Causes, Symptoms & Treatment of Acute Kidney Failure

Acute Kidney Failure is a rapid deterioration of the kidney's ability to cleanse blood from toxic materials, which causes the accumulation of metabolic waste in the blood (e.g.: urea).

What causes acute kidney failure?

Acute kidney failure may be the result of many factors that causes:

• Reduced blood flow to the kidneys
• Blockage of urine flow after leaving the kidney
• Trauma to the kidneys.

What are the symptoms of acute kidney failure?

Symptoms found in acute kidney failure:

• Reduced production of urine (oliguria = decreased urine volume or anuria = completely absent urine)
• Nocturia (micturition at night)
• Swelling of the legs, feet or ankles
• Thorough swelling (due to fluid accumulation)
• Decreased taste, especially in the hands or feet
• Mental or mood changes
• Seizures
• Hand tremor
• Nausea and vomiting

Symptoms that arise depend on the severity of kidney failure, disease development and the cause.

Factors that cause kidney damage usually produce serious symptoms that are not related to the kidneys. For example: high fever, shock, heart failure and liver failure, can occur before kidney failure and can be more serious than the symptoms of kidney failure.

Some conditions that cause acute kidney failure also affect other parts of the body. For example, Wegener's granulomatosis, which causes damage to blood vessels in the kidneys, also causes damage to blood vessels in the lungs, causing the patient to cough up blood.

Skin rash is a typical symptom for several causes of acute renal failure, i.e.: polyarteritis, systemic lupus erythematosus and some toxic drugs.

Hydronephrosis can cause acute renal failure due to urinary blockage. Backflow from the urine in the kidney causes the urinary collecting area in the kidney (pelvis renalis) stretched, resulting in cramping pain (can be mild or very severe) on the affected side. In about 10% of patients, urine contains blood.

Diagnosis of acute kidney failure

If urinary production is decreasing, it can be suspected as acute renal failure. Blood tests will also show high levels of urea and creatinine, with metabolic disorders (eg, acidosis, hyperkalemia, hyponatremia).

On physical examination, an assessment of the kidneys are performed; whether there is swelling or dull pain.

Narrowing of kidneys main artery can cause a whistle (bruit) that will be heard on examination with a stethoscope.

If suspected blockage occurs, a rectal or vaginal examination is needed to determine the presence of mass in both places.

Laboratory tests on urine can help determine the cause and severity of renal failure. If the cause is reduced blood flow to the kidneys or blockage of the urinary tract, then the urine will appear normal.

If the cause is an abnormality in the kidney, then the urine will contain blood or a collection of red blood cells and white blood cells.

Urine also contains large amounts of protein or various types of proteins that are normally not found in the urine.

Treatment for acute kidney failure

The goal of the treatment is to find and treat the cause of acute renal failure. In addition, the treatment is focused on preventing excessive accumulation of fluids and metabolic wastes.

The fluid intake is limited and adjusted for the volume of urine released. Salt intake and substances that are normally abandoned by the kidneys are also limited.

Patients are advised to undergo a diet rich in carbohydrates but low in protein, sodium and potassium.

Antibiotics may be given to prevent or treat infections. To increase the amount of liquid discharged through the kidneys, diuretics may be given. Sometimes sodium polystyrene sulfonate is prescribed to overcome hyperkalemia.

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To remove excess fluids and metabolic waste, dialysis is needed. With dialysis the patient will feel better and easier to control kidney failure. Dialysis does not have to be done by every patient, but it can often extend the life expectancy of the patient, especially if the potassium serum levels are very high.

Indications whether dialysis is needed are:

• Mental state is declining
• Pericarditis
• Hyperkalemia
• Anuria
• Excessive liquid
• Creatinine levels> 10 mg / dL and BUN> 120 mg / dL

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