Acute kidney failure
Definition
Acute kidney failure occurs when illness, infection, or injury damages the kidneys. Temporarily, the kidneys cannot adequately remove fluids and wastes from the body or maintain the proper level of certain kidney-regulated chemicals in the bloodstream.
Description
The kidneys are the body’s natural filtration system. They perform the critical task of processing approximately 200 quarts of fluid in the bloodstream every 24 hours. Waste products like urea and toxins, along with excess fluids, are removed from the bloodstream in the form of urine. Kidney (or renal) failure occurs when kidney functioning becomes impaired. Fluids and toxins begin to accumulate in the bloodstream. As fluids build up in the bloodstream, the patient with acute kidney failure may become puffy and swollen (edematous) in the face, hands, and feet. Their blood pressure typically begins to rise, and they may experience fatigue and nausea. Unlike chronic kidney failure, which is long term and irreversible, acute kidney failure is a temporary condition. With proper and timely treatment, it can typically be reversed. Often there is no permanent damage to the kidneys. Acute kidney failure appears most frequently as a complication of serious illness, like heart failure, liver failure, dehydration, severe burns, and excessive bleeding (hemorrhage). It may also be caused by an obstruction to the urinary tract or as a direct result of kidney disease, injury, or an adverse reaction to a medicine.
Symptoms
* Bloody stools
* Breath odor
* Brusing easily
* Changes in mental statusor 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 AND VOMITING, may last for days
* NOSEBLEED
* Persistent hiccups
* Prolonged bleeding
* SEIZURES
* Slow, sluggish movements
* Swelling – generalized (fluid retention)
* Swelling of the ankle, feet, and leg swelling
* URINATION changes:
o Decrease in amount of urine
o Excessive urination at night
o Urination stops completely
Treatment
Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys 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 build-up of toxins normally handled by the kidneys. 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 the kidneys lose fluid.
Calcium, glucose/insulin, or potassium will be given through a vein to help avoid dangerous increases in blood potassium levels.
Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your potassium levels are dangerously high. Dialysis will also be used if your mental status changes, you stop urinating, develop pericarditis, retain too much fluid, or cannot eliminate nitrogen waste products from your body.
Resources
Kidney failure, acute – mayoclinic.com
