Acute renal failure (ARF) or acute kidney injury (AKI) is a situation in which the kidneys have suddenly stopped working. Kidneys filter the waste products from blood and it balances the water, salt and other minerals present in blood. So naturally what happens is, when the kidneys stop working, waste products, fluids, and electrolytes starts accumulating. If this is not treated early then it may prove to be a life threatening danger.
Types of Acute Renal Failure (ARF)
There are 3 types.
- Prerenal ARF
- Postrenal ARF
- Intrinsic renal ARF
Causes of Acute Renal Failure
Prerenal – A sudden interruption of blood flow to the kidneys: Serious injuries with heavy blood loss or injury, or a Bacterial Blood Infection (Sepsis) can reduce blood flow to the kidneys. In some cases dehydration may also harm the kidneys. Heart-bypass surgery is an example in which the blood flow to the kidneys is reduced.
Intrarenal – Damage from some medicine overdoses, poisons, or infections: Generally people who take medicines are not affected by Kidney problem but overdoses of certain medicines over a period of time can cause problems. Individuals who are suffering from any health disorder for a long time are more likely to have a kidney problem from medicines. Some of the medicines than can harm the Kidneys are gentamicin and streptomycin (Antibiotics), aspirin and ibuprofen (Pain Relievers) and ACE inhibitors (Blood Pressure medicines). Certain Dyes that are used in X-ray tests are also harmful.
Postrenal – Block in Kidney that stops the urine from passing out of the kidneys: Kidney blocks are formed due to Kidney stones, tumors or enlarged prostate gland.
Symptoms of Acute Renal Failure
The following symptoms may occur with acute kidney failure. Some people don’t experience any of these symptoms in the early stages or the symptoms may be less intense.
Symptoms of are categorized based on the causes
Because of High urea content in Blood
- Vomiting and continuous diarrhea leading to dehydration
- Unusual Weight loss
- Foamy or bubbly urine
- Nocturnal Enuresis (commonly called Bedwetting)
- More frequent urination or less frequent urination
- The amount of urine excreted is unusually high or low and the color pale or dark colored.
- Blood flow in the urine
- Difficulty in urinating or giving more pressure
Because of high amount of phosphates in the blood that are not filtered by the diseased kidney
- Bone pain or damage
- Muscular cramps
- Itching sensation
- Because of high amount of potassium in the blood that are not filtered by the diseased kidney (hyperkalemia)
Abnormal or Irregular heart rhythms (arrhythmias)
- Muscular Paralysis
Because of the Kidney’s failure to remove excess fluid or electrolytes
- Leg swelling
- Ankle swelling
- Feet swelling
- Face swelling
- Hand swelling
- Shortness of breath
Because of Polycystic kidney disease
- Back Pain
- Side Stitch or Side Ache
- Because of less production of erythropoietin that leads to less haemoglobin in blood known as anemia
- Feeling tired and/or weak
- Memory problems
- Difficulty to concentrate
- Dizziness (vertigo, presyncope or disequilibrium)
- Low blood pressure
Other symptoms include
- Loss of Appetite
- Insomnia (Difficulty sleeping)
- Darkening of the skin
Treatment for Acute Renal Failure
Treatment for acute renal failure (ARF) depends mainly on what caused it.
Persons taking medicines are reviewed thoroughly by the Doctor and if any medicine or over dosage cause problems and if it’s true then alternates are suggested.
The treatment is done to meet the following goals
- Correct dehydration or an electrolyte imbalance through intravenous therapy.
- Fluid control is done if excess fluid is not properly eliminated due to kidney failure.
- Blood flow to the Kidney is increased by improving heart function or increasing blood pressure.
- Electrolyte abnormalities are cured to keep other body organs working properly.
- Remove blocks in the urinary tract (postrenal ARF). Blockages such as kidney stones can be removed. If the blockage cannot be removed then the urine is made to flow through a catheter or a stent. If the urinary bladder is not getting emptied completely, it can be quickly relieved by inserting a catheter in the bladder and allow kidney function to restore to normal.
- Dialysis should be done if the patient’s kidneys do not respond to treatment. Hemodialysis or Peritoneal Dialysis is done depending on the patient’s condition. Generally patients require hemodialysis three times per week.
Most people who suffer from acute kidney failure get better if the cause of the kidney failure is removed they don’t need dialysis. With advanced treatment techniques normal kidney function is restored but still in few cases residual damage exists after treatment or only partially restoration is possible. Patients who have only partially recovered don’t require dialysis but they have to regularly take the prescribed medicines to supplement lost kidney function.