Acute Renal Failure
En Español (Spanish Version)

Definition
Acute renal failure is the sudden loss of kidney function. Kidneys clean waste from the blood and manage the balance of fluid in the body.

The Kidneys

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Causes
There are many possible causes of sudden kidney failure because there are three anatomical sites for problems to occur in the renal system: before the blood enters the kidneys, within the kidneys, and after the urine is processed by the kidneys and enters the ureters.

Sudden kidney failure can result from problems with blood flow to the kidney, which can be caused by acute renal artery obstruction, blood loss, or dehydration. It can also result from conditions such as infections that interfere with the work of the kidney.

The most common cause of sudden kidney failure occurs inside the kidney. Acute tubular necrosis is the death of the cells inside the kidney that act as the blood's filter. These cells die when they are deprived of oxygen. This can be due to surgical complications, inflammatory processes, blood clots, or the side effects of certain medicines. Physical problems, such as swollen prostate glands or kidney stones can also cause sudden kidney failure.

Risk Factors
Factors that may increase your chance of developing acute renal failure include:

  • Having a chronic disease, such as diabetes, kidney disease, heart disease, liver disease, or high blood pressure
  • Increased age
  • Dehydration
  • Bleeding, especially from the gastrointestinal tract
  • Certain medications and illegal drugs
  • Complications following surgeries or care in an intensive care unit (ICU)
  • Overuse of certain over-the-counter painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen sodium, and ketoprofen
  • Use of angiotensin converting enzyme (ACE) inhibitors
  • Obstructive causes such as benign prostatic hypertrophy and bladder tumor
Symptoms
Many people do not have any symptoms, but symptoms can include the following:

  • Less frequent urination
  • Swelling throughout the body
  • Dark-colored urine
  • Tiredness
  • Confusion
  • Nausea or vomiting
  • Muscle weakness or muscle cramps
  • No appetite
  • Metallic taste
  • In severe cases, coma or seizures
Diagnosis
You will be referred to a kidney specialist (nephrologist) for diagnosis and treatment. Your doctors will ask about your symptoms and medical history. A physical exam will be done. Your doctor will ask about any medications you are taking.

Your bodily fluids will be tested. This can be done with:

  • Blood tests
  • Urine tests
Images may be taken of your bodily structures. This can be done with:

Treatment
The treatment for acute renal failure will depend on the exact cause and severity. Your doctor may recommend any of the following:

  • Undergoing dialysis
  • Treating obstruction with a catheter or stent
  • Maintaining adequate blood volume with fluids given by IV
  • Stopping medications or drugs that caused the loss of function
  • Treating related problems, such as kidney stones or infections
  • Incorporating a diet with limited protein intake, supervised by a physician
  • Renal transplant
Prevention
To help reduce your chance of acute kidney failure, take the following steps:

  • Get a physical every year that includes a urine test to monitor your kidney health.
  • Drink water and other fluids to stay hydrated.
  • Don't take drugs or other substances that can damage your kidneys. Check with your doctor to find out about the potential side effects of any medications you are taking.
  • People at risk for chronic kidney disease should get more frequent check-ups at their doctor's office.



RESOURCES:
National Kidney Disease Education Program

National Kidney Foundation

CANADIAN RESOURCES:
The College of Family Physicians of Canada

The Kidney Foundation of Canada

References:
Acute renal failure. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 4, 2013. Accessed July 12, 2013.

Hilton R. Acute renal failure. BMJ. 2006;333:786-790.

Needham E. Management of acute renal failure. Am Fam Physician. 2005;72:1739-1746. Available at: http://www.aafp.org/afp/20051101/1739.html. Accessed July 13, 2013.

Rondon-Berrios H, Palevsky PM. Treatment of acute kidney injury: an update on the management of renal replacement therapy. Curr Opin Nephrol Hypertens. 2007;16:64-70.

Venkataraman R, Kellum JA. Prevention of acute renal failure. Chest. 2007;131:300-308.

Last Reviewed July 2013



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