrates and poor in salt, potassium and proteins is recommended

Complications

Acute kidney failure can end up in the below complications if a timely treatment is not available:

  • Chronic kidney failure
  • End-stage renal failure
  • High blood pressure
  • Heart damage
  • Nervous system damage

Prevention

The below measures can help to prevent the development of acute kidney failure:

  • Incorporating lifestyle changes such as a healthy diet, regular exercise or physical activity
  • Avoiding or getting a prompt treatment for the diseases which can increase the risk of acute kidney failure
  • Avoiding the use of drugs which can cause kidney injury
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