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Acute Kidney Failure
Acute kidney failure is a condition in which there is a sudden stopping of the kidney function is present which results in an accumulation of nitrogenous waste products as the kidney’s main function is to eliminate the waste products of the body. When the waste products accumulate in the body it leads to disturbance in the endocrine and metabolic functions.
It usually occurs in older age group people. It occurs rapidly in a very less duration. Acute kidney failure is caused when there is a sudden decrease in the blood flow to the kidney, direct damage to the kidney by infections, toxins, or drugs, or whenever there is an obstruction to the flow of urine by kidney or ureteral stones or prostate adenoma.
Acute kidney failure when occurs it requires immediate treatment. Fluid loss should be replaced. Electrolyte imbalance should be treated. Nutrition also plays important role in treating the condition. If treated on time the condition can be reversed.
Acute Kidney Failure Causes
The problems which affect the blood supply to the kidney before reaching the kidneys include the following −
Dehydration − occurs in patients having vomiting, loose stools, blood loss
Disturbance in the blood flow to the kidney − Severe injury, following measure surgeries, burns, infections
Any block or narrowing of the vessels supplying the kidneys
Heart failure which in turn causes a low blood supply to the kidneys
Liver failure causes hormonal changes affecting the blood supply and pressure to the kidneys
Post-renal causes include −
Tumors of the kidney
Cancer of the urinary tract
Use of some of the medicines
Ureteral stones or tumors
Bladder infection, cancer, or stone
Causes of the kidney itself that affect the filtration of the blood and the production of the urine −
Use of medicines such as antibiotics, pain killers especially NSAIDs
Immune disorders such as leukemia, lymphoma, or sarcoidosis
Poisons, chemotherapeutic agents, toxins
Polycystic kidney disease
Acute Kidney Failure Symptoms
The patients with acute kidney failure mainly present with the following symptoms −
The color of the urine is dark, the urine appears foamy or bubble kind and getting up at night to urinate
Decrease the amount of urine output, to less than 30ml an hour urine output despite replacement.
Abnormally high levels of nitrogen-containing compounds such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood.
Skin and mucous membranes are dry because of dehydration
Hypertension and Rapid heart rate
Edema or Fluid retention, which causes swelling in legs, ankles, or feet
Gastrointestinal System − Loss of appetite, nausea, vomiting, loose stools or constipation, pain in the abdomen, and may have the dirty smell of urine
Fluid and electrolyte imbalance
Increased susceptibility to secondary infection
Patient looks pale because of anemia
Electrolyte levels in the blood may be abnormally high or low because of improper filtering
Acute Kidney Failure Risk Factors
Some of the risk factors which increase the risk of acute kidney failure include −
Advanced age or elder age group people are at more risk
High blood pressure
Blockages in the blood vessels in the arms or legs
Abuse of the medicines
Acute Kidney Failure Diagnosis
The diagnosis of acute kidney failure is done based on various investigations which include −
Serum electrolytes show the decreased amount of sodium in the urine and high potassium level
Blood tests show increased blood urea nitrogen, low blood pH
Urine studies show protein in the urine, blood in the urine, and decreased specific gravity.
The amount of urine excreted in one day can help to determine the cause of kidney failure.
Urinalysis − can show abnormalities that suggest kidney failure.
Imaging tests − such as ultrasonography, plain films of the abdomen, KUB radiography, renal scan, pyelography, and computerized tomography.
Kidney Biopsy − To look for tumor cells.
Acute Kidney Failure Treatment
Once the cause is found, the aim of treatment is to treat the cause of kidney failure, restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal.
Treatment for acute kidney failure involves −
Pharmacological therapy −
Drugs to reduce the blood pressure
Low dose dopamine to dilate the arteries of the kidney
Calcium or glucose/insulin is given to avoid an increase in the blood potassium levels
Intravenous sodium bicarbonate to correct acidosis
Antibiotics to treat infections
Fluid and electrolyte replacement − Intravenous fluids depending on the patient’s fluid and electrolyte status.
Nutritional therapy − A high-calorie diet low in protein, sodium, and potassium (banana and coffee avoided).
Dialysis − The last measure to be considered. In this, the blood is filtered for toxic products in a machine and the pure blood is returned to the body.
Acute Kidney Failure Prevention
Preventing the risk factors and causes of acute kidney failure can help in reducing its occurrence. Some of the preventive measures include −
A healthy balanced diet
Lifestyle modifications which include regular exercise, a balanced diet
Avoiding the misuse of drugs
Under control of chronic disorders such as diabetes, hypertension
Acute kidney failure is a condition in which the kidney does not function adequately because of various causes. The cause can be a pre-renal decrease in the blood supply to the kidney or damage to the kidney itself or post-renal obstruction of the urine flow, resulting in the accumulation of blood products. It mainly affects elder patients and also patients having chronic disorders such as hypertension, diabetes, liver disease, etc.
The diagnosis of kidney failure is done by urine analysis, imaging tests, serum electrolyte levels, and a biopsy to find the cause. Once the cause is found the required treatment should be done. The treatment includes fluid replacement, pharmacological therapy, high calorie diet with low protein, restriction of foods containing high potassium. If treated on time the condition can be reversed.
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