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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

Definition:

Acute renal failure is a sudden loss of the kidneys' ability to excrete wastes, concentrate urine, and conserve electrolytes.

Causes and Risks

The kidneys filter wastes and excrete fluid when the pressure of blood in the bloodstream forces blood through the internal structures of the kidney.  Because of its function as a filter, there are numerous potential causes of damage to this organ.

Decreased blood flow is one cause of kidney damage. This may occur when there is extremely low blood pressure from trauma, complicated surgery, septic shock, hemorrhage, burns and associated dehydration, or other severe or complicated illnesses.

Acute tubular necrosis (ATN) is another cause of acute renal failure. ATN may be caused by ischemia (decreased oxygenation of the tissues) or by obstruction or narrowing of the renal artery (see acute arterial occlusion of the kidney, renal artery stenosis). Over-exposure to metals, solvents, radiographic contrast materials, certain antibiotics and other medications or substances can also cause acute kidney failure.

Myoglobinuria (myoglobin in the urine) is another potential cause. This condition may be caused by rhabdomyolysis, alcohol abuse (see alcoholism), a crush injury, necrosis (tissue death) of muscles from any cause, seizures, and other disorders.

Acute renal failure can follow direct injury to the kidney. It can also be caused by infections such as acute pyelonephritis or septicemia. Urinary tract obstruction such as a narrowing of the urinary tract (stricture), tumors, kidney stones, nephrocalcinosis, or enlarged prostate with subsequent acute bilateral obstructive uropathy can also cause kidney failure. Severe acute nephritic syndrome is another possible cause.

Disorders of the blood, such as idiopathic thrombocytopenic purpura (ITP), transfusion reaction, or other hemolytic disorders, malignant hypertension and disorders resulting from childbirth-like bleeding associated with placenta abruptio or placenta previa can damage the kidneys. Autoimmune disorders such as scleroderma can cause also acute renal failure.

In young children, hemolytic uremic syndrome is an increasingly common cause of acute renal failure. A toxin secreting bacterium, Eschereshia coli, found in contaminated undercooked meats, has been implicated as the cause of hemolytic uremic syndrome.

Acute renal failure affects approximately 3 out of 10,000 people admitted to the hospital.

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