RENAL FAILURE, ACUTE

General Information

DEFINITION--Sudden failure of the kidneys to function. Kidneys normally help rid the body of waste products, and when they fail, the waste products build up and cause symptoms that vary in severity. This usually has a short, relatively severe course, but often is curable.

BODY PARTS INVOLVED--Kidneys.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Early stages:

• Little or no urine output.

Later stages:

• Nausea, vomiting, diarrhea and appetite loss.
• Mental changes, including irritability, drowsiness, stupor or coma.
• Convulsions.
• Severe itching.
• High or low blood pressure.
• Unexplained bruising, bleeding spots under the skin or spontaneous bleeding. The symptoms of the underlying cause (see list below) will also be present.

CAUSES--

Conditions in the kidney, or in other areas of the body, that cause the kidneys to stop functioning. This leads to a buildup of waste products in the blood and tissues. Underlying conditions include:

• Shock with very low blood pressure.
• Blood poisoning (septicemia).
• Congestive heart failure.
• Fluid and electrolyte imbalance.
• Blood-transfusion reaction.
• Severe accident with extensive muscle injury.
• Acute glomerulonephritis.
• Multiple myeloma.
• Obstruction of blood vessels that supply the kidney.
• Kidney stones that obstruct both ureters or the urethra.
• Prostate enlargement.
• Use of certain medications, including anticancer drugs, kanamycin, amphotericin B, anticonvulsants or excessive vitamin D.
• Overdose of many poisons or drugs, especially mind-altering drugs.

RISK INCREASES WITH

• Persons with one kidney.
• Recent surgery.
• Accidents with severe injuries.
• Medical history of conditions affecting the kidney, such as diabetes or gout.

HOW TO PREVENT--No specific preventive measures. Avoid causes and risk factors when possible.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood counts and blood and urine tests that measure kidney function and fluid and electrolyte balance.
• ECG (See Glossary).
• Needle biopsy (See Glossary) of kidneys.
• X-rays of the abdomen, kidneys, ureters and bladder to detect kidney stones.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery, if surgery can correct cause.
• Hospitalization for fluid and electrolyte therapy and kidney dialysis (sometimes).
• Dialysis (See Glossary) may be required until the kidneys recover function.

POSSIBLE COMPLICATIONS

• Congestive heart failure.
• Increased risk of infections.
• Chronic kidney failure.

PROBABLE OUTCOME--If the underlying condition can be controlled and the kidney failure can be treated promptly, complete recovery is likely. If not, the disorder can lead to chronic kidney failure or death.

How To Treat

GENERAL MEASURES--

• Follow your doctor's instructions. Compliance with your medical treatment plan is essential.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Medications appropriate to control the underlying condition.
• Antibiotics if infection develops.

ACTIVITY--Rest in bed until the condition is cured. Then resume your normal activities as soon as symptoms improve.

DIET--Food and water intake is rigorously controlled to prevent fluid and electrolyte imbalance, and to minimize buildup of body wastes. A diet high in carbohydrates and low in protein (main source of waste products) to reduce workload for kidneys may be part of the treatment.

Call Your Doctor If

The following occurs during treatment: Chills, fever, headache or muscle aches. Shortness or breath. Unexpected bleeding from any body opening.