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Alternative names Return to top
Renal failure - acute; Kidney failure; Kidney failure - acute; Renal failure; ARFDefinition Return to top
Acute renal failure is sudden loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes. ("Acute" means sudden, "renal" refers to the kidneys.)Causes, incidence, and risk factors Return to top
The kidneys filter wastes and excrete fluid by using the bloodstream's own natural pressure. There are numerous potential causes of damage to the kidneys:Symptoms Return to top
Signs and tests Return to top
Examination and testing can reveal acute renal failure and help rule out other disorders that affect kidney function. In this condition, there is generalized swelling caused by fluid retention.
With a stethoscope, a heart murmur or other sounds related to increased fluid volume may be heard and crackles may be heard from the lungs. Also, if inflammation of the heart lining (pericarditis) is present, a pericardial friction rub may be heard with a stethescope over the heart.
Lab values may change suddenly (within a few days to 2 weeks):
Treatment Return to top
The goal of treatment is to identify and treat any reversible causes of the kidney failure (e.g., use of kidney-toxic medications, obstructive uropathy, volume depletion). Treatment also focuses on preventing excess accumulation of fluids and wastes, while allowing the kidneys to heal and gradually resume their normal function. Hospitalization is required for treatment and monitoring.
Your fluid intake may be severely restricted to an amount equal to the volume of urine you produce. You may be given specific dietary modifications to reduce build-up of toxins normally handled by the kidneys, including a diet plan high in carbohydrates and low in protein, salt, and potassium.
Antibiotics may be used to treat or prevent infection. Diuretics may be used to remove fluid from the kidney.
A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be used, including IV (intravenous) calcium, glucose/insulin, and oral or rectal administration of potassium exchange resin (Kayexalate).
Dialysis may be used to remove excess waste and fluids. This often makes the person feel better and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high.
Common symptoms that require the use of dialysis include decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products (serum creatinine > 10 mg/dl and BUN > 120 mg/dl).
Support Groups Return to top
The stress of having an illness can often be helped by joining a support group where members share common experiences and problems. See kidney disease - support group. Your local hospital or dialysis center may also have information regarding local support groups.Expectations (prognosis) Return to top
Although acute renal failure is potentially life-threatening and may require intensive treatment, it usually reverses within several weeks to a few months after the underlying cause has been treated.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if decreased urine output or other symptoms indicate the possibility of acute renal failure.Prevention Return to top
Treating any causative disorders may help to prevent acute renal failure. Many cases may not be preventable. Update Date: 7/22/2004 Updated by: Ari Mosenkis, M.D., Department of Nephrology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |