Topic Overview
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This topic provides
information about sudden kidney failure. If you are looking for information
about long-term kidney disease, see the topic
Chronic Kidney Disease.
What is acute renal failure?
Acute renal failure
(also called acute kidney injury) means that your
kidneys have suddenly stopped working. Your kidneys
remove waste products and help balance water and salt and other minerals (electrolytes) in your blood. When your kidneys stop
working, waste products, fluids, and electrolytes build up in your body. This
can cause problems that can be deadly.
What causes acute renal failure?
Acute renal
failure has three main causes:
-
A sudden, serious drop in blood flow to the kidneys. Heavy blood loss, an injury, or a bad
infection called
sepsis can reduce blood flow to the kidneys. Not
enough fluid in the body (dehydration) also can harm the
kidneys.
-
Damage from some medicines, poisons, or infections. Most people don't have any kidney problems from taking
medicines. But people who have serious, long-term health problems are more likely
than other people to have a kidney problem from medicines. Examples of medicines that
can sometimes harm the kidneys include:
- Antibiotics, such as gentamicin and
streptomycin.
- Pain medicines, such as aspirin and
ibuprofen.
- Some blood pressure medicines, such as ACE
inhibitors.
- The dyes used in some X-ray tests.
-
A sudden blockage that stops urine from flowing out of the kidneys. Kidney stones, a tumor, an
injury, or an enlarged prostate gland can cause a blockage.
You have a greater chance of getting acute renal failure
if:
- You are an older adult.
- You have
a long-term health problem such as kidney or liver disease,
diabetes,
high blood pressure,
heart failure, or
obesity.
- You are already very ill and are
in the hospital or intensive care (ICU). Heart or belly surgery or a
bone marrow transplant can make you more likely to
have kidney failure.
What are the symptoms?
Symptoms of acute renal
failure may include:
- Little or no urine when you
urinate.
- Swelling, especially in your legs and feet.
- Not feeling like eating.
- Nausea and
vomiting.
- Feeling confused, anxious and restless, or
sleepy.
- Pain in the back just below the rib cage. This is called
flank pain.
Some people may not have any symptoms. And for people who are already quite ill, the problem that's causing the kidney failure may be causing other symptoms.
How is acute renal failure diagnosed?
Acute renal failure is most often diagnosed during a hospital stay for another cause. If you are already in the hospital, tests done for other problems
may find your kidney failure.
If you're not in the hospital but have symptoms of kidney failure, your doctor
will ask about your symptoms, what medicines you take, and what tests
you have had. Your symptoms can help point to the cause of your kidney
problem.
Blood and urine tests can check how well your kidneys are
working. A chemistry screen can show if you have normal levels of
sodium (salt),
potassium, and
calcium. You may also have an
ultrasound. This imaging test lets your doctor see
a picture of your kidneys.
How is it treated?
Your doctor or a kidney
specialist (nephrologist) will try to treat the problem that is causing your
kidneys to fail. Treatment can vary widely, depending on the cause. For example, your doctor may need to restore blood flow to the kidneys, stop any medicines that may be causing the problem, or remove or bypass a blockage in the urinary tract.
At the same time, the doctor will try to:
- Stop wastes from building up in your body.
You may have
dialysis. This treatment uses a machine to do the work
of your kidneys until they recover. It will help you feel
better.
- Prevent other problems. You may take antibiotics to prevent
or treat infections. You also may take other medicines to get rid of extra
fluid and keep your body’s minerals in balance.
You can help yourself heal by taking your medicines as
your doctor tells you to. You also may need to follow a special diet to keep
your kidneys from working too hard. You may need to limit sodium, potassium,
and
phosphorus. A dietitian can help you plan
meals.
Does acute renal failure cause lasting problems?
About half the time, doctors can fix the problems that cause kidney
failure, and the treatment takes a few days or weeks. These people’s kidneys will work well enough
for them to live normal lives.
But other people may have permanent
kidney damage that leads to
chronic kidney disease. A small number of them
will need to have regular
dialysis or a
kidney transplant. Older people and those who are
very sick from other health problems may not get better. People who die usually
do so because of the health problem that caused their kidneys to fail.