What is Acute Renal Failure and Causes of Acute Renal Failure

Acute renal failure (ARF), also known as acute kidney failure or acute kidney injury, is a rapid loss of renal function due to damage to the kidneys, resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products that are normally excreted by the kidney. Depending on the severity and duration of the renal dysfunction, this accumulation is accompanied by metabolic disturbances, such as metabolic acidosis (acidification of the blood) and hyperkalaemia (elevated potassium levels), changes in body fluid balance, and effects on many other organ systems.

What causes acute renal failure?

Acute renal failure has three main causes:

A sudden, serious drop in blood flow to the kidneys. Heavy blood loss, an injury, or a bad infection called sepsis can reduce blood flow to the kidneys. Not enough fluid in the body (dehydration) also can harm the kidneys.

Postrenal: Problems affecting the movement of urine out of the kidneys

Renal: Problems with the kidney itself that prevent proper filtration of blood or production of urine

You have used medicines that can affect the kidneys, including antibiotics such as gentamicin and streptomycin, ACE inhibitors for high blood pressure, anti-inflammatory drugs such as aspirin and ibuprofen, or the dyes (contrast agents) used in certain X-ray tests.

You have a sudden blockage that prevents urine from flowing out of the kidneys. Kidney stones, a tumor, an injury, or an enlarged prostate gland can cause a blockage.

Symptoms

Symptoms and signs of acute glomerulonephritis are often vague and ill-defined. On the other hand, symptoms associated with pyelonephritis are often acute with fever, chills, back ache, and nausea.

Metabolic acidosis, or increased acidity of the body due to the inability to manufacture bicarbonate, will alter enzyme and oxygen metabolism, causing organ failure.

Loss of appetite, nausea, and vomiting.
Feeling confused, anxious and restless, or sleepy.
Pain on one side of the back, just below the rib cage and above the waist (flank pain).

How is it diagnosed?

To diagnose acute renal failure, your doctor will review your medical history and symptoms to determine the cause of your condition. He or she will perform a thorough physical examination, checking specifically for any enlargement or tenderness in the kidney area. You may be referred to a nephrologist, who specializes in kidney function. Your doctor will order blood and urine tests to check levels of waste products, sodium, and potassium in your bloodstream and urine. Levels of a waste product called creatinine and urea will be high in patients with renal failure.

Treatment:

Acute renal failure is a life threatening illness whose mortality has remained high since the introduction of hemodialysis 25 years ago, despite advances in supportive care. Acute renal failure is an extremely morbid and costly disorder with a significant proportion of patients progressing to end-stage renal disease requiring dialysis.

Close monitoring of important electrolytes such as potassium, sodium, and calcium

Medications (to control blood pressure)

Specific diet requirements

Administration of intravenous (IV) fluids in large volumes (to replace depleted blood volume)

Diuretic therapy or medications (to increase urine output)

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