Kidney Failure

Kidney Failure

Acute kidney failure, characterized by the sudden inability of the kidneys to effectively remove waste and concentrate urine without electrolyte loss, can stem from various causes, including:

- Acute tubular necrosis (ATN)

- Autoimmune kidney diseases like acute nephritic syndrome and interstitial nephritis

- Reduced blood flow due to severe low blood pressure resulting from burns, dehydration, hemorrhage, injury, septic shock, serious illness, or surgery

- Disorders causing clotting within the kidney's blood vessels such as hemolytic-uremic syndrome, idiopathic thrombocytopenic thrombotic purpura (ITTP), malignant hypertension, transfusion reaction, and scleroderma

- Infections like acute pyelonephritis and septicemia

- Pregnancy complications like placenta abruptio and placenta previa

- Urinary tract obstruction

Symptoms associated with acute kidney failure encompass a wide range, including bloody stools, breath odor, easy bruising, changes in mental status or mood, decreased appetite, decreased sensation in hands or feet, fatigue, flank pain, hand tremor, high blood pressure, metallic taste in mouth, nausea or vomiting, nosebleeds, persistent hiccups, prolonged bleeding, seizures, slow movements, generalized swelling or swelling in specific areas like ankles, feet, and legs, and changes in urination patterns such as decreased urine output or excessive nighttime urination.

Medical evaluation typically involves physical examination revealing signs like generalized swelling and abnormal heart or lung sounds. Laboratory tests may indicate changes in blood urea nitrogen (BUN), creatinine clearance, serum creatinine, serum potassium, and urinalysis. Imaging tests like kidney or abdominal ultrasound, abdominal x-ray, abdominal CT scan, or abdominal MRI help diagnose kidney failure and identify urinary tract blockages.

Treatment aims to restore kidney function, prevent fluid and waste buildup, and support healing. Hospitalization is often necessary, with restrictions on fluid and dietary intake to match urine output and minimize toxin buildup. Antibiotics may be administered to treat or prevent infections, while diuretics help eliminate excess fluid. Intravenous calcium or glucose/insulin may be given to control dangerous blood potassium levels. Dialysis may be required in severe cases to manage high potassium levels, mental status changes, decreased urine output, pericarditis, fluid retention, or nitrogen waste buildup.