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What Is Acute Renal Failure?

Acute renal failure (also known as acute kidney injury (AKI)) means that kidneys suddenly can’t get rid of the body’s waste and balance chemicals in your body. Kidneys normally do this by making urine. When they fail, waste products and chemicals build up and are harmful.

What Causes Acute Renal Failure?

Conditions that reduce the blood supply to kidneys, block flow of urine after it leaves kidneys, or injure kidneys can cause renal failure. Diseases that predispose to acute kidney failure include chronic urinary infections, dehydration, and kidney damage from congestive heart failure, diabetes, or high blood pressure.

Causes of acute renal failure include illnesses that have an indirect effect on kidneys (e.g., low blood pressure), kidney blockage, and direct kidney injury (e.g., by drugs and x-ray dyes).

What Are the Symptoms of Acute Renal Failure?

An early symptom is often little or no urine output.

Later ones include nausea, vomiting, diarrhea, and appetite loss. Irritability, insomnia, convulsions, stupor, coma, severe itching, high or low blood pressure, unexplained bruising, and bleeding for no reason may be additional signs. In some forms of acute renal failure the kidneys continue to produce urine but it does not contain the waste products normally removed by the kidneys.

How Is Acute Renal Failure Diagnosed?

Blood and urine tests can measure how well kidneys work. A biopsy (taking a sample of tissue from kidneys) may be done in certain cases, as may x-rays of the chest, belly, kidneys, and ureters (tubes taking urine from kidneys to the bladder).

How Is Acute Renal Failure Treated?

Treatment depends on the reason for acute renal failure. In many cases, a hospital admission may be necessary to start treatment. Medicines may be given to help increase the amount of urine made, and an artificial kidney machine may be used for dialysis (hemodialysis). In another type of dialysis known as peritoneal dialysis, fluid (called dialysate) is placed in the abdomen (belly) to help clean waste products from the blood and is then removed with a special tube (catheter). The health care provider may suggest a reduced intake of protein, salt, and potassium and use of blood pressure pills and calcium supplements. In many cases, kidneys may recover completely, but recovery may take up to 6 weeks or longer.

DOs and DON’Ts in Managing Acute Renal Failure:

  • DO follow a low-protein diet if your health care provider recommends it. A proper diet is critical to prevent complications. You may have to eliminate some fruit, chocolate, and nuts because of high potassium levels. When kidneys don’t work, high levels are dangerous for your heart.
  • DO take medicines as prescribed.
  • DO weigh yourself daily and keep a record of fluids you drink and the amount of fluid you pass if your health care provider asks you to.
  • DO tell your health care provider of any exposure to toxic chemicals or drugs.
  • DO keep to your fluid restriction to avoid fluid buildup in your lungs.
  • DO tell your health care provider about all your medicines, including over-the-counter and herbal preparations.
  • DO call your health care provider if you have chills, fever, vomiting, headache, muscle aches, or diarrhea.
  • DO avoid anything poisonous to kidneys, such as some drugs.
  • DO take care of medical disorders that might damage kidneys, such as high blood pressure, diabetes, congestive heart failure, and infections.
  • DON’T stop taking your medicines before asking your health care provider. Don’t miss any doses.
  • DON’T take over-the-counter medicines or herbal preparations unless you check with your health care provider.

Contact the following sources:

  • National Kidney Foundation, Inc.
    Tel: (800) 622-9010, (212) 889-2210
  • National Institute of Diabetes, Digestive, and Kidney Diseases

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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