Acute Renal Failure

Also known as: Acute Tubular Necrosis
What is it?
Acute renal failure is a temporary condition in which kidney function declines rapidly. The kidneys become unable to filter wastes from the body, maintain the proper balance of water and chemicals such as sodium and potassium in the bloodstream, or produce urine. Acute Renal Failure is also called acute tubular necrosis.
Who gets it?
Acute renal failure can occur in anyone with an illness or injury that affects the kidneys. It is not limited to any age group or ethnic background.
What causes it?
The most common causes of acute renal failure are dehydration, serious illnesses that cause heart or liver failure, severe blood loss, shock, or traumatic injury such as a burn. It may also occur in: those with conditions that block the flow of urine, such as kidney stones, tumors, or enlarged or inflamed prostate gland; those with a blood infection (sepsis); or those with kidney damage caused by kidney disease or exposure to a toxic (poisonous) substance.
What are the symptoms?
When the kidneys fail, toxins and fluids build up in the bloodstream. The excess fluid causes swelling (edema), usually in the hands, feet, face, and abdomen. The extra fluid also causes the blood pressure to rise. Other symptoms may include nausea, fatigue, confusion, joint pain, reduced urination, blood in the urine, seizures, headaches, itching, and pain in the kidney area. Acute renal failure can result in chronic renal failure, a life-long condition caused by permanent damage to the kidneys.
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. Your physician will check your bladder and may need to insert a tube, called a catheter, into the bladder to remove urine. Your doctor will also order ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) scans, which produce a picture of the kidneys and surrounding structures. In some cases, a biopsy is necessary. In this procedure, a small sample of kidney tissue is removed for examination under a microscope.
What is the treatment?
Treatment for acute renal failure depends upon the cause. For example, when this condition is caused by severe blood loss or dehydration, kidney function can be regained by replacing blood and fluids intravenously. Surgery and/or medication may be needed by patients whose kidney failure is caused by tumors, prostate disorders, or kidney stones. All patients in kidney failure are monitored for intake and output of fluids so treatment and medications can be adjusted as necessary. In severe cases, patients will need dialysis, a procedure in which waste products are filtered from the blood for the kidneys. While dialysis is usually necessary for the short term, until the kidneys have regained full function, there is a possibility that the kidneys will suffer permanent damage. In these cases, the patient will require life-long dialysis, or a kidney transplant.
Self-care tips
If you are at risk for acute renal failure because of kidney disease or other conditions that can affect the kidneys, it is important to follow your doctor’s recommendations for treatment and prevention of kidney complications. If you have been diagnosed with acute renal failure, follow your doctor’s recommendations for monitoring salt, protein, and fluid intake.