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Acute kidney failure

Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute

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Causes

There are many possible causes of kidney damage. They include:

  • Acute tubular necrosis (ATN; damage to the tubule cells of the kidneys)
  • Autoimmune kidney disease
  • Blood clot from cholesterol (cholesterol emboli)
  • Decreased blood flow due to very low blood pressure, which can result from burnsdehydration, hemorrhage, injury, septic shock, serious illness, or surgery
  • Disorders that cause clotting within the kidney blood vessels
  • Infections that directly injure the kidney, such as acute pyelonephritis or septicemia
  • Pregnancy complications, including placenta abruption or placenta previa
  • Urinary tract blockage
  • Illicit drugs such as cocaine and heroine
  • Medicines including non-steroidal anti-inflammatory drugs (NSAIDs), certain antibiotics and blood pressure medicines, intravenous contrast (dye), some cancer and HIV drugs

Definition

Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your body.

Exams and Tests

The health care provider will examine you.

Tests to check how well your kidneys are working include:

Other blood tests may be done to find the underlying cause of kidney failure.

A kidney or abdominal ultrasound is the preferred test for diagnosing a blockage in the urinary tract. X-ray, CT scan, or MRI of the abdomen can also tell if there is a blockage.

Prevention

To prevent acute kidney failure:

  • Health problems such as high blood pressure or diabetes should be well controlled.
  • Avoid drugs and medicines that can cause kidney injury.

Symptoms

Symptoms of acute kidney failure may include any of the following:

Treatment

Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and waste from building up in your body while they heal. Usually, you will have to stay overnight in the hospital for treatment.

The amount of liquid you drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys would normally remove. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.

You may need antibiotics to treat or prevent infection. Water pills (diuretics) may be used to help remove fluid from your body.

Medicines will be given through a vein to help control your blood potassium level.

You may need dialysis. This is a treatment that does what healthy kidneys normally do -- rid the body of harmful wastes, extra salt, and water. Dialysis can save your life if your potassium levels are dangerously high. Dialysis will also be used if:

  • Your mental status changes
  • You develop pericarditis
  • You retain too much fluid
  • You cannot remove nitrogen waste products from your body

Dialysis will most often be short term. In some cases, the kidney damage is so great that dialysis is needed permanently.

When to Contact a Medical Professional

Call your provider if your urine output slows or stops or you have other symptoms of acute kidney failure.

Review Date: 4/13/2018
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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