| What is Acute Renal Failure / Acute Kidney Failure / ARF ? |
Acute Renal Failure (ARF) is the sudden loss of kidney function. It occurs when the kidneys stop working over a period of hours, days, or in some cases, weeks. It is also referred clinically as, An acute increase of the serum creatinine level from baseline (i.e., an increase of at least 0.5 mg/dl) and the urine output is less than 400 ml per day (oliguria), but it is not used strictly for ARF.
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 How does Acute Renal Failure cause damage to the body? |
When ARF occurs,waste products, such as nitrogen or salt, and excess fluids are not removed by the kidneys and builds up in the body, upsetting the body's normal chemical balance. Chemicals and electrolytes, such as sodium, potassium, and calcium, which are needed for normal body functioning, become harmful or sometimes poisonous (toxic) to the body when they reach abnormally high or low levels.
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| What are the symptoms of Acute Renal Failure? |
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| Who are affected by Acute Renal Failure? |
Acute Renal Failure (ARF) occurs most often in people who are already hospitalized for other medical conditions.
ARF develops from 5% to 7% of all patients in the hospital. Of those hospitalized in intensive or critical care units, up to 30% develop ARF. Factors that increase a person's risk of Acute Renal Failure include advanced age, chronic renal insufficiency, liver disease, diabetes, high blood pressure, heart failure, and obesity. People having heart surgery and abdominal surgery also have an increased risk.
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| How is Acute Renal Failure diagnosed? |
Acute Renal Failure is usually diagnosed using blood and urine tests to monitor kidney function. Tests may include blood urea nitrogen (BUN), serum creatinine, complete blood count (CBC), and a urinalysis.
A chemistry screen may be used to look for abnormalities in electrolytes, such as sodium, potassium, and calcium. |
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| How is Acute Renal Failure treated? |
The treatment of Acute Renal Failure depends on the cause and may include:
 Correcting the underlying cause of kidney failure, such as dehydration or medication toxicity.
Providing supportive care for the kidneys through hemodialysis.
Preventing other complications, such as infection or fluid or electrolyte imbalances.
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| What are the complications of Acute Renal Failure? |
The complications of Acute Renal Failure (ARF) can affect the entire body, including the digestive system, heart, lungs, and nervous system.
Infection is one of the most common complications of ARF, because the body's immune system may stop working properly.
Uremic syndrome (uremia) is a serious complication of severe or prolonged Acute Renal Failure. It can cause severe nausea, confusion, psychosis, irregular heart beats, and pulmonary edema (fluid in lungs).
Increased potassium in the blood - due to inability to filter and excrete the electrolytes properly. |
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| What is the prognosis for Acute Renal Failure? |
Acute Renal Failure (ARF) can usually be reversed, but it can also cause permanent loss of kidney function leading to Chronic Kidney Disease (CKD). Older adults and people who have other serious medical conditions are less likely to recover from ARF and its complications.
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| What is recovery from Acute Renal Failure like? |
Kidney function may quickly return to normal if the cause of Acute Renal Failure (ARF) is diagnosed and corrected. ARF may be corrected within a few days, or it may last for more than a month. Chances of recovery from ARF depend on many factors, including what caused the ARF, how severe and prolonged it was, how quickly the problem was recognized and treated, and what other medical conditions the person has.
"Acute Renal Failure caused by dehydration, blood loss, or obstruction in the urinary system rapidly reversed". About 50% of people who develop ARF recover completely. Some may have only partial recovery and others may require long term dialysis. |
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| Frequently asked questions about Acute Renal Failure |
Which doctor should I consult?
A Nephrologist
What increases my risk for Acute Renal Failure?
Acute Renal Failure (ARF) is seen more often in people already in the hospital for another serious problem.
Other risk factors include:
Severe dehydration like in cases of severe blood loss (hemorrhage), shock, severe vomiting or diarrhoea and overuse of diuretics.
Decreased cardiac output like in heart attack, abnormal heart beats (arrthymia), high blood pressure, inflammation of heart tissue (endocarditis), disease of the heart valves.
Other causes of circulatory disturbance like Nephrotic syndrome, advanced liver disease (cirrhosis) severe malnutrition, burns, severe injury or crushing injuries, severe infection (sepsis).
What is the difference between acute kidney (renal) failure and chronic kidney disease and how does my doctor come to a conclusion of what type of kidney failure is present?
To treat kidney failure effectively, it is important to know whether kidney disease has developed suddenly (acute) or over the long term (chronic). Many conditions, diseases, and medications can create situations that lead to acute and chronic kidney disease.
Acute Renal Failure (ARF) is usually caused by an event that leads to kidney malfunction, such as dehydration; blood loss from major surgery or injury; or the use of medications, such as contrast agents used in X-ray tests or antibiotics such as Gentamicin.
There are also other tablets that can cause problem with kidney or its failure, more so when there is some other disease or when given in combination with other tablets or injection.
Chronic kidney disease (CKD) is usually caused by a long-term disease, such as high blood pressure or diabetes, that slowly damages the kidneys and reduces their function over time. The presence or lack of symptoms may help your health professional determine whether Acute Renal Failure or chronic kidney disease is present. Acute form presents itself as any of the symptoms discussed above.
Symptoms of CKD may not develop until less than 10% to 15% of kidney function remains. Other problems may develop with CKD, such as anemia and increased levels of phosphates in the blood (hyperphosphatemia), along with complications caused by end-stage renal disease (ESRD). These complications often do not develop until kidney disease has been present for some time.
Also by comparing the laboratory values obtained, acute and chronic forms can be diagnosed. Ultrasonography can also be used in diagnosis.
What are the medications that can cause Acute Renal Failure?
a. Antibiotics, such as aminoglycosides, cephalosporins, amphotericin B, bacitracin,vancomycin. etc
b. Blood pressure medications (angiotensin-converting enzyme [ACE] inhibitors) eg. captopril and ramipril.
c. Chemotherapy medications, such as cisplatin, carboplatin, and methotrexate.
d. Contrast media used in medical imaging studies.
e. Illegal "street" drugs, such as heroin and methamphetamine.
f. Medications used to treat HIV (protease inhibitors), such as
indinavir and ritonavir.
g. Nonsteroidal anti-inflammatory medications, such as
ibuprofen, ketoprofen, rofecoxib, and celecoxib.
h. Ulcer medications such as cimetidine.
i. Other chemicals, such as insecticides, herbicides, and ethylene glycol, can also cause ARF.
Please remember that the list of drugs may appear long but many of these medications only when given unsupervised or if given for a long period of time will cause problem.
The non steroidal anti-inflammatory drugs should not be taken without prescription and should be avoided if possible.
What is End Stage Renal Disease (ESRD)?
End-stage renal disease (ESRD) occurs when kidney damage is so severe that dialysis or a kidney transplant is needed to control symptoms and prevent complications and death. ESRD often occurs after kidney damage has been present for 10 years or more. Diabetes and high blood pressure are the most common causes of ESRD.
Kidney failure can be measured by how well the kidneys are able to filter wastes from the blood (Glomerular Filtration Rate, or GFR). ESRD usually occurs when the GFR falls 10% to 15% below what is expected in a person with normal kidney function.
Heart disease is the most common cause of death in people with end-stage renal disease.
What is Uremic syndrome?
Uremic syndrome (uremia) is a serious complication of chronic kidney disease. It occurs when urea and other waste products build up in the body because the kidneys are unable to eliminate them. These substances can become poisonous (toxic) to the body if they reach high levels.Prolonged or severe fluid buildup (edema) may make the uremic syndrome worse.
Uremic syndrome may affect any part of the body and can cause:
Nausea, vomiting, loss of appetite, and weight loss. Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. Abnormal bleeding, such as bleeding spontaneously or profusely from a very minor injury. Heart problems, such as an irregular heartbeat, inflammation of and excess fluid in the sac that surrounds the heart (pericarditis), and increased pressure on the heart. Shortness of breath from fluid buildup in the space between the lungs and the chest wall (pleural effusion). Kidney dialysis is usually needed to relieve the symptoms of uremic syndrome until normal kidney function can be restored.
Is there any home treatment or surgery available for ARF?
There is no home treatment for Acute Renal Failure (ARF)
If there is a blockage in the urinary system (stones, tumors or abnormal prostate enlargement) it is possible to relieve him and hence improve the acute renal failure situation using some process of surgery, as such there is no surgical treatment for Acute Renal Failure (ARF). Your nephrologist may talk to you about kidney transplantation if you develop End-Stage Renal Disease (ESRD).
Dialysis {hyperlink to types of dialysis}
What is hemodialysis and how is it connected to ARF?
Hemodialysis is a mechanical process that partly performs the work of healthy kidneys. Hemodialysis uses a man-made membrane (dialyzer) to filter wastes, remove extra fluid from the blood, restore the proper balance of chemicals in the blood, and eliminate extra fluid (edema) from the body.
Before you begin hemodialysis, your doctor will need to create an access where blood can flow in and out of your body (dialysis access). This is usually done by inserting a tube (catheter) into a blood vessel in your forearm, chest or groin.
Hemodialysis is done in a hospital or dialysis center. A hemodialysis session usually lasts from 3 to 6 hours and must be done 3 times per week. You can read, watch television, or sleep during your dialysis sessions.
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