by Kimberly Allen, RN
Acute renal failure, also known as acute kidney injury (AKI) occurs when your kidneys suddenly stop functioning. In acute renal failure your kidney function diminishes quickly over a period ranging from hours to a few days until they cease to function all together.
Your kidneys are vital for survival and although most of us are born with two we can survive with just one healthy kidney. Our kidneys not only filter out the waste products in our bloodstream but they also play a crucial role in maintaining the balance between the water and salt as well as other minerals, which are called electrolytes, in our bloodstream.
There are three main causes of acute renal failure, prerenal, intrarenal, and postrenal. Prerenal causes are the most common, they result from a sudden and severe decrease in blood flow to your kidneys. This can occur because of a severe injury that causes severe blood loss or an infection that becomes septic both can significantly reduce the blood flow to your kidneys. There can also be systemic prerenal causes like heart failure or narrowing of the arteries that supply the kidney’s as well as the formation of a blood clot in the renal vein. Intrarenal causes are the result of damage to the internal structure of the kidney including the renal tubes and glomeruli. This damage can be caused by certain antibiotics like gentamicin and streptomycin, certain pain medications like ibuprofen and aspirin as well as certain medications used to treat hypertension like ACE inhibitors. For the most part a healthy person will have no problems taking these medications, however, someone with chronic health problems especially heart disease need to us more caution when taking certain medications. Postrenal causes are the result of an obstruction in the urinary tract. This obstruction can be due to conditions like benign prostatic hyperplasia, a ureteral or renal cancer as well as kidney or bladder stones.
Some people my not have any symptoms indicating their kidneys are failing or they may be very subtle. While in other cases where the person is already seriously ill the condition that is causing the acute renal failure is usually causing other symptoms as well. Those that do exhibit symptoms would notice there is either no or very little urine when they void. The build up of fluid causes swelling, especially in your lower extremities ie. your legs and feet. Many also complain of nausea and vomiting as well as a poor appetite. As the toxic waste builds in your bloodstream you may become confused as well as anxious and restless or even sleepy. Many also experience pain in their lower back, known as flank pain.
Treatment of acute renal failure requires you to stay in the hospital, though most people that develop acute renal failure are already in the hospital. The length of your stay is dependant on two main things, what caused your acute renal failure and how fast your kidneys are able to recover. Finding and treating the underlying cause of your acute renal failure is key to your survival. We now know that as a rule survivors of acute renal failure do not have a single benign episode. Studies indicate that approximately twelve and a half percent of survivors are dependent on dialysis approximately 1 to 10 years after developing their first episode of acute renal failure. Also, that as many as 31% of those that survive their first episode of acute renal failure regain only partial kidney function and move on to develop chronic kidney disease.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.