Acute kidney failure: overview and more

Acute kidney failure is caused by damage to the kidneys, which can result from blood loss, toxins, or physical damage to the kidneys . Acute kidney failure occurs rapidly, causing general symptoms such as nausea and confusion. It is a serious condition, but it can be treated. With proper treatment , most people can survive the episode without long-term consequences.

Verivell / Ellen Lindner

Symptoms of acute kidney failure

The kidneys control the amount of fluids, electrolytes, and wastes in the body and send excess material for excretion in the urine. Symptoms of acute kidney failure are due to these substances building up in the body when the kidneys are not working properly.

Normal fluid and electrolyte levels are essential for optimal body function. Waste is toxic to most cells and tissues in the body, causing a variety of symptoms.

Symptoms of acute kidney failure develop rapidly, over several hours or days. The most common symptoms are:

  • Lack of energy and fatigue – This is the result of early dysfunction of your body’s organs that do not have the correct concentration of electrolytes to function properly .
  • Loss of appetite, nausea, and vomiting – This feeling occurs when your digestive system, which requires healthy digestive enzymes, muscles, and nerves to function properly, may slow down and be unable to maintain normal activity if your kidneys do not properly regulate these substances. In your body.
  • General muscle weakness – Your muscles need electrolytes to function properly. With kidney failure, muscle function is impaired .
  • Fast, slow, or irregular heartbeat: The heartbeat is controlled by the muscles of the heart (heart), which depend on a number of important electrolytes to function properly. Your body tries to keep your heart working for as long as possible. If your body cannot compensate for the effects of acute kidney failure, your heart function can be impaired, causing irregular heart rhythms. Ultimately, this can lead to insufficient blood supply throughout the body.
  • Confusion – A serious symptom of acute kidney failure, confusion means that your brain is not getting enough blood supply. If you experience confusion as a result of acute kidney failure, you can rapidly progress to unconsciousness or coma.
  • Loss of consciousness or coma: This symptom means that the brain lacks a blood supply and could cause permanent damage if you do not receive urgent medical attention .

Causes

Many factors affect the kidneys, such as blood pressure, medications, general health, diet, and the amount of water a person drinks. There are several different causes of acute kidney failure . Anything that quickly damages the kidneys reduces the amount of work they can do.

Acute kidney failure can be temporary or it can be a sign of a more serious problem.

Very well

There are three main categories of causes of acute kidney failure:

Prerenal

Describes the causes of kidney failure that begin before the blood reaches the kidneys. For example, low blood pressure can occur if your heart is not working efficiently or if you are very dehydrated.

In this case, the kidneys themselves are not the main problem, but they suffer from a low blood supply. This stops the kidneys from doing their job of filtering the blood.

A severe infection can even progress to septic shock , a condition that can cause acute kidney damage because blood pressure drops so low that the kidneys cannot function effectively.

Inside

Describe the causes of kidney failure in which the kidneys themselves are affected. Toxins, including chemicals, illegal drugs, and even some prescription drugs, must pass through the kidneys and can damage them.

Examples of medications that can cause acute kidney failure include imaging contrast media. These types of drugs do not cause acute kidney failure in everyone who takes them, otherwise no one would use them. But in some people, they can cause acute kidney failure, and it is difficult to predict whether you will have such a reaction.

Sometimes you may need blood tests to measure your kidney function before you can take medications that are more likely to cause acute kidney failure.

Other conditions that can cause internal category acute kidney failure include lack of oxygen in the bloodstream, kidney infection, kidney inflammation, and kidney disease. A very large kidney stone can also cause internal kidney damage.

Postrenal

Describes the causes of kidney failure, which originate in the urinary tract, through which urine flows after it has been processed by the kidneys. These causes include problems with the ureters (the tubes that carry urine to the bladder), the bladder, or the urethra (the tube that carries urine from the bladder).

For example, a large kidney stone or tumor may be located in the bladder or urethra. If it is large enough that urine cannot pass, urine may begin to flow back, eventually to the kidneys. This pressure and reflux of urine can cause hydronureteronephrosis (dilation of the ureters and / or kidneys) and acute kidney damage.

Diagnostics

There are certain criteria for the diagnosis of acute kidney failure . If you have one of the following three criteria within 48 hours, you have acute kidney failure:

  1. If your serum creatinine level (a blood test that measures kidney function) increases by 0.3 mg / dL
  2. If the serum creatinine level rises by 50 percent or more of the normal level
  3. If urine output drops to 0.5 milliliters per kilogram of body weight per hour for more than six hours

Urine production

If you have acute kidney injury, you may be passing too much or too little urine. You may even have a significant increase in creatinine levels, indicating acute kidney damage, but your urine levels remain normal.

More than half of people with acute kidney failure continue to produce urine normally.

  • For adults, normal urine output is 0.5 to 1 milliliter per hour per kilogram of body weight, or one to two liters per day.
  • For children, the norm is about 1 milliliter per hour per kilogram.
  • For babies, the norm is 2 milliliters per hour per kilogram of body weight.

(For reference, 30 milliliters is about one ounce of urine.)

There are three categories that describe the amount of urine production in acute kidney injury:

  1. Non-oliguric: describes a situation in which a person continues to produce a sufficient amount of urine, which is usually more than 400 milliliters per day or more, depending on health status and fluid intake.
  2. Oliguric: describes a situation in which a person produces 400 milliliters of urine or less per day.
  3. Anurik: describes a situation where a person produces less than 100 milliliters of urine per day.

Watch out

Treatment of acute kidney failure depends on the cause of the problem and the severity of the situation. Many people get better after treatment and do not experience long-term problems or chronic kidney failure .

Identifying the problem and getting treatment as soon as possible is the best way to prevent kidney damage that causes life-long kidney problems or requires dialysis treatment.

Treatment may include:

  • Intravenous (IV) fluids: In a person with acute kidney failure, severe dehydration after heatstroke may improve with intravenous fluids . When low fluid volume is the cause of acute kidney failure, supplying fluid to the body can help restore fluid levels.
  • Electrolyte management: If your fluids and electrolytes are not in the optimal range, your healthcare providers may prescribe electrolyte supplements or prescribe medications that can remove some of the excess electrolytes.
  • Stop using toxins – If acute kidney failure is caused by a drug or supplement, treatment should include stopping the drug.
  • Dialysis – When effective removal of toxins is not expected, if you simply stop taking them, treatment for acute kidney failure requires removing the body of the chemical as quickly as possible. Sometimes dialysis is needed, a method by which a machine can do the work of the kidneys, removing toxins and regulating fluid and electrolyte balance.

Kidney function tests

Kidney function tests are a group of tests that monitor kidney function. These tests are not used to diagnose acute kidney failure, but are used to monitor whether your kidney failure is getting better or worse.

Kidney function tests can often determine the severity of the problem, give some indication of the cause of the problem, and be repeated to show whether the kidneys are responding to treatment.

Kidney function tests include:

  • Creatinine – A waste product of muscle breakdown, blood creatinine levels give an indication of how well your kidneys are working because they have to remove creatinine from the blood. A level greater than 1.21 mg / dL is considered high and indicates that the kidneys are not working properly.
  • Blood Urea Nitrogen (BUN): Urea nitrogen, also measured in the blood, is eliminated by the kidneys. Levels above 25 mg / dL indicate kidney failure.
  • Glomerular Filtration Rate (GFR): This number is calculated based on your blood creatinine level, taking into account age, height, weight, and other factors that take into account individual expected changes. A normal GFR should be above 60. A GFR below 20 often means that a person has kidney failure.
  • Urinalysis: Urinalysis can detect blood, protein, infections, inflammation, and medications. This information allows us to understand the cause and sometimes the progression of acute kidney failure.
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