Acute kidney failure

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Acute kidney failure is the rapid loss your kidneys' ability to remove waste and help balance fluids
and electrolytes in your body. In this case, rapid means less than 2 days.
Causes
There are many possible causes of kidney damage. They include:

Acute tubular necrosis (ATN)

Autoimmune kidney disease

Blood clot from cholesterol (cholesterol emboli)

Decreased blood flow due to very low blood pressure, which can result from:
o

Burns

Dehydration

Hemorrhage

Injury

Septic shock

Serious illness

Surgery

Disorders that cause clotting within the kidney's blood vessels

Infections that directly injure the kidney, such as:

Acute pyelonephritis

Septicemia

Pregnancy complications, including:

o

Placenta abruptio

Placenta previa

Urinary tract blockage

Symptoms

Bloody stools

Breath odor and metallic taste in mouth

Bruising easily

Changes in mental status or mood

Decreased appetite

Decreased sensation, especially in the hands or feet

Fatigue

Flank pain (between the ribs and hips)

Hand tremor

High blood pressure

Metallic taste in mouth

Nausea or vomiting, may last for days

Nosebleeds

Persistent hiccups

Prolonged bleeding

Seizures

Shortness of breath

Slow, sluggish movements

Swelling due to the body keeping in fluid

Swelling, usually in the ankles, feet, and legs

Urination changes:
o

Little or no urine

Excessive urination at night

Urination stops completely

Exams and Tests

The doctor or nurse will examine you. Many patients with kidney disease have body swelling caused by
fluid retention. The doctor may hear a heart murmur, crackles in the lungs, or other abnormal sounds
when listening to the heart and lungs with a stethoscope.
The results of laboratory tests may change suddenly (within a few days to 2 weeks). Such tests may
include:

BUN

Creatinine clearance

Serum creatinine

Serum potassium

Urinalysis

A kidney or abdominal ultrasound is the preferred test for diagnosing a blockage in the urinary tract. X-ray,
CT scan, or MRI of the abdomen can also tell if there is a blockage.
Blood tests may help reveal the underlying cause of kidney failure. Arterial blood gas and blood
chemistries may show metabolic acidosis.
Treatment
Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and
waste from building up in the body while they heal. Usually, you have to stay overnight in the hospital for
treatment.
The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can
produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys
would normally remove. Your diet may need to be high in carbohydrates and low in protein, salt, and
potassium.
You may need antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help remove
fluid from your body.
Medicines will be given through a vein to help control your blood potassium level.
Dialysis may be needed for some patients, and can make you feel better. It can save your life if your
potassium levels are dangerously high. Dialysis will also be used if:

Your mental status changes, if you stop urinating

You develop pericarditis

You retain too much fluid

You cannot eliminate nitrogen waste products from your body

Dialysis will most often be short term. Rarely, the kidney damage is so great that dialysis may be
permanently needed.
Support Groups
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
When to Contact a Medical Professional
Call your health care provider if your urine output slows or stops or you have other symptoms of acute
kidney failure.
Prevention
Treating disorders such as high blood pressure can help prevent acute kidney failure.