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Acute renal failure   

Overview | Symptoms | Treatment | Prevention

Alternative names:

Renal failure - acute; Kidney failure; Kidney failure - acute; Renal failure; Acute kidney failure; ARF

Treatment

The goals of treatment of acute renal failure include identifying and treating any reversible causes of the kidney failure (e.g., use of nephrotoxic medications, obstructive uropathy, volume depletion, etc.). Additionally, treatment focuses on preventing the excess accumulation of fluids and wastes, while allowing the kidneys to heal. The kidneys may gradually resume function. Hospitalization is required for treatment and monitoring.

Fluid intake may be severely restricted to an amount equal to the volume of urine produced. Specific dietary modifications to reduce build-up of toxins normally handled by the kidneys include following a diet plan that is high in carbohydrates, low in protein, salt, and potassium intake.

Antibiotics may be used to treat or prevent infection. Diuretics may be tried in an attempt to increase the excretion of fluid from the kidney.

A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be utilized for this including IV (intravenous) calcium, glucose/insulin, and oral or rectal administration of potassium exchange resin (Kayexalate).

Dialysis may be used to remove excess waste and fluids. This often makes the person feel better and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high. Decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products (serum creatinine > 10 mg/dl and BUN > 120 mg/dl) are common indications for dialysis.

Prognosis

Although acute renal failure is potentially life-threatening and may require intensive treatment, it usually reverses within several weeks to a few months after the underlying cause has been treated.

A few people will progress to chronic renal failure and/or end-stage renal disease. Death is most common when the cause of the kidney failure is related to surgery or trauma, or when it occurs in people with coexisting heart disease, lung disease, or recent stroke. Old age, infection, loss of blood from the GI (gastrointestinal) tract, and progression of the kidney failure also increase the risk of death.

Complications

• increased risk of infections
• gastrointestinal loss of blood
• chronic renal failure
• end-stage renal disease
• damage to the heart or nervous system
• hypertension

Call Your Health Care Provider If:

Call your health care provider if decreased urine output or other symptoms indicate the possibility of acute renal failure.

Ency. home > Disease > A > Acute renal failure

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