Acute Kidney Failure

Acute Kidney Failure

Article
Kidney & Bladder Health
Men's Health
+3
Contributed byMaulik P. Purohit MD MPHApr 04, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Hypotensive Renal Failure
  • AKI (Acute Kidney Injury)
  • ARF (Acute Renal Failure)

What is Acute Kidney Failure? (Definition/Background Information)

  • Acute Kidney Failure is a condition when the kidneys can no longer filter wastes out of blood. In this condition, there is an abrupt loss of kidney function that develops over a period of few days. It is also known as Acute Renal Failure (ARF)
  • Elderly adults are more prone to developing Acute Kidney Failure. The risk factors also include diabetes and high blood pressure
  • ARF may be caused by a variety of conditions such as severe dehydration, blood loss, use of certain medications, and direct kidney damage
  • Due to this condition there is decreased urine output and swelling of the body. The condition may be diagnosed through exams and tests such as serum creatinine, serum potassium, urine analysis, and imaging scans
  • Treatment of Acute Kidney Failure is based on identifying and treating the underlying cause. The prognosis depends upon the underlying cause and is variable
  • Preventing the risk factors and appropriately treating the underlying cause promptly can help prevent Acute Renal Failure

Who gets Acute Kidney Failure? (Age and Sex Distribution)

  • Acute Kidney Failure can occur at any age, but older people are more predisposed to this condition
  • There is no distinct gender, racial, or ethnic predilection observed

What are the Risk Factors for Acute Kidney Failure? (Predisposing Factors)

The risk factors associated with Acute Kidney Failure are:

  • Recent hospitalization
  • Advanced age
  • Diabetes
  • High blood pressure
  • Previous kidney disease
  • Liver disease
  • Heart disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Kidney Failure? (Etiology)

Common causes of Acute Kidney Failure include:

  • Injury to the kidney
  • Blood or fluid loss
  • Heart failure, heart attacks
  • Kidney stones
  • Liver failure
  • Increased susceptibility to a variety of Infections
  • Use of certain medications such as aspirin, ibuprofen, and naproxen
  • Severe burns
  • Severe allergic reactions such as anaphylaxis
  • Glomerulonephritis: Inflammation of the glomeruli, which are the tiny filters in the kidneys
  • Toxins such as alcohol, heavy metals, and cocaine
  • Enlarged prostate
  • Cancer of the prostate, bladder

What are the Signs and Symptoms of Acute Kidney Failure?

The signs and symptoms associated with Acute Kidney Failure include:

  • Decreases urine output, though rarely it may be normal
  • Swelling of the legs, ankles, or feet, due to fluid retention
  • Breath odor
  • Metallic taste in the mouth
  • Decreased appetite, fatigue
  • High blood pressure
  • Nosebleeds, prolonged bleeding, easy bruising
  • Seizures
  • Persistent hiccups
  • Shortness of breath
  • Changes in the mental status or mood

How is Acute Kidney Failure Diagnosed?

A diagnosis of Acute Kidney Failure may include:

  • A complete evaluation of medical history along with a thorough physical exam
  • The following lab tests may be performed:
    • Serum creatinine
    • Blood urea nitrogen
    • Serum potassium
    • Creatinine clearance
    • Urine analysis            
    • Arterial blood gases
  • Ultrasound, CT, or MRI scan of the kidneys

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Kidney Failure?

Complications of Acute Kidney Failure could include:

  • Generalized swelling of the body due to fluid buildup
  • Pericarditis: Inflammation of the heart membrane
  • Hyperkalemia: Elevated levels of potassium may lead to disturbances in the electrical activity of the heart with muscle weakness
  • Progression to permanent kidney damage

Acute Renal Failure may lead to death, especially in individuals with pre-existing kidney damage.

How is Acute Kidney Failure Treated?

Acute Kidney Failure is treated by identifying the underlying cause and correcting the condition.

  • Generally, the patients are required to stay in the hospital for proper management
  • As the kidneys recover from acute damage, the following supportive measure may be provided:
    • Diet high in carbohydrates and low in salt, protein, and potassium
    • Use of diuretics to remove excess fluid form the body             
  • Preventing the excess accumulation of potassium is very important, which is controlled by using medications such as insulin and keyexalate
  • Antibiotics to prevent infections
  • Dialysis: In cases of refractory fluid overload; severe and refractory disturbances in electrolyte

How can Acute Kidney Failure be Prevented?

Acute Kidney Failure can be prevented by suitably and promptly treating the underlying cause.

What is the Prognosis of Acute Kidney Failure? (Outcomes/Resolutions)

  • The prognosis of Acute Kidney Failure is variable and depends upon the underlying cause
  • Factors such as old age, multi-organ failure (failure of more than one organ simultaneously), and pre-existing damage are associated with bad prognosis

Additional and Relevant Useful Information for Acute Kidney Failure:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/kidney-health/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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